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Columbia Atypical Depression

A Subgroup of Depressives with Better Response to MAOI than to Tricyclic Antidepressants or Placebo

Published online by Cambridge University Press:  06 August 2018

Frederic M. Quitkin*
Affiliation:
New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University
Jonathan W. Stewart
Affiliation:
New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University
Patrick J. Mcgrath
Affiliation:
New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University
Elaine Tricamo
Affiliation:
New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University
Judith G. Rabkin
Affiliation:
New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University
Katja Ocepek-Welikson
Affiliation:
New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University
Edward Nunes
Affiliation:
New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University
Wilma Harrison
Affiliation:
Roerig Division, Pfizer Inc., New York
Donald F. Klein
Affiliation:
New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University
*
New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, Department of Psychiatry, New York, NY, USA

Abstract

We summarise a series of studies using a MAOI to help establish the validity of a subgroup of depressives referred to as atypical depressives. Patients with reactive mood meeting DSM-III criteria for depressive illness who had associated atypical features (which include hyperphagia, hypersomnolence, leaden paralysis, and rejection sensitivity) were randomised to imipramine, phenelzine and placebo. Non-responders were crossed over, and in all there were over 400 patient trials. Phenelzine consistently was found to be superior to imipramine. Only in trials which included patients lacking atypical, vegetative symptoms was imipramine found to equal phenelzine. We conclude that the researcher and the clinician should consider the relevance of the atypical depressive syndrome.

Type
Research Article
Copyright
Copyright © 1993 The Royal College of Psychiatrists 

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