Advertisement

Psychopharmacology

, Volume 82, Issue 3, pp 258–262 | Cite as

Tranylcypromine vs nortriptyline vs placebo in depressed outpatients: a controlled trial

  • Kerrin White
  • Javad Razani
  • Barbara Cadow
  • Ronald Gelfand
  • Ruby Palmer
  • George Simpson
  • R. Bruce Sloane
Original Investigations

Abstract

This study was designed to compare the therapeutic and adverse effects of tranylcypromine (a monoamine oxidase inhibitor), nortriptyline (a tricyclic antidepressant), and placebo. A total of 122 depressed outpatients randomly assigned to double-blind treatment with one of these agents completed the 4-week protocol. Treatment groups were balanced for proportions of endogenous versus nonendogenous depressions, defined according to the Research Diagnostic Criteria; however, nonendogenous depressions outnumbered endogenous depressions by such a large proportion (4:1) that meaningful statistical comparisons were limited to the nonendogenous group. In this group, both active drugs proved more effective than placebo, with little differences between the two active drugs except in the areas of side effects and of differential sensitivity of the outcome scales to a given drug. It was concluded that tranylcypromine, a drug which has received relatively little use and study in recent years, represents an effective and reasonably safe treatment for nonendogenous depression, although significant advantages over tricyclics with this disorder remain to be demonstrated.

Key words

Depression Endogenous Nonendogenous Monoamine oxidase inhibitor Tricyclic Tranylcypromine Nortriptyline 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Atkinson RM, Ditman KS (1965) Tranylcypromine: a review. Clin Pharmacol Ther 6:631–655Google Scholar
  2. Blackwell B, Taylor D (1967) An operational evaluation of monoamine oxidase inhibitors. Proc R Soc Med 60:42–46Google Scholar
  3. Cole JO, Davis JM (1975) Antidepressant drugs. In: Freedman AM, Kaplan HI, Sadock BJ (eds) Comprehensive textbook of psychiatry/II, vol 2. Williams & Wilkins Company, Baltimore, pp 1941–1956Google Scholar
  4. Everett GM (1968) Comparison of hydrazine and non-hydrazine monoamine oxidase inhibitors. In: Rocha e Silva M (ed) Proceedings of the third international pharmacological meeting, vol 10. Pergamon Press, Oxford, pp 79–82Google Scholar
  5. Free SM, Overall JE (1977) The brief outpatient psychopathology scale (BOPS). J Clin Psychol 33:677–688Google Scholar
  6. Glick BS (1964) Double-blind study of tranylcypromine and phenelzine in depression. Dis Nerv Syst 25:617–619Google Scholar
  7. Gottfries CG (1963) Clinical trial with the monoamine oxidase inhibitor tranylcypromine on a psychiatric clientele. Acta Psychiatr Scand 39:463–472Google Scholar
  8. Hendley ED, Snyder SH (1968) Relationship between the action of monoamine oxidase inhibitors on the noradrenaline uptake system and their antidepressant efficacy. Nature 220:1330–1131Google Scholar
  9. Himmelhoch JM, Fuchs CE, Neil JF, Symons BJ, Ingenito JE (1980) Tranylcypromine treatment of anergic depression. Prog Neuropsychopharmacol (Suppl): 173–174Google Scholar
  10. Knoll J (1981) The pharmacology of selective MAO inhibitors. In: Youdim MBH, Paykel ES (eds) Monoamine oxidase inhibitors — the state of the art. John Wiley & Sons, London, pp 45–61Google Scholar
  11. Lesse S (1978) Psychotherapy in combination with antidepressant drugs in severely depressed out-patients-20-year evaluation. Am J Psychother 32:48–73Google Scholar
  12. Lipper S, Murphy DL, Slater S, Buchsbaum MS (1979) Comparative behavioral effects of clorgyline and pargyline in man: a preliminary evaluation. Psychopharmacology 62:123–128Google Scholar
  13. Morris JB, Beck AT (1974) The efficacy of antidepressant drugs. Arch Gen Psychiatry 30:667–674Google Scholar
  14. Mountjoy CO, Roth M, Garside RF, Leitch IM (1977) A clinical trial of phenelzine in anxiety depressive and phobic neuroses. Br J Psychiatry 131:486–492Google Scholar
  15. Nies A, Robinson DS (1981) Comparison of clinical effects of amitriptyline and phenelzine treatment. In: Youdim MBH, Paykel ES (eds) Monoamine oxidase inhibitors — the state of the art. John Wiley & Sons. London, pp 141–148Google Scholar
  16. Paykel ES, Rowan PR, Parker RR, Bhat AV (1982) Response to phenelzine and amitriptyline in subtypes of outpatient depression. Arch Gen Psychiatry 39:1041–1049Google Scholar
  17. Razani J, White K, White J, Simpson G, Sloane RB, Rebal R, Palmer R (1983) The safety and efficacy of combined amitriptyline and tranylcypromine antidepressant treatment: a controlled trial. Arch Gen Psychiatry 40:657–661Google Scholar
  18. Richmond PW, Roberts AH (1964) A comparative trial of imipramine, amitriptyline, isocarboxazid, and tranylcypromine in out-patient depressive illness. Br J Psychiatry 110:846–850Google Scholar
  19. Robinson DS, Nies A, Ravaris CL, Ives JO, Bartlett D (1978) Clinical pharmacology of phenelzine. Arch Gen Psychiatry 35:629–635Google Scholar
  20. Spitzer RL, Endicott J, Robins E (1977) Research diagnostic criteria (RDC) for a selected group of functional disorders, 3rd edn. Biometrics Research, New YorkGoogle Scholar
  21. Tyrer P, Candy J, Kelly D (1973) Phenelzine in phobic anxiety: a controlled trial. Psychol Med 3:120–124Google Scholar
  22. White K, Pistole T, Boyd JL (1980) Combined MAOI-TCA vs. single antidepressant treatment: a pilot study. Am J Psychiatry 137:1422–1425Google Scholar
  23. Zeller EA (1968) Structure-activity relationship of monoamine oxidase inhibitors. In: Rocha e Silva M (ed) Proceedings of the third international pharmacological meeting, vol 10 Pergamon Press, Oxford, pp 3–13Google Scholar

Copyright information

© Springer-Verlag 1984

Authors and Affiliations

  • Kerrin White
    • 1
    • 2
  • Javad Razani
    • 1
    • 2
  • Barbara Cadow
    • 1
    • 2
  • Ronald Gelfand
    • 1
    • 2
  • Ruby Palmer
    • 1
    • 2
  • George Simpson
    • 1
    • 2
  • R. Bruce Sloane
    • 1
    • 2
  1. 1.Department of PsychiatryUniversity of Southern California School of MedicineLos AngelesUSA
  2. 2.Behavioral SciencesUniversity of Southern California School of MedicineLos AngelesUSA

Personalised recommendations