Assay of antianginal agents: A long-acting nitrate, psychic energizers and a tranquilizer

A double-blind procedure with multiple control periods was employed to assay as antianginal agents the effectiveness of a long-acting nitrate, Cardilate; four amine oxidase inhibitors, Marplan, Catron, Nardil, Niamid; a psychic energizer which was not an amine oxidase inhibitor, Tofranil; and a tranquilizer, Librium. Cardilate decreased the frequency of anginal attacks and nitroglycerin intake in 3 of 9 patients with angina pectoris, but never completely. Toxic effects were primarily headache in 2 patients not severe enough to cause treatment to be discontinued. When the daily dosage of the amine oxidase inhibitors was individualized to fit each patient and the duration of therapy was varied until the optimal dose was achieved, Marplan eliminated anginal attacks and nitroglycerin intake in 2 patients on repeated occasions and produced good results in 6 more of 12 patients. Catron was effective in 12 of 22 patients; Nardil, in 7 of 15, and Niamid in 10 of 19 patients. Toxic effects were infrequent—mild hypotension occasionally potentiated by chlorothiazide, insomnia, euphoria, jitteriness and anxiety, soon controlled by adjusting dosage without discontinuing treatment. One patient became habituated to Marplan. Tofranil decreased the frequency of anginal attacks and nitroglycerin in 3 of 12 patients, an effect not consistently repeatable. Mild hypotension and nausea were uncommon side effects. Librium reduced general anxiety in 5 of 15 patients and decreased the frequency of anginal attacks and nitroglycerin intake of 3 of them. Drowsiness and depression in 5 patients caused reduction in dosage but not cessation of treatment.