Cecilio Alamo González

Half a Century of Antidepressant Drugs On the Clinical Introduction of Monoamine Oxidase Inhibitors, Tricyclics, and Tetracyclics. Part II: Tricyclics and Tetracyclics

FIVE DECADES OF ANTIDEPRESSANTS The 50th anniversary of antidepressive pharmacotherapy is worth commemorating. In 2 parts, we review the onset of drug treatment with convincing antidepressive efficacy, and in this second part, we recap the development and clinical introduction of tricyclics and tetracyclics. In speaking with Gerhart Harrer, who reviewed his own experience, he said, BThe introduction of antidepressants meant an enrichment for doctor’s therapeutic possibilities which matched a Quantum leap.[ A whole generation of psychiatrists felt the same way, remembering the improvements after the introduction of imipramine and iproniazid. These compounds, together with other tricyclic antidepressants, revolutionized the approach to the treatment of depression. Until the clinical introduction of selective serotonin reuptake inhibitor at the beginning of the 1990s, tricyclic antidepressants were the Bgold standard[ in drug treatment of depression. Progress has been achieved during the last 2 decades, with new reuptake inhibitors on the market, new methodologies for data analysis, and new principles of action. This second part focuses on the historical background of tricyclics and tetracyclics.