Contrasts in antidepressant medications.

Two studies are reviewed, one in depressed patients, the other in healthy volunteers. The effect of nomifensine and imipramine on depressed out-patients has been studied in a controlled double-blind manner. Treatment lasted for 4 weeks and assessments were carried out before and at weekly intervals during the study. These involved use of a self-rating scale and four observer rating scales. In the self-rating scale, 13 of the 14 discriminating items favoured nomifensine, and indicated that it possessed a strengthening or energizing activity, and analysis of individual items on the Hamilton Depression Scale confirmed this. In this study, imipramine showed greater effect on mood and on sleep disturbances. A comparison of nomifensine, imipramine and placebo was carried out in 90 volunteers in a double-blind randomized study. Each volunteer received three doses of medication during the study day. The assessments include a Digit Symbol Substitution Test, the production of a temporal interval, and a simple and a complex test of attention or vigilance. The influence of nomifensine on these tests could not be distinguished from that of placebo. There was evidence, however, that imipramine depressed performance and possessed a sedative effect. The results of both studies, when considered together, are essentially in agreement.