Antidepressantsin the Treatment of Post-PsychoticDepressionin Schizophrenia:Drug Interactionsand other Considerations

Adjunctive imipramine has been found to be useful in the treatmentof a substantialnumberofpatientswithsyndromal-ly defined post-psychotic depressions. This paper examines the clinicaleffectsof the combined anticholinergic activity of imipramine,when addedto ongoingfluphenazinedecanoate/ benztropine treatment, in such patients. Little additional anticholinergicImpact of the imipramine was observable beyond that already attnbutable to the benztropine, and no significantrelationshipswere found between a clinical mea-sure of peripheral anticholinergicactivity and either global clinicaloutcome or antidepressiveefficacy.This paper also reportson the concentrations of imipramineand its metabo-lites in plasma under the conditionsof this therapeutictrial. The changes in relative concentrationsof imipramineand metabolites with time were consistent with the concept tha