Treatment Of Depressive States Research Articles

Italian psychedelic therapies of the past century: An historical overview

In recent years, the historical record of psychedelic therapy in Europe and the Americas has undergone considerable revision. In this article, we contribute to this re-interpretation by sharing documentation relating to psychedelic therapy carried out in Italy during the period 1927–1966. Our library research has uncovered one hundred publications, documenting at least 60 clinical studies in which psychedelics were administered. There is evidence of some primacy regarding this psychedelic research: Italy has the world record, for the twentieth century, for having carried out the largest number of clinical studies on patients with psilocybin and with lysergic acid amide (LSA); humans first received the high dose of 500 mcg of lysergic acid diethylamide (LSD) in Italy; and LSD plus LSA, and LSD plus psilocybin, were administered simultaneously for the first time. The most successful Italian clinical studies appear to have been those in which psilocybin was used in the treatment of depressive states, with the observed optimal dose being that of 3 mg administered intravenously every second or third day, alternated with placebo injections. Another therapeutic target that seems to have provided interesting results concerns the use of LSD and psilocybin for what was then called “neurosis.” Italian psychiatrists have also made useful contributions to theoretical aspects concerning psychedelic therapies, for example in the conflicting debate on the “psychotomimetic paradigm” and in the distinction between the “primary” and “secondary” effects of these substances.

Nialamide in the treatment of depressive states

Depression is a mental disorder manifested by depressed mood, cognitive and motor retardation, and suicidal ideas. In the modern world, the number of cases of a combination of mental and somatic pathologies is increasing in medical practice. Therefore, the issue of studying and correctly prescribing antidepressants is crucial. It is necessary that the drug should not only treat the mental illness of the patient, but also should not harm his/her physical health. Nialamide belongs to antidepressants, the mechanism of which is non-selective and irreversible inhibition of MAO-A and MAO-B.

Heterogeneity of the mechanisms of action of antidepressants

The article discusses the heterogeneous mechanisms of the pharmacodynamics of antidepressants that underlie the therapeutic response. Sharing the similar clinical activity, antidepressants determine the development of drug-induced homeostasis by means of different molecular mechanisms (selective or nonselective blockade of monoamine reuptake, inhibition of monoamine oxidase, blockade of certain monoamine receptors). However, an increase of serotonin and other monoamines concentrations in the synapses of the central nervous system is only the initiating factor in the development of specific clinical effects. The latter are probably determined by other neurochemical effects, including changes in the density of postsynaptic receptors and an increase in the synthesis of neurotrophic factors. However, the primary mechanisms that increase monoamine concentrations in the synapses might not always “work properly”, leading to the lack of efficacy of the initial antidepressant, while the probability of the therapeutic response to the subsequent antidepressant remains rather high. Thus, the efficacy of an antidepressant may depend on the baseline differences in the neurochemical state contributing to the pathological “depressive” homeostasis. The heterogeneous neurochemical effects of antidepressants can determine the dissociation of existing neuronal interactions, leading to the development of the new — druginduced — homeostasis. At the same time, it is possible that stimulation of general neurotrophic processes by antidepressants may contribute to the progression and chronicity of pathology due to the ambiguous influence on certain stages of the pathological process. This determines the significance of neurophysiological studies of central disturbances in depression and search of fundamentally new neurochemical targets for the treatment of depressive states associated with various mental disorders.

Investigation of the extract's composition of Viper's bugloss (Echium vulgare)

The characteristics of Viper's bugloss (Echium vulgare) plant, its pharmacological properties, and extracts’ composition are presented in this study. Results of the literature analysis, data on the biologically active compounds and areas of use of this medicinal plant are summarized. Viper's bugloss (E. vulgare) is a species of flowering plant in the borage family Boraginaceae. It is native to most of Europe as well as western and central Asia. Viper's bugloss (E. vulgare) is a plant that has been utilized as food (honey), medicine, a poison, an oil, and as a dye and tannin-producing ornamental plant. Viper's bugloss (E. vulgare) is especially rich in pyrrolizidine alkaloids, flavonoids, phenolcarboxylic acids, sterones and naphthoquinones. In traditional medicine, Viper's bugloss (E. vulgare) is utilized as exhilarant and a mood stimulant. That is why one of the possible uses of this plant is considered to be treatment of depressive states. Like most representatives of Boraginaceae family, it has been insufficiently studied. No previous work quantifying flavonoids content of aerial parts of Viper's bugloss (E. vulgare) growing in Ukraine has been presented. Continuing the studies of this species, the aqueous and ethanolic extracts from Viper's bugloss (E. vulgare) aerial parts were obtained and their phytochemical composition was investigated. For the first time, the qualitative analysis of biologically active compounds in Viper’s bugloss’s extract as well as the quantitative analysis of flavonoids by aluminum chloride spectrophotometric method are reported. The experimental results showed that the total concentration of flavonoids was 2.59% in the extract. The maximum yield of extractives was found to be 16%. The obtained research data will be used in future investigations.

Plant secondary metabolites- potent inhibitors of monoamine oxidase isoforms.

Target of monoamine oxidase inhibitions are considered as the treatment of depressive states and neurodegenerative disorders, including Parkinson’s and Alzheimer’s diseases. Many medicinal chemistry research groups are actively working in this area for the development of most promising selective MAO inhibitors. Many plant isolates also showed remarkable MAO inhibition in recent years. The objective of this review is to identify the major MAO inhibitors secondary metabolites from plants like flavonoids, alkaloids and xanthones class of compounds.

Clinical findings in the use of Tofranil in depressive and other psychiatric states. 1959.

1. Preliminary observation would indicate that Tofrānil is a useful drug in the treatment of depressive states. It is not a tranquilizer and, therefore, is of little value in other conditions. It is a promising drug which can be used as an anti-depressant. However, its indication and scope must be studied for a longer period to determine what symptoms respond best to it. 2. The effect of Tofrānil in many patients can be increased by the concomitant use of a tranquilizer or a stimulant. In a number of patients Tofrānil, by removing the depressive elements, frees and exaggerates anxiety. 3. It can be used in combination with electric shock or after electric shock as a maintenance dose. 4. It is of little value in the treatment of schizophrenics and in paranoid types may often aggravate the condition and break down an unstable equilibrium to which the patient has become adjusted. 5. The combined use of Tofrānil and a tranquilizer is helpful in certain psychoneurotic states, associated with anxiety or with re...

Review of the 12 years' activity of the International Committee for Prevention and Treatment of Depression.

The recognition and treatment of depressive states, as well as their prevention, call for special knowledge and experience. Therefore it was considered desirable that practising physicians with no specialised knowledge of psychiatry should be given more extensive opportunity for post-graduate instruction in the diagnosis and management of depression and also that they should be in a position to collaborate more closely with psychiatrists. Hence the idea of establishing an international committee, the members of which would in their turn set up national committees with the aim of promoting and intensifying post-graduate instruction in their respective countries.

Running as Treatment for Depression: Is It Worth It?

The present review examined the premise that running is a useful therapeutic strategy in the treatment of depressive states. Four of the major theoretical treatment models of depression were outlined to demonstrate how each conceptualized the relationship of running to improvement in mood. Research was then examined that linked running to improvement in psychological variables other than depression. Finally, research directly pertaining to the effects of running on depression was reviewed. Discussion of conceptual and methodological problems of this research indicated that definitive conclusions regarding the antidepressant properties of running are currently unwarranted. Specific guidelines and refinements for future research were provided.

A Comparative Trial of Opipramol with Phenelzine and Chlordiazepoxide in the Treatment of Depression

A double-blind trial comparing the action of opipramol against a combination of phenelzine and chlordiazepoxide in the treatment of depressive states was carried out jointly in a psychiatric out-patient clinic and in a general practice. While both preparations were effective there was no statistically significant difference favouring one agent at the end of the six weeks trial period. Certain advantages occurred with each preparation at different times during the trial period, and these are described in the text.

Clinical effects of lithium carbonate on depression.

Summary1. Therapeutic effects of lithium carbon ate were studied on a total of 55 cases comprising 15 cases of involutional melancholia, 23 cases of monopolar depression and 17 of bipolar depression.2. Lithium carbonate was found to be effective to seven cases (47%) of involutional melancholia, 14 cases (61%) of monopolar depression, and nine cases (53%) of bipolar depression, indicating no significant difference among these three groups.3. There was observed no correlation between the characteristics of symptoms and the therapeutic effect in depressive states.4. The serum lithium concetration in the lithium responder was 0.47±0.13 mEq/1 and that in non‐responder 0.55 ±0.14 mEq/1, showing no significant difference between the two groups.5. Lithium carbonate has been found to be effective in the treatment of depressive states. Therefore, it requires further studies using the double‐blind controlled method for clarification of its therapeutic effects.

The use of parenteral and oral chlorimipramine (Anafranil) in the treatment of depressive states.

This paper is an extension of an earlier introductory one (1) and evaluates the results of treatment with parenteral and oral chlorimipramine of 200 patients suffering from depressive states of varying severity. The current research project was started in January 1968, and is still in progress. Further references to the literature may be obtained from the original paper or by application to the author. Fifty-seven of the cases treated were so severely depressed that ECT would normally have been given. All were in-patients and were treated with intravenous infusions of chlorimipramine. The other 143 patients were less severely depressed and were seen as out-patients. They were treated with increasing doses of oral chlorimipramine, but a few cases in both groups also had ECT to expedite recovery. Approximately 50 patients exhibited obsessional features in addition to depression, and their response to treatment was so promising as to merit special mention.

Flupenthixol in the treatment of depressive states.

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Studies on the ultrastructural distribution of H 3 -dimetacrine in rat cerebral cortex.

Dimetacrine (1), 10-[3-(dimethylamino)propyl]-9,9-dimethyl-acridan, is a tricyclic compound with a central hexagonal ring instead of the heptagonal ring common to most antidepressants. Clinical properties and the value of this drug in the treatment of depressive states, and in a variety of psychic disorders have been well established (2,3). A previous paper (4) demonstrated the metabolic fate of dimetacrine by means of a radiometric assay.

Studies on the Ultrastructural Distribution of H3-Dimetacrine in Rat Cerebral Cortex

Dimetacrine (1), 10-[3-(dimethylamino)propyl]-9,9-dimethyl-acridan, is a tricyclic compound with a central hexagonal ring instead of the heptagonal ring common to most antidepressants. Clinical properties and the value of this drug in the treatment of depressive states, and in a variety of psychic disorders have been well established (2,3). A previous paper (4) demonstrated the metabolic fate of dimetacrine by means of a radiometric assay.

THE PHARMACOLOGICAL STUDIES ON DIMETACRINE: I. STUDIES ON THE ABSORPTION, DISTRIBUTION AND EXCRETION OF H3-LABELED DIMETACRINE IN THE RAT

Dimetacrine, 10-[3(dimethylamino)propyl]-9, 9-dimethylacridan, is a tricyclic compound with a central hexagonal ring instead of the heptagonal ring common to most antidepressants. The synthesis and chemistry of this compound have been reported by Molnar et al. (1). The unique pharmacological properties of dimetacrine as a reserpine antagonism, central parasympathicolytic action and the occurrence of behavioral changes in cats and rats were observed by Jahn (2). The clinical properties and the value of this drug in the treatment of depressive states, and in a variety of psychic disorders have been well established (3-5). Schatz et al. (6) demonstrated the metabolic fate of dimetacrine by means of colorimetric assay based on the method of Herrmann et al. (7). However, the sensitivity of this method is relatively low for detection of dimetacrine and its metabolites, therefore, the present paper was undertaken to determine the metabolic patterns of this drug using radiometric assay.

Narcostimulation in depressive states.

Convulsive therapy is widely used in the treatment of depressive states; narcostimulation is a modified convulsive therapy which alternately produces narcosis and stimulation of the central nervous system. The authors used this method with 60 depressive patients in Amritsar, India, and achieved an over-all improvement rate of 68.3 percent, which compares favorably with other types of convulsive therapy.

Depressive States: A Pharmacotherapeutic Study

The thesis of this volume is that amitriptyline (Elavil) hydrochloride is the drug of choice in the treatment of depressive states. A total of 137 female patients were treated in a double-blind, wellstructured, comprehensive analysis —clinical and statistical—of symptoms and response. Analysis of the tables and of the statements made, however, does not provide conclusive proof of the superiority of this drug. After the first week of treatment, imipramine hydrochloride (Tofranil) was superior in effectiveness to amitriptyline; after one month's therapy, amitriptyline was superior; after six months follow-up, both drugs reached the finish line at the same time. In terms of results, amitriptyline showed 84% improvement, and imipramine a 79% improvement in the 137 case studies. Admitting that electric-shock therapy is simple, safe, and effective, the authors state that the relapse rate of patients treated with electric shock is between 20% and 30%. In the authors' series, the relapse

AMITRIPTYLINE IN DEPRESSIVE STATES: SIX-MONTH TREATMENT RESULTS.

The proven effectiveness of electroconvulsive therapy (E.C.T.) and antidepressant drugs has lately led to a resurgence of interest in the treatment of depressive states. Amongst the principal problems currently confronting the clinician, the following would seem to be particularly pertinent: should E.C.T. be used in preference to drugs or vice versa? Which drug is to be preferred? Can drug response be predicted? How long should drugs be given? When are drugs contra-indicated? Given in maintenance dosage after a depressive episode, do antidepressants lower the rate of relapse? This paper, the third report on an investigation of the effectiveness of amitriptyline (‘Tryptizol’, ‘Elavil’, ‘Tryptanol’) and imipramine (‘Tofranil’) in depressive states, sets out to answer the above questions in the light of the results that were obtained.

AMITRIPTYLINE IN DEPRESSIVE STATES: PHENOMENOLOGY AND PROGNOSTIC CONSIDERATIONS.

In recent years the development of effective anti-depressant drugs has led to much controversy and uncertainty regarding the treatment of depressive states. Indications for the primary use of E.C.T. remain obscure, whilst choice of drug seems to be determined by current personal preference rather than by any specific rationale. If reliable prognostic formulations—and so, rational lines of treatment—are to be developed, there is an urgent need for the accumulation of data from controlled trials rather than a continuing spate of “1”.Amitriptyline, a new anti-depressant chemically resembling both imipramine and chlorpromazine has, in a blind controlled study carried out by the authors, been shown to be significantly superior to imipramine in the treatment of female patients between 30 and 70 years of age, hospitalized with primary depressive states (Burt, Gordon, Holt and Hordern, 1962). The findings in the first 74 patients were unexpectedly so much in favour of amitriptyline that to confirm them the trial was extended to include a further 65 patients conforming to the same criteria; but as two died, the total sample consisted of 137 female patients. The size of this sample facilitated (1) an investigation of the phenomenology of depressive states in women and (2) a study of the significance of a number of prognostic variables in relation to the outcome of treatment with amitriptyline and imipramine.

A Comparative Trial of Imipramine and Phenelzine in the Treatment of Depression

Much work has been done in recent years on the use of individual anti-depressant drugs, but relatively little on comparative studies of their values. So many new drugs have appeared in such rapid succession that the psychiatrist has difficulty in knowing which to choose in the treatment of his depressed patient. The aim of this study was to compare imipramine (Tofranil) and phenelzine (Nardil), both of which had been found by personal experience to be of value in the treatment of depressive states. In the past two years there have been several well-controlled trials of both these drugs which have proved them to be of definite value in the treatment of depression. (Ball and Kiloh, 1959; Harris and Robin, 1960; Holdway, 1960; Hutchinson and Smedberg, 1960; Ashby and Collins, 1961; Rees et al., 1961.) At the time of commencement of this trial imipramine and phenelzine seemed to be the two best antidepressant agents available. It was decided to compare the remission rate or degree of improvement produced by them and the rapidity of response to each. It was hoped to determine what factors in the depressive illness were associated with a good or bad response to either drug. No similar direct comparison of these two drugs had been made, to the writer's knowledge.