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January 12, 1970

Depression: Its Diagnosis and Treatment; Lithium: The History of Its Use in Psychiatry

Author Affiliations

New York State Psychiatric Institute New York

JAMA. 1970;211(2):302. doi:10.1001/jama.1970.03170020066022

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This is the third and shortest monograph in the "Modern Problems of Pharmacopsychiatry" series. Kline briefly outlines the psychiatric uses of the term "depression," combining various current theories with his own, and presents a modified version of Lehmann's classification of depressive illnesses. He compares the effectiveness of monoamine oxidase inhibitors and tricyclic antidepressants in the reactive and endogenous depressions but notes that studies attempting to demonstrate the superiority of one drug over another in a particular subtype of depression are inconclusive.

Considering contraindications, prior treatments, degree of sedation desired, and possible side effects, he gives suggestion on choice of appropriate medication. Recommended doses are tabulated for the major tricyclics and monoamine oxidase inhibitors (MAOI). The physician is cautioned against the legal risk he takes in prescribing the sometimes efficacious combination of MAOI and tricyclics. The controversial issue of the value of lithium salts in recurrent depressions is presented without definitive