Treatment for Severe Depression
A great deal of effort has been devoted recently to the investigation of drugs that have beneficial effects in cases of mental illness. The best known of such drugs are the “ataraxics,” or tranquilizers, which are particularly effective in alleviating severe anxiety and agitation. Other drugs have been developed that have proved beneficial in cases of severe depression and other conditions.
Tranquilizing Drugs. The first so-called tranquilizing drug-chlorpromazine-was made in France, and it was soon discovered that this drug was of great value in the treatment of many of the illness including mental and emotional disorders. The early clinical reports were received with great enthusiasm, and some hoped that such drugs might be a miracle for all emotional and mental illness. However, there is an old saying in psychiatry that “any new technique will achieve good results until the initial enthusiasm for it wears off; therefore, one had better take full advantage of it before it ceases to work”. Research has demonstrated that while the tranquilizing drugs are very effective in controlling certain conditions, they are not universally effective. In addition, in some patients the probability of relapse increases markedly following termination of drug therapy.
Nevertheless, while the tranquilizing drugs does not cure all, they have affected changes in our mental hospitals that are little short of miraculous. Many disturbed patients who formerly required constant surveillance and restraint are now living on open wards. Open wards are generally locked at night, but during the day, patients on such wards are allowed freedom of the hospital. The number of open wards in mental hospitals has increased so greatly in recent years that in many hospitals these wards now outnumber the closed wards.
However, not all psychotic or psychoneurotic conditions are characterized by such symptoms. There are many conditions in which severe depression and apathy are the most predominant symptoms, and in such cases tranquilizing drugs are ineffective. The depressed or apathetic patient is often treated with other drugs, sometimes referred to as “energizers.”
Energizing Drugs. Prior to the development of new drugs for alleviating apathy and severe depression, Benzedrine sulfate was often used. While this drug was helpful in the treatment of apathy and depression among mental patients, it unfortunately often produced undesirable side effects such as mild drowsiness or feelings of elation. In addition, the effect it might have on different patients was unpredictable.
Hydrotherapy was also frequently used in the treatment of depression. Special shower stalls were developed that alternate streams of very hot and very cold water, and depressed patients were given these showers at frequent intervals. With this kind of treatment, however, if there was any alleviation of depression at all, it was often temporary.
Both of these methods of treating severely depressed or apathetic patients have lost value in view of some new drugs that have been introduced very recently. These are drugs that serve as cerebral stimulants- the energizing drugs. There are only a few currently in use, but many more will undoubtedly be developed within the next few years. Two classes of drugs, the monoamine oxidase (MAO) inhibitors and their successors, the dibenzazepine compounds, have proved beneficial so far. These drugs do not produce undesirable side effects and have proven of great value in both mild and severe depressive reactions.