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IPRONIAZID CHEMOTHERAPY IN MELANCHOLIA
THEODORE R. ROBIE
Am J Psychiatry 1958;115:402-409.
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Abstract

1. Chemotherapeutic remission of melancholia can now be accomplished, in a majority of cases, without resort to ECT, by carefully supervised administration of Marsilid, Roche iproniazid (1-isonicotinyl, 2-isopropylhydrazine phosphate).2. However, until methods are discovered for accelerating Marsilid's effectiveness in the first few days of treatment, the aggressively suicidal case must still be given ECT, which assures most immediate remission of depression. Each case must be carefully evaluated when first seen.3. This chemical, introduced 6 years ago for the treatment of tuberculosis, is now found to possess much wider scope in medicine including therapeutic efficacy in some apathetic and withdrawn, seclusive types.4. A major factor in the effectiveness of this chemical in accomplishing psychic energization is the prevention of inactivation of the brain-stored powerful hormone serotonin, by its amine oxidase inhibitor action, but other equally powerful chemical Interactions may be simultaneously involved.5. The powerful chemical forces released may Induce serious complications unless the physician psychiatrist is constantly alert to the need for frequent alteration of dosage as indicated by his physical findings.6. Excellent antidotes for certain complications are available.7. A by-product of major significance is the enhancement of psychotherapy through increased spontaneity, improved sense of well being and resulting betterment of rapport.

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