A Double-Blind Comparative Study of Opipramol and Amitriptyline in Neurotic and Endogenous Depressions

Abstract

A comparative double-blind study of two antidepressant drugs, opipramol and amitriptyline, had been undertaken in neurotic and endogenous depressions. It was to be carried out simultaneously in a well-staffed university clinic and in an understaffed mental hospital. The depression rating scale used was the one constructed by Wechsler et al. Criteria to differentiate both entities were those described by Kiloh and Garside. It was hoped; 1) to compare the efficacy of both drugs; 2) to compare differences in milieu in regard to the two types of depression and the drugs used; 3) to test the hypothesis, by means of comparing scores on the DRS, that there exists a difference between neurotic and endogenous depressions. The trial could not be completed because it was very difficult to find neurotic depressions at the state hospital and endogenous depressions at the university clinic. Although the results could not be compared in terms of both institutions and no conclusion could be drawn as to the efficacy of either drugs in neurotic depressions because of too small a sample, it was nevertheless shown that amitriptyline was significantly superior to opipramol in endogenous depressions. Some methodological flaws of the present study were pointed out, namely, the lack of placebo in the neurotic group, the drawback of a flexible posology and the short observation period (4 weeks). Explanations were propounded to explicate the sampling difference between the two psychiatric institutions.

Update Opipramol

“…In der Fachinformation von "Insidon ® " wird aufgeführt, dass Opipramol beim Menschen sedierend, angstlösend und geringgradig stimmungsaufhellend wirkt [7]. Studien am Mensch und Tier zeigen, dass antidepressive Effekte eher bei höheren Dosierungen auftreten, während anxiolytische Effekte auch bei geringeren Dosierungen zu beobachten sind [4,12,13,17].…”

Neuropharmacology of the Anxiolytic Drug Opripramol, a Sigma Site Ligand

“…1) is structurally related to the tricyclic antidepressant imipramine and the anticonvulsant and mood stabilizing drug carbamazepine. Originally developed in the sixties as an antidepressant [27,32] its anxiolytic properties were soon recognized [3,12] and have recently been confirmed in a well-designed clinical trial in patients with generalized anxiety disorders, demonstrating superiority over placebo and similar efficacy to alprazolam [24]. Opipramol is clinically used in Germany and some other European countries with increasing tendency as a substitute for benzodiazepines, also because there is no risk of drug dependence.…”