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Monoamine oxidase inhibitors in resistant major depression
Abstract
In a double-blind study the selective monoamine oxidase-A inhibitor brofaromine was compared with the classical MAOI tranylcypromine in 39 patients with major depression resistant to treatment with tricyclic antidepressants. Concerning efficacy no significant differences were found. Ten out of 22 patients responded to brofaromine and 5 out of 17 patients to tranylcypromine. Adverse effects favoured brofaromine. Although orthostatic hypotension occurred in both groups, severe decrease in blood pressure and dizziness occurred significantly more with tranylcypromine. Both MAOIs caused a decrease in stage 4 and REM sleep and an increase in REM latency. In most patients receiving tranylcypromine REM sleep was completely abolished.
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Tranylcypromine (20-100mg) significantly increased REM sleep latency and almost completely suppressed REM sleep overall.
“(Nolen et al., 1993) found that tranylcypromine (20-100mg) significantly increased REM sleep latency and almost completely suppressed REM sleep overall.”
From Antidepressants and their effect on sleep (2005) · cites this paper as Nolen et al., 1993
Sleep latency was also increased with tranylcypromine, but patients reported deeper and more refreshed sleep than with brofaromine (50-250mg).
“Sleep latency was also increased, but patients reported deeper and more refreshed sleep than with brofaromine (50-250mg).”
From Antidepressants and their effect on sleep (2005) · cites this paper as Nolen et al., 1993
MAOIs have been reported to significantly suppress REM sleep.
“MAOIs have been reported to significantly suppress REM sleep (Nolen et al., 1993).”
From Antidepressants and their effect on sleep (2005) · cites this paper as Nolen et al., 1993
Subjective reports of sleep were favourable with tranylcypromine and isocarboxazid.
“Nevertheless, subjective reports of sleep were favourable with tranylcypromine (Nolen et al., 1993) and isocarboxazid (Giller et al., 1982).”
From Antidepressants and their effect on sleep (2005) · cites this paper as Nolen et al., 1993
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Research works printed but not linked: 15
- Amsterdam, 1989, High-dose tranylcypromine therapy for refractory depression, Pharmacopsychiatry, 22, 21, 10.1055/s-2007-1014572 · DOI
- Bech, 1986, Mini-compendium of rating scales for states of anxiety, depression, mania and schizophrenia with corresponding DSM III syndromes, Acta Psychiatr. Scand., 326, 23
- Carney, 1965, The diagnosis of depressive syndromes and prediction of ECT response, Br. J. Psychiatry, 111, 547, 10.1192/bjp.111.477.659 · DOI
- Georgotas, 1983, Resistant geriatric depressions and therapeutic response to monoamine oxidase inhibitors, Biol. Psychiatry, 18, 195
- Larssen, 1980, Long-term treatment of depression with isocarboxazide, Acta Psychiat. Scand., 70, 254
- Lieb, 1978, Treatment of delusional depression with tranylcypromine, J. Nerv. Ment. Dis., 166, 805, 10.1097/00005053-197811000-00009 · DOI
- McGrath, 1987, Treatment of tricyclic refractory depression with a monoamine oxidase inhibitor antidepressant, Psychopharmacol. Bull., 23, 169
- Möller, 1991, Brofaromine — a selective, reversible and short-acting MAO-A inhibitor: review of the pharmacological and clinical findings, Pharmacopsychiatry, 24, 50, 10.1055/s-2007-1014438 · DOI
- Mulder, 1980, Measurements of subjective sleep quality, Vth European Sleep Congress, Sleep Research 98
- Nolen, 1985, L-5HTP in depression resistant to re-uptake inhibitors, and open comparative study with tranylcypromine, Br. J. Psychiatry, 147, 16, 10.1192/bjp.147.1.16 · DOI
- Nolen, 1988, Treatment strategy in depression; II: MAO inhibitors in depression resistant to cyclic antidepressants: two controlled studies with tranylcypromine versus 1–5-hydroxytryptophan and nomifensine, Acta Psychiatr. Scand., 78, 676, 10.1111/j.1600-0447.1988.tb06403.x · DOI
- Nolen, 1993, Hypnotics as concurrent medication in depression. A placebo-controlled, double-blind study comparison of flunitrazepam and lormetazepam in patients with major depression, treated with a (tri)cyclic antidepressant, J. Affect. Disord., 28, 179, 10.1016/0165-0327(93)90103-Q · DOI
- Roose, 1986, Tricyclic nonresponders: phenomenology and treatment, Am. J. Psychiatry, 142, 619
- Thase, 1992, Treatment of imipramine-resistant recurrent depression, III: efficacy of monoamine oxidase inhibitors, J. Clin. Psychiatry, 53, 5
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Antidepressants and their effect on sleep
Mayers, A. G., & Baldwin, D. S. (2005) · Human Psychopharmacology: Clinical and Experimental · doi:10.1002/hup.726 · Cited by 323
Ruhé, H. G., Huyser, J., Swinkels, J. A., & Schene, A. H. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n1203 · Cited by 230
Montgomery, S. A., Nielsen, R. Z., Poulsen, L. H., & Häggström, L. (2014) · Human Psychopharmacology: Clinical and Experimental · doi:10.1002/hup.2424 · Cited by 143
Metadata
- Authors
- Nolen, W. A., Haffmans, P. M. J., Bouvy, P. F., & Duivenvoorden, H. J.
- Affiliations
- Erasmus University Rotterdam (NL)
- Corresponding author
- Nolen, Willem A.
- ORCID
- Nolen, Willem A.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 1993-07
- Volume
- 28
- Issue
- 3
- Pages
- 189-197
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W1531202574
- Cited by
- 56
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2022: 2 · 2020: 1 · 2019: 1 · 2017: 2 · 2015: 1 · 2014: 1 · 2013: 1 · 2012: 3
- FWCI
- 3.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- monoamine oxidase inhibitors, brofaromine, tranylcypromine, treatment-resistant depression, major depressive disorder, REM sleep, orthostatic hypotension, adverse drug reactions, antidepressant efficacy
- MeSH terms
- Adult, Depressive Disorder, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Hypotension, Orthostatic, Male, Middle Aged, Monoamine Oxidase Inhibitors, Piperidines, Psychiatric Status Rating Scales, Sleep, REM, Tranylcypromine
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