A neglected modality in psychiatric treatment--the monoamine oxidase inhibitors

The monoamine oxidase inhibitors are at present being used relatively infrequently in my opinion because of reports of severe and dangerous side effects such as toxic hepatocellular damage and hypertensive crises and also on account of several studies which have not given a very encouraging picture regarding the efficacy of this group of drugs. The purpose of this article is to demonstrate that this group of antidepressant drugs is very useful when the proper indications for their employment are observed and are relatively safe provided that appropriate precautions such as the avoidance of cheese and other foods high in tyramine content are taken by the patients being treated with these compounds. The history, pharmacology, side effects, and indications for their use are reviewed, and it is indicated that the MAO inhibitors are the therapeutic agents of choice in atypical depressions associated with anxiety, phobic and hysterical symptoms, and depressive illnesses (including endogenous depressions) which have failed to respond satisfactorily to tricyclic antidepressants. It is then demonstrated both from a review of the literature relating to these drugs and also from my own clinical experience that these compounds are very effective when used in the treatment of the psychiatric conditions for which they are indicated and are also relatively safe when the appropriate precautions are conscienciously observed.