Concerning the subject of antagonism to the syndrome produced by reserpine and similar agents, it was shown in rats pretreated with desipramine the effect of reserpine was reversed. The test animals pretreated with desipramine showed no neuroleptic effect after administration of reserpine or the related benzoqninoline derivative tetrabenazine, but on the contrary showed a particular kind of hyperactivity (B~oDIE et al., G~A~I~I et al.).
These observations interested us especially because we successfully combined imipramine with reserpine in depressive patients who did not respond to imipramine alone. We observed that in imipramine-resistant depressions we gave, instead of electroconvulsions, 7--10 mg reserpine a day i.m. for 1 or 2 days, whereupon these patients immediately responded to imipramine (PSLDI~G~ 1959). There were 11 patients, 7 of whom responded favourable to this treatment. It has to be admitted that this conteraction on the part of reserpine of the resistance to therapy need not be the same phenomenon as that described in the animal test.
On the strength of this we gave 7 depressive patients who did not respond to desipramine (on an average 75 mg daily) one or two injections either of reserpine (a single dose of 2,5--7,5 rag) or tetrabenazine (a single dose of 50--100 rag) i.v. or i.m. in addition. Four of these patients after the i.v. injection of reserpine or tetrabenazine showed a distinct excitation state with autonomic side-effects (hightened pulse, mydriasis, perspiration, tremor) which finally went over to a rapid and marked improvement of the depressive mood. In one case, however, the remission took place very slowly and was incomplete. In the other three patients no distinct response was manifest, but two of them had received only 2,5 mg reserpine i.m.
Below we describe one case where the response was positive and one where it was negative.
:No. 1. 51-year-old patient (male) suffering from endogenous depression who gave an impression of merked dejection of mood and inhibition. On the first day of treatment we gave him 2 doses of 12,5 mg and on the second day 3 doses of 12,5 mg of desipramine i.m. Since no improvement was manifest, on the third day he obtained 2 doses of desipramine i.m. at 8 a.m. and 12,30 p.m. respectively.