Drug-Responsive Symptoms in Melancholia

Depressive symptoms present in 43 patients with unipolar nondelusional melancholia were studied to determine which symptoms were the best measures of response to desipramine hydrochloride. An extended Hamilton Depression Scale was used to identify symptoms that were present frequently. We then determined which symptoms improved in direct relation to achievement of therapeutic plasma desipramine concentrations, using multiple regression analysis to account for pretreatment symptom severity. In ten symptoms, improvement was significantly associated with desipramine treatment. These ten symptoms seem to be the best measure of drug response during tricyclic antidepressant treatment in patients with nondelusional melancholia.