In a double-blind clinical trial involving 28 patients with multiple
sclerosis and major depressive disorder, 14 patients were randomly assigned
to a 5-week trial of desipramine and individual psychotherapy and 14 to
placebo plus psychotherapy. Clinical judgments indicated that patients
treated with desipramine improved significantly more than the placebo
group. This was confirmed by scores on the Hamilton Rating Scale for
Depression but not by Beck Depression Inventory scores. Side effects
limited desipramine dosage in half of the treated patients. The authors
conclude that desipramine has a modest beneficial effect in serious
depression associated with multiple sclerosis but that side effects may be
more of a limiting factor than in patients without medical or neurologic
disease.
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