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Treatment strategy in depression
Author(s) -
Nolen W. A.,
Putte J. J. van de,
Dijken W. A.,
Kamp J. S.,
Blansjaar B. A.,
Kramer H. J.,
Haffmans J.
Publication year - 1988
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/j.1600-0447.1988.tb06403.x
Subject(s) - tranylcypromine , nomifensine , depression (economics) , lithium (medication) , electroconvulsive therapy , antidepressant , medicine , psychiatry , psychology , schizophrenia (object oriented programming) , monoamine oxidase , chemistry , biochemistry , dopaminergic , hippocampus , dopamine , economics , macroeconomics , enzyme
Antidepressants are ineffective in about 30% of the patients with major depression. Besides electroconvulsive therapy (ECT) and lithium, MAO inhibitors have been suggested as an alternative in such patients. In 2 controlled, partial crossover studies involving 47 patients with major depression who had already been treated unsuccessfully with at least 2 cyclic antidepressants, the effect of the MAO inhibitor tranylcypromine was studied. The first study was an open comparison with L‐5‐hydroxytryptophan (L‐5HTP), the second study a double‐blind comparison with nomifensine. Neither the patients treated with L‐5HTP nor the patients treated with nomifensine, except one, improved. In contrast, tranylcypromine was effective in 50% of the patients. The depressions of the responders to tranylcypromine appeared to be more endogenous (according Newcastle Scale II) and of shorter duration than those of the non‐responders. It is concluded that MAO inhibitors such as tranylcypromine are an effective alternative to ECT and lithium in patients with major depression who have failed to respond to cyclic antidepressants.