TREATMENT OF PREVIOUSLY INTRACTABLE DEPRESSIONS WITH TRANYLCYPROMINE AND LITHIUM

Twenty-one depressed patients with so-called “bipolar characteristics” and treated with tranylcypromine are reported. Twenty of these were already on lithium carbonate and 20 had failed to respond to these tricyclic antidepressants in the past. Eighteen patients were hypersomnic and 3 experienced no change in sleep pattern when depressed. Sixteen out of 21 had a good to excellent response to tranylcypromine. Four out of 5 failures demonstrated an “irritable-paranoid” tableau and were diagnosed “schizoaffective” in the past. Questions about the mechanism of action of monoamine oxidase inhibitors and of lithium are raised. The possible existence of subtypes of depression in addition to “unipolar” and “bipolar” is also discussed.