A CONTROLLED STUDY OF TREATMENTS OF DEPRESSION. Imipramine in office management of depressive reactions. (A double blind clinical study). CONTROLLED COMPARISON OF AMITRIPTYLINE, IMIPRAMINE AND PLACEBO IN HOSPITALIZED DEPRESSED PATIENTS. THE INFLUENCE OF MEDICATION (IMIPRAMINE) AND DOCTOR IN RELIEVING DEPRESSED PSYCHONEUROTIC OUTPATIENTS. CLINICAL JUDGMENT IN PSYCHOPHARMACOLOGICAL RESEARCH. Cognitive therapy and pharmacotherapy. Singly and together in the treatment of depression. Interaction of drug therapy with marital therapy in depressive patients. Imipramine (Tofranil vs. placebo in hospitalized psychotic depressives. (a comparison of patients' self-ratings, psychiatrists' ratings and psychological test scores).
nan nan nan nan nan Eight-seven moderately to severely depressed psychiatric outpatients were randomly assigned to 12 weeks of cognitive therapy (CT) (n = 24), pharmacotherapy (n = 24), CT plus pharmacotherapy (n = 22), or CT plus active placebo (n = 17). Seventy patients completed the treatment protocol. Seventeen dropped out before the end of the treatment period. Patients who completed treatment showed significant improvement in mean scores on two common measures of severity of depression (the Beck Depression Inventory and the Hamilton Rating Scale for Depression) between evaluation and termination. Improvement did not differ as a function of the different treatment modalities. Inclusion of dropout patients' end-point scores did not alter these results. Treatment gains in all groups were maintained at one-month follow-up assessment. A portion of this study replicated an earlier study. While the results were not identical, they indicated that either CT or antidepressant drug treatment can be effective in treating outpatients with primary, nonbipolar depression of moderate or greater severity. Combining treatments did not lead either to additive effects or negative interactions. Comparative effects of the antidepressant drug, amitriptyline hydrochloride, marital therapy, and the drug-psychotherapy interaction effects were studied in a 12-week course of treatment of outpatient depressives. Patients were assigned randomly to four treatment groups, in a 2 times 2 factorial design: (1) drug-marital therapy; (2) drug-minimal contact; (3) placebo-marital therapy; and (4) placebo-minimal contact. Both drug and marital therapy showed substantial beneficial advantages over their control conditions, but drug therapy was faster and generally superior in symptom relief and clinical improvement. Marital therapy was superior in family role task performance and perception of the marital relationship. For reducing hostility and enhancing the perception of the marital relationship, drug therapy had a better early effect, but marital therapy had superior effects by the end of treatment. nan
The more conservative estimates from the present analysis found that differences between antidepressants and active placebos were small. This suggests that unblinding effects may inflate the efficacy of antidepressants in trials using inert placebos. Further research into unblinding is warranted.