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Reserpine augmentation of desipramine in refractory depression: clinical and neurobiological effects

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Abstract

Early studies showed dramatic improvement in some depressed patients when a brief course of parenteral reserpine was added to ineffective tricyclic antidepressant (TCA) treatment. We treated eight patients with DSM-III melancholic major depression with desipramine (DMI)≥2.5 mg/kg/day (plasma levels>125 ng/ml) for at least 4 weeks. All patients failed to respond and received reserpine 5 mg IM b.i.d. over 2 days, in seven cases as a placebo-controlled, double-blind trial. One patient had dramatic resolution of depressive and psychotic symptoms within 48 h, but relapsed within 2 weeks; two other patients had transient hypomanic symptoms. Depression ratings did not significantly change for the sample as a whole, but plasma and cerebrospinal fluid (CSF) levels of 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) decreased and CSF levels of homovanillic acid (HVA) and 5-hydroxy-indoleacetic acid (5-HIAA) increased. Despite robust effects on central monoamine metabolism, reserpine augmentation appears insufficiently effective for routine use in managing refractory depression.

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Authors and Affiliations

  1. Department of Psychiatry, Yale University School of Medicine and The Connecticut Mental Health Center, Ribicoff Research Facilities, 34 Park Street, 06508, New Haven, CT, USA

    L. H. Price, D. S. Charney & G. R. Heninger

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  1. L. H. Price
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  2. D. S. Charney
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  3. G. R. Heninger
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Price, L.H., Charney, D.S. & Heninger, G.R. Reserpine augmentation of desipramine in refractory depression: clinical and neurobiological effects. Psychopharmacology 92, 431–437 (1987). https://doi.org/10.1007/BF00176473

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  • DOI: https://doi.org/10.1007/BF00176473

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