Treatment of anxiety states by antidepressant drugs

Abstract

Two years ago iproniazid was reported as being valuable in the treatment of “ atypical ” depressions. Subsequent experience with iproniazid and the newer monoamine oxidase inhibitors (M.A.O.I.) has shown that there is no clear treatment demarcation between some atypical depressions and anxiety states; and many anxiety states have now, in fact, been found to respond equally well to treatment with the M.A.O.I., preferably combined with chlordiazepoxide hydrochloride. To illustrate these points, the effect of these drugs on 60 out-patients with a diagnosis of atypical depression, anxiety hysteria, or anxiety neurosis is reported. They fall into three groups: 15 patients responded to M.A.O.I. alone, 28 did best with M.A.O.I. combined with chlordiazepoxide, and 17 did not respond to M.A.O.I. Chlordiazepoxide given alone to these patients was much less effective, except in the last group. These findings are discussed, and stress is laid on the proper use of M.A.O.I. drugs to avoid undesirable side-effects and relapse. The essential factor for success with M.A.O.I. and chlordiazepoxide in the treatment of anxiety states is a good previous personality. © 1962, British Medical Journal Publishing Group. All rights reserved.