middle-aged patient dresses to look young, exhibits a tense, continuous smile, and may have bitten nails or overplucked eyebrows
Triavil advertisement, 1970.
JAMA: The Journal of the American Medical Association, Vol. 211, No. 1, pp. 102-104.

Lady, your anxiety is showing (over a coexisting depression)
On the visible level, this middle-aged patient dresses to look too young, exhibits a tense, continuous smile,
and may have bitten nails or overplucked eyebrows.
Symptoms of anxiety are hard to miss.   What doesn't show as clearly is the coexisting depression that often complicates treatment.
TRIAVIL offers effective tranquilizer-antidepressant therapy.   TRIAVIL provides perphenazine to help allay anxiety and amitripyline
HCl to lift depressive mood and relieve the functional somatic complaints often encountered in patients of this age group.
For moderate to severe anxiety with depression ~ TRIAVIL containing perphenazine and amitryptyline HCl tranquilizer-antidepressant
Patients who have received MAO inhibitors within two weeks should not receive TRIAVIL. Those on TRIAVIL should be warned that
response to alcohol may be potentiated. The drug may impair alertness in some patients; operation of automobiles and other activities
made hazardous by diminished alertness should be avoided. Contraindicated in glaucoma, in patients expected to experience problems
of urinary retention, in CNS depression from drugs, and in bone marrow depression. Should not be given with guanethidine or similarly
acting compounds. Not recommended in pregnancy. Since the possibility of suicide is inherent in any serious depressive illness,
close supervision of patients is essential until you are satisfied that significant remission has taken place.
For moderate severe anxiety with coexisting depression
TRIAVIL containing perphenazine and amitriptyline HCl tranquilizer-antidepressant
For additional prescribing information, please see following page.
        ...extrapyramidal symptoms (opisthotonos, oculogyric crisis, hyperreflexia, dystonia, akathisia, dyskinesia, parkinsonism)
        usually controlled by the concomitant use of effective antiparkinsonian drugs and/or by reduction in dosage,
        but sometimes persist after discontinuation...
For more detailed information consult your MERCK Sharp and Dohme representative or see the package circular.
Merck Sharp & Dohme ~ Division of Merck & Co. Inc.   West Point Pa 19486   where today's theory is tomorrow's therapy

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