The Monoamine Oxidase Inhibitor, Phenelzine, in the Treatment of Depressive-Anxiety States

The monoamine oxidase (MAO) inhibitor, phenelzine sulfate, and placebo were compared in a prospective, controlled, double-blind experiment involving 87 outpatients with features of atypical depression. Patients were treated for six weeks while MAO inhibition and symptom severity were monitored. By utilizing a structured depression interview, type and severity of depression were precisely assessed. Sixty patients completed the treatment period. Treatment groups were balanced for such risk factors as age, sex, severity, and type of depressive symptomatology. Improvement of phenelzine completers was greater than placebo completers for 15 out of 16 prospectively selected measures. Improvement in subscale scores for irritability, hypochondriasis-agitation, and psychomotor change was especially marked with phenelzine. These study findings suggest that MAO inhibitors may have a special efficacy in treating depressive illnesses with atypical features such as anxiety, fatigue, phobia, or other somatic complaints.