MAO inhibitors in mental disease: their current status

Available MAOIs seem to be mainly indicated for the heterogeneous group of patients with depressive syndromes. Although groups of patients with all the recognized major subtypes of depression (including "endogenous depression") probably respond in varying degrees, MAOIs appear to be particularly indicated for out-patients with "neurotic depression" complicated by panic disorder or hysteroid dysphoria, which involves repeated episodes of depressed mood in response to feeling rejected. MAOIs can also be effective in several anxiety syndromes, in particular panic disorder. Other reports have claimed success in a variety of other syndromes including bulimia, anorexia nervosa, obsessive-compulsive neurosis, atypical facial pain and some other types of chronic pain, childhood attention deficit disorder and delusions of infestation by parasites. The nature of any underlying personality disorder is an important response variable and the assessment of personality should be encouraged in further studies. The development of new drugs raises the prospect of a range of MAOIs targeted at specific patient populations. Tranylcypromine also merits further investigation as clinical experience suggests that it can produce a dramatic response in some patients with phenelzine-resistant disorders. This may be due, at least in part, to its amphetamine-like effects.