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Pharmacopsychiatry 2008; 41(6): 252-257
DOI: 10.1055/s-0028-1083819
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Safety of High-intensity Treatment with the Irreversible Monoamine Oxidase Inhibitor Tranylcypromine in Patients with Treatment-resistant Depression

M. Adli 1 , M. Pilhatsch 2 , M. Bauer 2 , U. Köberle 3 , R. Ricken 1 , G. Janssen 1 , S. Ulrich 4 , T. Bschor 2 , 3
  • 1Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
  • 2Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
  • 3Department of Psychiatry and Psychotherapy, Jewish Hospital of Berlin, Berlin, Germany
  • 4esparma GmbH, Osterweddingen, Germany
Further Information

Publication History

received 07.04.2008 revised 15.05.2008

accepted 19.05.2008

Publication Date:
09 December 2008 (online)

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Abstract

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 or 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.

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Correspondence

M. AdliMD 

Department of Psychiatry and Psychotherapy

Charité – Universitätsmedizin Berlin

Campus Charité Mitte

Charitéplatz 1

10117 Berlin

Germany

Phone: +49/30/450 517 146

Fax: +49/30/450 517 944

Email: mazda.adli@charite.de

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