Efficacy and tolerability of tranylcypromine versus phenelzine: a double-blind study in antidepressant-refractory depressed inpatients.

Abstract

BACKGROUND:

The aim of this study was to examine whether phenelzine is a suitable alternative to tranylcypromine in antidepressant-resistant depression.

METHOD:

A total of 77 severely depressed in-patients, meeting the DSM-IV criteria for major depressive disorder, who failed to respond to fixed plasma level treatment with either tricyclic antidepressants or fluvoxamine were withdrawn from psychotropic medication and included in a double-blind flexible-dose 5-week comparison of tranylcypromine and phenelzine.

RESULTS:

Of the 77 patients, 67 (87%) completed the trial, of whom 35 (52%) responded. No significant differences in response between both drugs were observed. Seventeen (44%) of 39 patients responded to tranylcypromine and 18 (47%) of 38 to phenelzine (> or = 50% reduction in Hamilton Rating Scale for Depression [HAM-D] score). The mean reduction in HAM-D score was 10.4 +/- 8.3 for the tranylcypromine sample versus 8.3 +/- 8.4 for the phenelzine-treated patients. Only a few patients (10%) used concomitant psychotropic medication. A substantial number of patients experienced severe side effects, mainly dizziness, agitation, and insomnia; the incidence was the same in both samples (21%).

CONCLUSION:

No difference in efficacy was observed between both monoamine oxidase inhibitors in a sample of patients with severe antidepressant-refractory depression. Phenelzine appears to be a suitable alternative to tranylcypromine.

• Authors: Tom K Birkenhäger, Walter W van den Broek, Paul G Mulder, Jan A Bruijn, Peter Moleman
• Journal: The Journal of clinical psychiatry (J Clin Psychiatry) Vol. 65 Issue 11 Pg. 1505-10 (Nov 2004) ISSN: 0160-6689 [Print] United States
• PMID: 15554763 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antidepressive Agents
• Monoamine Oxidase Inhibitors
• Tranylcypromine
• Phenelzine

Topics

• Antidepressive Agents (pharmacology)
• Depressive Disorder (drug therapy, psychology)
• Double-Blind Method
• Drug Resistance
• Humans
• Monoamine Oxidase Inhibitors (therapeutic use)
• Phenelzine (therapeutic use)
• Tranylcypromine (adverse effects, therapeutic use)
• Treatment Outcome