Safety of High-intensity Treatment with the Irreversible Monoamine Oxidase Inhibitor Tranylcypromine in Patients with Treatment-resistant Depression
Safety of High-intensity Treatment with the Irreversible Monoamine Oxidase Inhibitor Tranylcypromine in Patients with Treatment-resistant Depression
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DOI：
10.1055/s-0028-1083819
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发表时间：
2008-11-01
影响因子：
4.3
通讯作者：
Bschor, T.
中科院分区：
文献类型：
--
作者：
Adli, M.;Pilhatsch, M.;Bschor, T.
简介：由于不可逆的单胺氧化酶抑制剂反苯环丙胺（TCP）是近50年前引入的，因此在今天的临床处方实践中，与第二代和第三代精神药物一起使用的研究很少。我们对柏林两个精神科接受TCP治疗的抑郁症患者进行了一项基于实践的观察性研究，以评估副作用、有效性、结果：我们确定了32名患者在当前发作中平均3.3次预治疗后，以51.9 mg/天的平均剂量接受TCP治疗。TCP的剂量和多种精神科药物的使用表明高强度治疗。最常见的副作用是动脉张力减退（28%）。饮食限制主要被评为中度。59%的患者缓解（HAMD-（21）< 9或CGI-I = 1），22%有反应（HAMD-21降低> 50%或CGI-I = 2）。使用高剂量和多种联合用药，获益风险比良好。前瞻性数据旨在与现代抗抑郁药进行比较，并澄清进一步的安全性问题是必要的。
Introduction: Because the irreversible monoamine oxidase inhibitor tranylcypromine (TCP) was introduced nearly 50 years ago, only few studies exist on today's clinical prescribing practice together with 2nd and 3rd generation psychotropic drugs.Methods: We performed a practice-based observational study of patients with depression treated with TCP in two psychiatric departments in Berlin to assess side effects, effectiveness, comedication and acceptance of the low-tyramine diet.Results: We identified thirty-two patients treated with TCP at a mean dose of 51.9 mg/day after an average of 3.3 pre-treatments in the current episode. Dosing of TCP and the use of multiple psychotropic comedications indicate a high-intensity treatment. The most frequent side effects resulted from arterial hypotonia (28%). Dietary restrictions were mainly rated as moderate. 59% of patients remitted (HAMD-(21) < 9 OF CGI-I = 1) and 22% responded (HAMD-21 reduction > 50% or CGI-I = 2).Discussion: A high-intensity treatment of inpatients with TCP is clinically feasible, i.e., the use of high doses and multiple comedications with a good benefit-risk-ratio. Prospective data aiming at comparisons with modern antidepressants and clarifying further safety issues are warranted.