The authors administered lithium carbonate, 900 mg/day, in an open study
to seven patients with a major unipolar depression refractory to 3-week
treatment with iprindole, 90 mg/day, a tricyclic antidepressant devoid of
any action on monoaminergic reuptake. All patients showed clinically
significant improvement within 48 hours. Since iprindole induces in the
animal a sensitization of forebrain neurons to serotonin (5-HT), as do
other tricyclic antidepressants, and lithium enhances the activity of 5-HT
neurons, the authors propose that an enhanced release of 5-HT on sensitized
target neurons might underlie the rapid antidepressant effect in
tricyclic-refractory depression when lithium is added to the treatment
regimen.Abstract Teaser