Accelerated antidepressant response to lithium augmentation of imipramine

BACKGROUND Treatment of depressive episode often poses a challenge. Although there are numerous medicines available for its treatment but they all have a lag period of 2-3 weeks before they start showing their result. AIM The aim of the present study was to test the hypothesis that an initial lithium-tricyclic antidepressant (TCA) combination has a quicker and better antidepressant effect than standard TCA treatment in unipolar depression. MATERIALS AND METHODS Twenty unipolar depressed inpatients under lithium-TCA treatment were compared with twenty patients with similar diagnosis treated with TCA-placebo combination. The duration of the study was 4 weeks under double-blind conditions. RESULTS Initial lithium-TCA treatment reduced depressive symptoms significantly more than TCA alone. The difference was evident from 1st week onward and persisted at 4 weeks. CONCLUSION Lithium augmentation of TCA at the outset offers a strategy to reduce the lag period of antidepressant action. The choice can be made for those patients who are likely to benefit from long-term prophylaxis.