Treatment o Dlines-MEDICAL-JiiUNAl also seem that by the end of approximately 12 weeks onequarter (27%) of women had responded to the placebo alone, that a further seventh had responded to imipramine (41 %), and a further fifth to E.C.T. (61%).We have not been able to identify any factors associated with the specific therapeutic responses ; evaluation of demographic, social, and clinical characteristics revealed disappointingly little basis as reliable prognostic indicators. Thus there was no association between outcome as measured by final discharge from hospital and age, history of previous affective illness, and type of onset, previous duration, and clinical severity of the treated illness.
Summary and ConclusionsIn 250 patients aged 40-69 years (81 men and 169 women) a comparison has been made between different treatments of depressive illness as specifically defined for the purpose of the trial. The treatments employed were E.C.T., imipramine, a monoamine oxidase inhibitor (phenelzine), and, for a short period of time, a placebo. These treatments were randomly allotted, and comparable groups thus set up and their progress *assessed for six months. Many changes of treatment were made during the later stages of the trial period.On both a short-term basis (after four weeks' treatment in hospital) and on a long-term basis (up to six months) it appears that E.C.T. and imipramine increased the frequency of recovery over and above the spontaneous rate shown by patients on the placebo. This drug, it appears, was specially effective in men and E.C.T. specially effective in women. For these patients, as defined by clinical condition and age, phenelzine revealed no advantage over the placebo in the treatment of men and gave even less favourable results than the placebo in women. Imipramine showed a slower action than E.C.T., but its use certainly reduced the total number of patients for whom E.C.T. was finally regarded as necessary.The Committee is greatly indebted to the 55 physicians (see below) who admitted patients to this trial and completed the records so carefully; to William R.