Depressive mania associated with nonresponse to antimanic agents.

Of 39 patients consecutively admitted for the treatment of primary mania, 21 (53.8%) simultaneously met the Research Diagnostic Criteria for major depressive disorder ("mixed" or "depressive" mania). Only nine (42.9%) of the 21 patients with depressive mania responded to antimanic agents. In contrast, 16 (88.9%) of the 18 patients with pure mania responded to these drugs. This finding is consistent with previous reports suggesting that the mixed state is a virulent form of mania.

Comorbid panic disorder in patients with winter depression.

This study investigated the prevalence of comorbid panic disorder in patients with recurrent wintertime episodes of major depression. The subjects were 38 patients (10 male and 28 female) who met the DSM-III-R criteria for major depression with a seasonal pattern (wintertime depression). Diagnoses of panic disorder were made according to the DSM-III-R criteria. Nine (23.7%) of the subjects (four women and five men) met the criteria for panic disorder. Their panic attacks and depressive symptoms had simultaneous onset in the fall or winter and remitted spontaneously in the spring. Patients with winter depression appear to be at high risk for simultaneous panic disorder, consistent with results from studies in which season of illness was not considered.

Tranylcypromine withdrawal phenomena.

The gradual or abrupt withdrawal of tranylcypromine can result in syndromes ranging in severity from mild discomfort to incapacitation. Five patients were subjected to the withdrawal of tranylcypromine. Vignettes describing the withdrawal syndrome experienced by these patients are presented. These patients suffered from severe depression or impairment of cognition in association with a reduction in their daily dose of tranylcypromine. The authors conclude that reductions in a patient's dose or the discontinuation of tranylcypromine warrant the careful supervision of a physician.