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                  <text>March 8. 1971
Dr. Edward L. Platcow, Ph.D.
Department of Drugs
American Medical Association
535 North Dearborn

Illinois

Chicago,

Street

60610

Dear Dr. Platcow:
As

requested, I have read proposed chapter

It is well written

are few.

and

authoritative,

32

"Antidepressants".

and my comments and suggestions

Pg. 32$) Paragraph 1: Recent notes suggest that thiothixene
(Havana) also has antidepressant qualities. We demonstrated such
is my impression that Drs. Norman
activity in our studies, and
Pitts and Allen Borger at Pfizer Laboratories, Groton, Connecticut

it

can provide the available documentation.

Paragraph 3. The role of ECT is presented in too limited a
fashion. In every study of ECT and antidepressants, ECT is more
effective and more rapidly (see Cole and Davis, in Freedman and Kaplan,
"Comprehensive Textbook of Psychiatry“, 1967: 1263—1275; Klein and
Davis. Diagnosis and Treatment of Psychiatric Disorders, 1969: 187~322).

important, in suicidal risks, involutional melancholia, and
psychotic agitated depressives, ECT may he 1ife«saving, while antidepressants are too slow and ineffective. Although drug evaluation
is the focus, in my view, ECT is a complex way to achieve a biochemical
change in the CNS ~ which is, after all, the goal of pharmacotherapy.
Most

Paragraph

Too harsh an evaluation. The
show many controlled studies.

&amp;.

Klein and Davis

Paragraph 5.

depressions.

A

references cited by

reason to emphasize the value of

ECT

in severe

Pg. 259, Paragraph 1: English syntax is poor in phrase, ”..., since
these agents block the actions of these antihypertensive agents".

Paragraph 3. The duration of drug effects is generally 48~72 hours.
The recommendation of a 2~week interval between tricyclic compounds and
MAUI seems much too harsh, and too restrictive.
Probably 72 hours are

adequate.

�y‘)

Dr. Platcow

March 8, 1971

—2~

Paragraph 9. I do not know the evidence for restricting
imipramine in epileptice. My own data suggests it may reduce seizure

activity in the brain,

and may

therefore

be recommended.

the data source be checked (see Canad. Peychiat. Assn.

166-171, 1959).
A

J.,

I suggest

6(Suppl.):

restriction omitted is the use of imipremine in schizophrenia,

where excitement states may be precipitated
Plenum Press, 1965, 1; 53-61).

(in Biological Psychiatry,

Pg. 260, Paragraph 2.

Same as ?age 259, Paragraph 9.

Pg. 261, Paragraph 1.

Sinequan

is

now

prepared as a concentrate also.

Pg. 262: Nialamide, and Phenelzine: Efficacy is suggested in
endogenous depressions. The evidence is clearly that such patients
show no response to HAOI, and if there is any application, it could
be in the neurotic depressives.

Tranylcypromine. Same as for phenelzine. Surely, there
that tranylcypromine has been effective over ECT. I
is
would doubt that there are cases ”inapprOpriate for ECT” [such as?) who
may respond to tranylcypromine.
Pg. 263:

no evidence

I trust these

comments

are helpful.
Sincerely yours,
Fink, K.D.
Professor of Psychiatry

Wax

MF:kt

V

.ww‘ﬁw

~v—w.

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WWW”

93¢)Wmm-

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�</text>
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