The dose-effect relationship is a basic element in all research in experimental pharmacology. In clinical pharmacology, the central role of the dose-effect concept has usually been acknowledged, but the actual demonstration of dose-effect relationships in clinical drug research is often extremely difficult. In the early years after the introduction of imipramine and subsequently other tricyclic antidepressants (TCA), the dose-effect problems were not infrequently discussed in the clinical reports, usually on the basis of uncontrolled clinical assessments (Delay and Deniker 1959; Ayd 1959). However, towards the end of the 1960s, the question of appropriate dosing appeared to receive little attention, clinically or in research trials. In a larger review attempting to identify variables important for the therapeutic efficacy of TCA, the dose was not even considered (Smith et al. 1969). At that time, the demonstration of pronounced variations in steady state levels in patients on standard TCA (Sjoqvist et al. 1968) gave rise to a series of studies on concentration-effect relationships during the following two decades. For the introduction of new antidepressants, there is an increasing demand for data on the dose-effect relationship. In this situation, it seems awkward that our knowledge about the dose-effect relationship for the usual control therapy, TCA, is rather limited. Also for the clinical use of TCA, the dose-effect issue has been reintroduced by some authors in the 1980s (Quitkin 1985; Roose et al. 1986; Goethe et al. 1988). However, in clinical trials, this problem is seldom even discussed as a source of bias or variability.