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“In his work with depression, [Donald] Klein tried to distinguish those patients who were best treated with imipramine from those best treated with MAOis (monoamine-oxidase inhibitors). Klein found that imipramine was most useful in the treatment of severe depressive episodes with a definite and rapid onset. Patients who looked less depressed, had arrived at depression more gradually, and complained mostly of boredom and apathy did not respond to imipramine but might respond to MAOis. This second group could sometimes be interrupted by distractions or amusements; in the midst of a hospitalization for depression, they might be seen on the ward chatting happily. Yes, they were impaired. But the impairment extended only to appetitive pleasures. Though they had lost the capacity to forage, if pleasure landed on their plate, they consumed it.” — Peter D. Kramer