Certainly there are good and bad times, but our mood changes more often than our fortune.

Dieric Bouts, Der Abendmahlsaltar, 1464.

New typologies were envisioned as the basis for more evective prescription of the available treatments. Altered mood states were now labeled as vital or personal, primary or secondary, atypical, vegetative, endogenomorphic depressions and anxious thymopathy.

In an unusual study, Klein and Fink (1962a, 1962b) randomly assigned patients of varying diagnoses (depression, mania, psychosis) referred for medication treatments in an inpatient hospital setting to one of three treatments – imipramine, chlorpromazine (combined with the antiparkinson agent, procyclidine), or placebo. Imipramine relieved depressed mood in both the retarded and agitated forms. Chlorpromazine relieved psychosis but also relieved depressed mood. The labeling of the new psychoactive substances as either ‘‘antidepressant’’ or ‘‘antipsychotic’’ was challenged.

The diagnostic criteria of DSM-II served as poor guides in the prescription of the compounds. Many psychopharmacologists described their frustration with DSM-II criteria for the selection of treatments. They struggled with a confusion generated by the varying proposed causes of depression: being rooted in life events (reactive depression) or in body physiology (endogenous, vital depression), or dominated by neurotic symptoms (neurotic depression, dysthymia), psychosis (psychotic depression), or character pathology.