Since the introduction of antidepressant drugs, many studies have attempted
to assess their effectiveness, and a variety of reviewers have tried their hand
at summarizing the reports that have appeared in the literature. The reviewers
have focused on the antidepressant effects of tricyclic compounds and mono-
amine oxidase inhibitors (MAOIs). Obviously there is overlap in the studies
summarized by different authors. However, there is occasional disagreement
among reviewers in categorizing the same investigation as showing evidence
for or against drug use. Results have generally been compressed into either
box scores comparing the number of studies showing drugs to be superior to
placebos versus those showing no difference in outcome or compilations of
the percentage of patients significantly improving on drugs as opposed to
placebos. A search of the literature revealed 15 such reviews. Six assessed the
drug effects as relatively positive and superior to placebos and 7 suggested
more modest, cautious, or equivocal conclusions about drug effects. Two
reviews took a somewhat different tack and attempted to measure the degree
to which groups treated with antidepressant drugs have exceeded non-drug
control groups. Note that these 15 reviews were largely written in the 1960s.

Perhaps a presentation of the positive reviews should begin with the work
of Cole ( 1964) who, in providing an early impressionistic discussion of drug
treatments, noted that two thirds of 15 placebo-controlled studies of depressed
inpatients showed imipramine to be superior. Three placebo-controlled studies
of outpatients also declared imipramine to be the more effective treatment.
Similarly, Davis ( 1965) detailed a box score account of 47 antidepressant drug
studies. Most of these reports were placebo controlled and double-blind. The
drug was declared superior to placebos in 68% of the studies. At a later date,
Davis, Klerman, and Schildkraut ( 1968) tabulated box scores for 52 double-
blind placebo-controlled studies of tricyclics and 28 similarly controlled inves-

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