The effect of treatment on the melancholias (depressions).

The results described are based on data from 47 male and 83 female patients randomly assigned to treatment with imipramine or phenelzine in an open trial. All were fresh (untreated) cases diagnosed as suffering from depressive illness (melancholia). They were rated before treatment and 2 and four months later. Imipramine did not give results which were significantly better than phenelzine. With both drugs it was found that patients had done either very well or very poorly at follow-up, i.e. the distribution of scores was U-shaped (or bimodal at the least). The 55 men and 90 women who were unsuitable for treatment with drugs or who had failed to respond to such treatment were given a course of ECT and followed-up at corresponding intervals. The improvement after ECT was better than with drugs and the distribution of scores is quite different. An earlier series of male patients treated with ECT in the pre-drug days did not show as good a response to the treatment.