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January 1986

Imipramine and Chlordiazepoxide in Depressive and Anxiety Disorders: I. Efficacy in Depressed Outpatients

Author Affiliations

From the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore (Drs Lipman and Covi and Ms Lasseter); the Department of Psychiatry, University of Pennsylvania, Philadelphia (Drs Rickels and Downing); the Department of Psychology and Division of Psychiatry, Boston University (Drs McNair and Kahn); and the Statistical and Mathematical Applications Branch, Alcoholism, Drug Abuse, and Mental Health Administration, Rockville, Md (Dr Faden). Dr Lipman is now with the Friends Hospital, Philadelphia.

Arch Gen Psychiatry. 1986;43(1):68-77. doi:10.1001/archpsyc.1986.01800010070009

• We randomly assigned 425 outpatients, independently classified as primarily depressed by two trained psychiatrists, to double-blind treatment with imipramine hydrochloride, chlordiazepoxide hydrochloride, or placebo. Those patients who remained at least moderately depressed (following a twoweek placebo washout period) were treated for an additional eight weeks. An endpoint analysis of 387 patients who completed two or more weeks of medication disclosed early therapeutic advantages of chlordiazepoxide. By week 4 of treatment, however, imipramine produced more improvement than did placebo and chlordiazepoxide. By six and eight weeks a general, marked therapeutic advantage was found for imipramine relative to placebo and to chlordiazepoxide on measures of depression, anxiety, anger-hostility, interpersonal sensitivity, and global improvement. Chlordiazepoxide-treated patients generally did significantly better on sleep difficulty but significantly worse on anger-hostility and interpersonal sensitivity than did imipramine- or placebo-treated patients.

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