Psychiatry: Quick Lift for Depression

No man has pioneered more boldly with "psychic-energizer" drugs for lifting patients out of a severe depression than Dr. Nathan S. Kline of New York's Rockland State Hospital. And no man has been quicker to admit that the drugs take too long—usually two to three weeks—to begin to work. Since depressed patients are the ones most likely to try to commit suicide, psychiatrists would like to give them a quick lift. Such help may soon be available, Dr. Kline told a pharmacology meeting in Prague; he has found a promising accelerator for psychic-energizer drugs.

The energizer drugs are technically called monoamine-oxidase inhibitors because they seem to work as antagonists to the enzyme, monoamine oxidase, which destroys some of the amines essential to normal brain function. Working with Dr. William Sacks, a biochemist, Dr. Kline reasoned that it was all very well to muzzle the destroyer, but why not speed up the repair process by supplying the system with some of those amines? They decided to try 5-hydroxy-tryptophane because of its known importance in brain chemistry.

Dr. Kline picked 20 private patients, living at home, suffering from "pure" depression. One patient, who was also physically ill, failed to respond, and one responded feebly. But 18 showed marked improvement within 24 hours after they got an injection of 5-HTP along with oral doses of energizer drugs. Among 30 patients with different types of depression associated with hardening of the brain arteries or schizophrenia-like disorders, only seven showed marked improvement. But this is better than with previous drug treatments.

Electric shock is still the fastest and most effective treatment for depression. But psychiatrists prefer to try the drugs first, because shock so often produces temporary memory loss and confused thinking. Dr. Kline hopes not only to reduce the need for shock, but to speed up the energizers more conveniently with doses of 5-HTP taken by mouth, instead of injection.