A biphasic change in mood with a tricyclic antidepressant.

Eight depressed patients received 150 mg of clomipramine for 4 weeks. They completed the Profile of Mood States five to seven times the first week of treatment and five to seven times at the end of treatment. Moods showing significant decrease from the beginning to the end of the first week were: tension-anxiety, depression, anger-hostility, and confusion. The only changes from the beginning to the end of the 4-week period were an increase in vigor and a decrease in fatigue. The occurrence of rapid and slow mood changes with antidepressants suggested that the former were due to sedative effects and the latter occurred at the rate of the improvement in the disease depression.