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Published Online:https://doi.org/10.1176/ajp.129.3.337

The response of 21 manic-depressives to imipramine was followed over a period of two years, during which both manic and depressed states were treated. Most patients responded differently to this treatment at different times. The variation in response is considered in the context of a hypothecated biochemical instability in the manic-depressive that is manifest in behavioral, pharmacological, and biochemical measures.

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