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  • Title: The pharmacological treatment of delusional depression: Part II.
    Author: Spiker DG, Perel JM, Hanin I, Dealy RS, Griffin SJ, Soloff PH, Weiss JC.
    Journal: J Clin Psychopharmacol; 1986 Dec; 6(6):339-42. PubMed ID: 3805326.
    Abstract:
    This study investigated the pharmacological treatment of delusional depressives by assigning patients on a random double-blind basis to amitriptyline (AT) alone, perphenazine (PER) alone, or AT + PER. As reported in an earlier paper, the combination of AT + PER was the superior treatment with a response rate of 78% compared with 41% for AT alone and 19% for PER alone. This difference is both clinically and statistically significant (p less than 0.01). In this second article, the authors report that the patients on AT + PER had higher plasma levels of AT and its pharmacologically active metabolite nortriptyline (NT) than the patients on AT alone. Although the response rate had a direct relationship to AT + NT plasma levels, an analysis of variance showed that the group of patients treated with AT + PER still had a significantly higher response rate, even after controlling for the plasma levels of AT + NT (p less than 0.05). There was also a correlation between PER plasma levels and clinical response.
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