Combined Tricyclic—MAOI Therapy for Refractory Depression: A Review, with Guidelines for Appropriate Usage

Goldberg, Richard; Thornton, William E.

doi:10.1002/j.1552-4604.1978.tb02435.x

Cited by 61 publications

(9 citation statements)

References 31 publications

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“…Concerning the treatment of resistant depression in general adult psychiatric patients, much has been written about the merits of several treatment strate- gies and combination therapies (Quitkin, 1985;Schrader and Levien, 1985;Goldberg and Thornton, 1978;Nolen and Haffmans, 1989). Studies specifically addressing the use of antidepressants in the elderly have been relatively few.…”

Section: Treatment Strategies In Treatment Resistant Depressionmentioning

confidence: 99%

Treatment resistant depression in the elderly

Bonner

Howard

1995

Int J Geriat Psychiatry

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Section: Treatment Strategies In Treatment Resistant Depressionmentioning

confidence: 99%

Treatment resistant depression in the elderly

Bonner

Howard

1995

Int J Geriat Psychiatry

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“…Nevertheless, a number of case reports and open label series from the 1960s (Sargant, 1963;Gander, 1965;Dally, 1965), 1970s (Ray, 1973;Winston, 1971;Schuckit et al, 1971;Sethna, 1974;Spiker and Pugh, 1976), and 1980s (Schmauss et al, 1986(Schmauss et al, , 1988 suggest that these agents may be synergistically effective, when used in combination (Table 5). This combination appears to be well tolerated when moderate to low doses of both agents are used, and when the MA01 is added to an established TCA dose (Goldberg and Thornton, 1978;White and Simpson, 1981). This combination appears to be well tolerated when moderate to low doses of both agents are used, and when the MA01 is added to an established TCA dose (Goldberg and Thornton, 1978;White and Simpson, 1981).…”

Section: Combining Tcas and Maoismentioning

confidence: 89%

“…The safety of this TCA-MA01 combination has been demonstrated in two controlled trials in nonresistant depressed patients (Razani et al, 1983;Young et al, 1979). This combination appears to be well tolerated when moderate to low doses of both agents are used, and when the MA01 is added to an established TCA dose (Goldberg and Thornton, 1978;White and Simpson, 1981). However, results of these studies do not indicate that the MAOI-TCA combination is more effective than either agent used alone in adequate dosages (Razani et al, 1983;Young et al, 1979).…”

Section: Combining Tcas and Maoismentioning

confidence: 99%

Tricyclics and newer antidepressant medications: Treatment options for treatment‐resistant depressions

et al. 1994

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Only about 60-70% of those depressed patients who can tolerate an antidepressant medication, and only about SO-60% of those who begin a medication will respond to the Frst trial. Furthemnore, S-10% will remain depressed despite multiple medication trials. When the disorder is poorly responsive, it is variously described as a resistant, refractory, or intractable depression. This review summarizes the available literature on treatment-resistant depression (TRD) to provide recommendations for the most rational alternative strategies. Depression 2: 1S2-168 (1994/1995). @ 199s Wiley-Liss, Inc.

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“…Currently, MAO inhibitors are prescribed to depressive patients resistant to usual treatment, mostly tricyclic antidepressants (TCAs) [Goldberg & Thornton 1978]. Their use in 'atypical depression', first described by West and Dally (1959), targeted them at 2 patient populations.…”

Section: Clinical Efficacymentioning

confidence: 99%

Risk-Benefit Assessment of Newer Versus Older Monoamine Oxidase (MAO) Inhibitors

Lecrubier

1994

Drug Safety

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The first generation of monoamine oxidase (MAO) inhibitors fell into disuse because of poor efficacy in major depression with melancholia and/or endogenous depression, and because of poor tolerability (drug interactions and the 'cheese' effect). New MAO inhibitors, reversible inhibitors of MAO-A (RIMAs), are able to induce a reversible and specific inhibition of MAO-A. Consequently, the inhibition of MAO is quicker and the dose-response relationship improved, such that dosage adjustment is easier. Also, no carry-over effect once treatment is terminated is observed. The frequency and severity of drug interactions with RIMAs is reduced, although coadministration with pethidine (meperidine) or dextromethorphan should still be avoided. No specific subgroup of patients with depression has shown a better or worse response to RIMAs. The presence of melancholia in major depression, or the existence of endogenous depression, are not predictive of reduced efficacy compared with tricyclic antidepressant (TCA) reference compounds. Dysthymic patients have shown a good response to both RIMAs and TCAs independent of the co-existence of a major depressive episode. Older MAO inhibitors are more effective than TCAs in the treatment of atypical depression, and further studies are needed to confirm if this is true for RIMAs. Long term studies to evaluate the effects of RIMAs on disease recurrence are also required. RIMAs are better tolerated than older MAO inhibitors, including use in subgroups particularly at risk of adverse effects such as the elderly. Overall, RIMAs appear to represent therapeutic progress in the treatment of depression in terms of both efficacy and tolerability.

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Combined Tricyclic—MAOI Therapy for Refractory Depression: A Review, with Guidelines for Appropriate Usage

Cited by 61 publications

References 31 publications

Treatment resistant depression in the elderly

Treatment resistant depression in the elderly

Tricyclics and newer antidepressant medications: Treatment options for treatment‐resistant depressions

Risk-Benefit Assessment of Newer Versus Older Monoamine Oxidase (MAO) Inhibitors

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