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February 16, 1970

The Drug Treatment of Depression

Author Affiliations

Center for Studies of Suicide Prevention NIMH, Bethesda, Md

JAMA. 1970;211(7):1189. doi:10.1001/jama.1970.03170070058021

To the Editor.—  There is no question but that Dr. Motto has clearly echoed my warning to the physician, "Do not be a psychopathogenic carrier of the suicidococcus contagiosa!" He indicates correctly that anxiety may exist within the physician which prevents him from diagnosing and managing suicidal conditions. However, I feel that Dr. Motto may have also contributed to raising that same anxiety for he would take from the practicing physician a useful tool—the antidepressant drugs. He states:

  1. "I fail to find even reasonable (not to say convincing) evidence of antidepressive effects in my own depressed patients... [nor] more than a mild tranquilizing effect." I would like to point out that when the results of 36 double-blind studies comparing imipramine hydrochloride, one of the more potent antidepressants, and a placebo are combined, 70% of the patients receiving imipramine are rated improved, while only 39% of the patients receiving a