[Restraining action of antidepressive agents of the imipramine group on the cardiovascular centers].
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In a group of 66 depressed patients, the choice of the antidepressant drug was based upon the result of tyrosine and tryptophan uptake by the membrane of red blood cells. After one month of treatment, 56 subjects were improved, that is 85% of the cases. This result is discussed in comparison with the percentage of improvement described in the literature.
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The need for drugs that lack the obtrusive and limiting side effects of the tricyclic antidepressants has prompted the search for agents with greatly enhanced selectivity for specific mechanisms believed to be essential for antidepressant efficacy. The potential role of derangements of 5-HT pathways in the etiology of depression has long been suspected and has given impetus to the development of newer compounds that accentuate inhibition of serotonin reuptake. This paper presents structure-activity relationships for a series of cis-1-amino-4-(substituted-aryl)tetralins, which are surprisingly potent and selective inhibitors of serotonin uptake in in vitro models. These compounds are pharmacologically distinct from corresponding members of the trans series, which also potently block uptake of dopamine and norepinephrine. The activity in both cis and trans series is stereospecific, being restricted to the cis-(1S,4S) and the trans-(1R,4S) enantiomers.
An analysis of the data currently available in the literature suggests that an endocrine factor should be borne in mind in considering the nature of the specific activity of antidepressants. Its important component may be to eliminate the concurrent psychic depression of higher production of corticosteroids by restoring normal relations in the hypothalamo-hypophyseo-adrenocortical system.
We present a case of a 62-year-old woman who developed severe and prolonged cognitive impairment after combined electro-convulsive therapy and tricyclic antidepressant drug therapy. The literature on the interaction between ECT and antidepressant drugs is sparse, and does not explain the severe cognitive impairment in our patient.
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