Effect of imipramine on the rheumatoid factor titre of psychotic patients with depressive symptomatology.

It was reported by Oreskes, Rosenblatt, Spiera, and Meadow (1968) that patients with depressive symptomatology show a high percentage of elevated rheumatoid factor titre as measured by the sensitized sheep cell test of Heller, Kolodny, Lepow, Jacobson, Rivera, and Marks (1955). They studied the blood samples of patients who were admitted to an acute psychiatric service. We were interested to ascertain whether the antidepressant medication imipramine has any effect on the titre of rheumatoid factor in depressed patients in need of antidepressant therapy. Haydu (1963) suggested that rheumatoid arthritis and depression are sequelae (in mutually exclusive directions) of a predepressive energy constellation that includes a high demand for adenosine triphosphate (ATP). In rheumatoid arthritis, the process was thought to be initiated by a high ATP-ase activity and a relative insufficiency ofadrenocortical support. This hypothesis, based on metabolic studies (Haydu and Wolfson, 1950a, b), was responsible for the broaching of chloroquine therapy in 1951 (Haydu, 1951, 1953). Since then there is more direct evidence (BarwickSchramm and Kolodzieczyk, 1965) that, in rheumatoid arthritis, blood ATP concentrations are low and the levels correlate with the values ofseromucoids and alpha-2 and gamma globulins as well as blood sugar curves. There is also more direct evidence that chloroquine inhibits obligatory aerobic ATP production of mitochondria (Ardneser and Heim, 1967; Stell and Thomas, 1972), and that it inhibits ATP-ase activity of the retina (Schmidt and Muller-Limmroth (1962)). According to the above, the study of imipramine effects on rheumatoid factor appeared feasible, especially since it was found (Tarve and Brechtlova, 1967) that imipramine reduced the activity of brain membrane-bound ATP-ase. Beyond a double-blind design and a sufficiently long medication period under constant observation, we wished to establish two placebo-controlled observation periods, one preceding and one following the medication period. We also wished to observe patients in need of antidepressant therapy who have been stabilized in a controlled hospital setting (research ward) under an identical environmental and