The pharmacological treatment of depression was quite limited in efficacy before the discovery of iproniazid and imipramine (Rees, 1960).

A number of synthetic drugs have recently been introduced as specific antidepressants in psychiatry. Isocarboxazid (Marplan) is an analogue of iproniazid (Marsilid). Both belong to the monoamine oxidase inhibitor group of antidepressants. Isocarboxazid is said to be less toxic but of equal potency for a lesser dose than iproniazid. A controlled clinical trial of isocarboxazid was therefore undertaken to assess this drug in the treatment of depression. The results of this trial are reported in this paper together with the results of an uncontrolled trial in a further group of patients (group M) who received isocarboxazid only.

Nialamide is claimed to inhibit the activity of the enzyme monoamine oxidase which is known to be responsible for the breakdown by catalytic oxidation of various amines, e.g. serotonin and norepinephrine. It has been suggested that depression may be associated with inadequate levels of serotonin and/or norepinephrine and that the administration of a monoamine oxidase inhibitor should rationally help to relieve depression. No serious side-effects have been reported in the available literature except that agitated patients might become somewhat more agitated and overactive.

In the absence of full understanding of the nature of anxiety neurosis, therapy must be, in part, symptomatic. Along with reassurance and efforts to comprehend the important aspects of the situation, most doctors are forced to use tranquillizing drugs. Careful clinical studies are, therefore, important.

In another paper, Jenner, Kerry and Parkin (1961) confirmed the views of earlier workers, Harris (1960) and Voelkel (1960) and others that methaminodiazepoxide is an effective agent in relieving anxiety in neurotic patients. That study was a blind controlled comparison of methaminodiazepoxide against lactose, but gave no indication of its value as compared with other drugs. The present paper is a comparison of methaminodiazepoxide (Librium, Roche) and amylobarbitone. The latter drug was felt to be one of the best known and most reliable drugs used in psychiatry for the treatment of anxiety. Raymond, Lucas, Beesley, O'Connell and Fraser-Roberts (1957) compared it very favourably with benactyzine, chlorpromazine, meprobamate, sedaltine and lactose. In that trial amylobarbitone was the only drug significantly better than lactose.

The theoretical framework developed by Eysenck (1955) to account for individual differences in motor and other types of performance has, as its main postulate, the statement that extraverts are characterized by high rates and introverts by low rates of inhibitory growth. An extension of this framework (1957) has allowed a link to be made between personality theory and the theory of drug action, since it has been proposed that depressant drugs increase cortical inhibition and so produce extraverted behaviour patterns, while the opposite is true of stimulant drugs. A test of this postulate by Eysenck, Casey and Trouton (1957) suggested that it was essentially confirmed when applied to motor performance. Dextro-amphetamine sulphate was found to improve and sodium amylobarbitone to depress pursuit rotor performance at all stages of practice. It was concluded that the effect of sodium amylobarbitone was to increase the two inhibitory factors recognized by Hullian learning theory, viz. conditioned inhibition (SIR) and reactive inhibition (IR).