Alaproclate--an open clinical study in depressive illness.

This open study of alaproclate points towards an antidepressant effect in a a relatively chronic and drug-resistant group of depressives. Five patients had an average improvement of more than 21 points on the Hamilton Rating Scale for Depression and six had an average improvement of seven points. Several patients had anticholinergic side effects, abnormal results in liver functional tests and faecal occult blood, but none were bad enough to require being taken off the drug and most side effects improved before the end of the trial. The biochemical results suggested that the responders and non-responders constituted two distinct biological groups. In the patients who responded well to treatment there were increases in Km values consistent with treatment. The Km and 5-HT values correlated strongly with plasma drug values. There was a strong correlation between Hamilton Rating scores in the 4th week and Km values in the 4th week, although there were only five cases. However, there were no significant relationships between improvement and any pretreatment value. These results are sufficiently promising to suggest that a controlled clinical trial would yield information on alaproclate as a therapeutic aid.