Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

A Controlled Study of the Antidepressant Efficacy and Side Effects of ( — )-Deprenyl: A Selective Monoamine Oxidase Inhibitor

A Controlled Study of the Antidepressant Efficacy and Side Effects of ( — )-Deprenyl: A Selective... Abstract • Monoamine oxidase (MAO) inhibitors are effective antidepressants whose use is limited because of unwanted side effects and the possibility of a tyramine-induced hypertensive crisis (cheese reaction). ( - )-Deprenyl (the official nonproprietary name for this substance is selegiline), a selective MAO type B inhibitor, may be safer and have fewer side effects, but its antidepressant efficacy is uncertain. A double-blind placebo-controlled study was carried out in depressed outpatients who were treated with ( - )-deprenyl in an MAO type B selective dose range and at a higher nonselective dose range. (-)-Deprenyl did not have a statistically significant antidepressant effect after three weeks of treatment at doses of 10 mg/d. However, after six weeks and at higher doses (averaging about 30 mg/d for the second three weeks), ( - )-deprenyl was superior to placebo in antidepressant effect with a positive response rate of 50% vs 13.6% and with a 41% reduction in the Hamilton Depression Rating Scale mean score vs 10% in the placebo-treated group. No hypertensive crises were seen. The rate of occurrence of side effects with (-)-deprenyl was no greater than with placebo. It was concluded that (-)-deprenyl is an effective antidepressant in a dose range where it is distinguished by the absence of many of the side effects typical of nonselective MAO inhibitors. References 1. Quitkin F, Rifkin A, Klein DF: Monoamine oxidase inhibitors: A review of antidepressant effectiveness . Arch Gen Psychiatry 1979;36:749-760.Crossref 2. Ravaris CL, Robinson DS, Ives JO, Nies A, Bartlett D: Phenelzine and amitriptyline in the treatment of depression: A comparison of present and past studies . Arch Gen Psychiatry 1980;37:1075-1080.Crossref 3. Ravaris CL, Nies A, Robinson DS, Ives JO, Lamborn KR, Korson L: A multiple-dose controlled study of phenelzine in depression-anxiety states . Arch Gen Psychiatry 1976;33:347-350.Crossref 4. Liebowitz MR, Quitkin FM, Stewart JW, McGrath PJ, Harrison W, Rabkin J, Tricamo E, Markowitz JS, Klein DF: Phenelzine versus imipramine in atypical depression . Arch Gen Psychiatry 1984;41:669-677.Crossref 5. Knoll J: The pharmacology of selective MAO inhibitors , in Youdim MBH, Paykel ES (eds): Monoamine Oxidase Inhibitors: The State of the Art . New York, John Wiley & Sons Inc, 1981, pp 45-61. 6. Knoll J: Deprenyl (selegiline): The history of its development and pharmacological action . Acta Neurol Scand 1983;95:57-80.Crossref 7. Murphy DL, Lipper S, Pickar D, Jimerson D, Cohen RM, Garrick NA, Alterman IS, Campbell IC: Selective inhibition of monoamine oxidase type A: Clinical antidepressant effects and metabolic changes in man , in Youdim MBH, Paykel ES (eds): Monoamine Oxidase Inhibitors: the State of the Art . New York, John Wiley & Sons Inc, 1981, pp 189-205. 8. Lader MH, Sakalis G, Tansella M: Interaction between sympathetic amines and a new monoamine oxidase inhibitor . Psychopharmacologia 1972;18:118-123.Crossref 9. Elsworth JD, Glover V, Reynolds GP, Sandler M, Lees AJ, Phaupradit P, Shaw KM, Stern GM, Kumar P: Deprenyl administration in man: A selective monoamine oxidase B inhibitor without the 'cheese effect.' Psychopharmacology 1978;57:33-38.Crossref 10. Stern GM, Lees AJ, Sandler M: Recent observations on the clinical pharmacology of ( - ) deprenyl . J Neural Transm 1978;43:245-251.Crossref 11. Pickar D, Cohen RM, Jimerson DC, Murphy DL: Tyramine infusions and selective monoamine oxidase inhibitor treatment . Psychopharmacology 1981;74:4-11.Crossref 12. Simpson G, White K, Pi E, Razani J, Sloane RB: Monoamine oxidase inhibition and tyramine sensitivity in L-deprenyl—treated subjects . Psychopharmacol Bull 1983;19:340-342. 13. Lees AJ, Shaw KM, Kahout LJ, Stern GM, Elsworth JD, Sandler M, Youdim MBH: Deprenyl in Parkinson's disease . Lancet 1977;2:791-795.Crossref 14. Varga E, Tringer L: Clinical trial of a new type of promptly acting psychoenergetic agent (phenyl-isopropylmethylpropenyl-HCI, E-250) . Acta Med Hung 1967;23:289-295. 15. Mann JJ, Gershon S: L-Deprenyl: A selective monoamine oxidase type B inhibitor in endogenous depression . Life Sci 1980;26:877-882.Crossref 16. Mann JJ, Frances A, Kaplan RD, Kocsis J, Peselow ED, Gershon S: The relative efficacy of L-deprenyl: A selective monoamine type B inhibitor, in endogenous and nonendogenous depression . J Clin Psychopharmacol 1982;2:54-57.Crossref 17. Mendlewicz J, Youdim MBH: L-Deprenyl: A selective monoamine oxidase type B inhibitor, in the treatment of depression: A double-blind evaluation . Br J Psychiatry 1983;142:508-511.Crossref 18. Quitkin FM, Liebowitz MR, Stewart JW, McGrath PJ, Harrison W, Rabkin JG, Markowitz J, Davies SO: L-Deprenyl in atypical depression . Arch Gen Psychiatry 1984;41:777-781.Crossref 19. Liebowitz MR, Karoum F, Quitkin FM, Davies SO, Schwartz D, Levitt M, Linnoila M: Biochemical effects of L-deprenyl in atypical depressives . Biol Psychiatry 1985;20:558-565.Crossref 20. Mendis N, Pare CMB, Sandler M, Glover V, Stern M: Is the failure of (-) deprenyl, selective monoamine oxidase B inhibitor, to alleviate depression related to freedom from the cheese effect? Psychopharmacology 1981;73:87-90.Crossref 21. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Press Inc, 1980. 22. Hamilton M: Development of a rating scale for primary depressive illness . Br J Soc Psychol 1967;6:278-296.Crossref 23. Gurney C: Diagnostic Scales for Affective Disorders, abstracted. Proceedings of the Fifth World Congress of Psychiatry. Mexico City, 1971, Abstract No 663, p 330. 24. Sheehan DV, Davidson J, Manschreck T, Van Wyck Fleet J: Lack of efficacy of a new antidepressant (bupropion) in the treatment of panic disorder with phobias . J Clin Psychopharmacol 1983;3:28-31.Crossref 25. Robinson DS, Nies A, Ravaris CL, Lamborn KR: The monoamine oxidase inhibitor, phenelzine, in the treatment of depressive-anxiety states . Arch Gen Psychiatry 1973;29:407-413.Crossref 26. Kayser A, Robinson DS, Nies A, Howard D: Response to phenelzine among depressed patients with features of hysteroid dysphoria . Am J Psychiatry 1985;142:486-488. 27. McGrath PJ, Stewart JW, Harrison W, Wager S, Quitkin FM: Phenelzine treatment of melancholia . J Clin Psychiatry 1986;47:420-422. 28. Himmelhoch JM, Detre TA, Kupfer DJ, Swartzburg M, Byck R: Treatment of previously intractable depression with tranylcypromine and lithium . J Nerv Ment Dis 1972;155:216-220.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

A Controlled Study of the Antidepressant Efficacy and Side Effects of ( — )-Deprenyl: A Selective Monoamine Oxidase Inhibitor

Download PDF
6 pages

Loading next page...
 
/lp/american-medical-association/a-controlled-study-of-the-antidepressant-efficacy-and-side-effects-of-vLuDKMrwAl

References (30)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1989.01810010047007
Publisher site
See Article on Publisher Site

Abstract

Abstract • Monoamine oxidase (MAO) inhibitors are effective antidepressants whose use is limited because of unwanted side effects and the possibility of a tyramine-induced hypertensive crisis (cheese reaction). ( - )-Deprenyl (the official nonproprietary name for this substance is selegiline), a selective MAO type B inhibitor, may be safer and have fewer side effects, but its antidepressant efficacy is uncertain. A double-blind placebo-controlled study was carried out in depressed outpatients who were treated with ( - )-deprenyl in an MAO type B selective dose range and at a higher nonselective dose range. (-)-Deprenyl did not have a statistically significant antidepressant effect after three weeks of treatment at doses of 10 mg/d. However, after six weeks and at higher doses (averaging about 30 mg/d for the second three weeks), ( - )-deprenyl was superior to placebo in antidepressant effect with a positive response rate of 50% vs 13.6% and with a 41% reduction in the Hamilton Depression Rating Scale mean score vs 10% in the placebo-treated group. No hypertensive crises were seen. The rate of occurrence of side effects with (-)-deprenyl was no greater than with placebo. It was concluded that (-)-deprenyl is an effective antidepressant in a dose range where it is distinguished by the absence of many of the side effects typical of nonselective MAO inhibitors. References 1. Quitkin F, Rifkin A, Klein DF: Monoamine oxidase inhibitors: A review of antidepressant effectiveness . Arch Gen Psychiatry 1979;36:749-760.Crossref 2. Ravaris CL, Robinson DS, Ives JO, Nies A, Bartlett D: Phenelzine and amitriptyline in the treatment of depression: A comparison of present and past studies . Arch Gen Psychiatry 1980;37:1075-1080.Crossref 3. Ravaris CL, Nies A, Robinson DS, Ives JO, Lamborn KR, Korson L: A multiple-dose controlled study of phenelzine in depression-anxiety states . Arch Gen Psychiatry 1976;33:347-350.Crossref 4. Liebowitz MR, Quitkin FM, Stewart JW, McGrath PJ, Harrison W, Rabkin J, Tricamo E, Markowitz JS, Klein DF: Phenelzine versus imipramine in atypical depression . Arch Gen Psychiatry 1984;41:669-677.Crossref 5. Knoll J: The pharmacology of selective MAO inhibitors , in Youdim MBH, Paykel ES (eds): Monoamine Oxidase Inhibitors: The State of the Art . New York, John Wiley & Sons Inc, 1981, pp 45-61. 6. Knoll J: Deprenyl (selegiline): The history of its development and pharmacological action . Acta Neurol Scand 1983;95:57-80.Crossref 7. Murphy DL, Lipper S, Pickar D, Jimerson D, Cohen RM, Garrick NA, Alterman IS, Campbell IC: Selective inhibition of monoamine oxidase type A: Clinical antidepressant effects and metabolic changes in man , in Youdim MBH, Paykel ES (eds): Monoamine Oxidase Inhibitors: the State of the Art . New York, John Wiley & Sons Inc, 1981, pp 189-205. 8. Lader MH, Sakalis G, Tansella M: Interaction between sympathetic amines and a new monoamine oxidase inhibitor . Psychopharmacologia 1972;18:118-123.Crossref 9. Elsworth JD, Glover V, Reynolds GP, Sandler M, Lees AJ, Phaupradit P, Shaw KM, Stern GM, Kumar P: Deprenyl administration in man: A selective monoamine oxidase B inhibitor without the 'cheese effect.' Psychopharmacology 1978;57:33-38.Crossref 10. Stern GM, Lees AJ, Sandler M: Recent observations on the clinical pharmacology of ( - ) deprenyl . J Neural Transm 1978;43:245-251.Crossref 11. Pickar D, Cohen RM, Jimerson DC, Murphy DL: Tyramine infusions and selective monoamine oxidase inhibitor treatment . Psychopharmacology 1981;74:4-11.Crossref 12. Simpson G, White K, Pi E, Razani J, Sloane RB: Monoamine oxidase inhibition and tyramine sensitivity in L-deprenyl—treated subjects . Psychopharmacol Bull 1983;19:340-342. 13. Lees AJ, Shaw KM, Kahout LJ, Stern GM, Elsworth JD, Sandler M, Youdim MBH: Deprenyl in Parkinson's disease . Lancet 1977;2:791-795.Crossref 14. Varga E, Tringer L: Clinical trial of a new type of promptly acting psychoenergetic agent (phenyl-isopropylmethylpropenyl-HCI, E-250) . Acta Med Hung 1967;23:289-295. 15. Mann JJ, Gershon S: L-Deprenyl: A selective monoamine oxidase type B inhibitor in endogenous depression . Life Sci 1980;26:877-882.Crossref 16. Mann JJ, Frances A, Kaplan RD, Kocsis J, Peselow ED, Gershon S: The relative efficacy of L-deprenyl: A selective monoamine type B inhibitor, in endogenous and nonendogenous depression . J Clin Psychopharmacol 1982;2:54-57.Crossref 17. Mendlewicz J, Youdim MBH: L-Deprenyl: A selective monoamine oxidase type B inhibitor, in the treatment of depression: A double-blind evaluation . Br J Psychiatry 1983;142:508-511.Crossref 18. Quitkin FM, Liebowitz MR, Stewart JW, McGrath PJ, Harrison W, Rabkin JG, Markowitz J, Davies SO: L-Deprenyl in atypical depression . Arch Gen Psychiatry 1984;41:777-781.Crossref 19. Liebowitz MR, Karoum F, Quitkin FM, Davies SO, Schwartz D, Levitt M, Linnoila M: Biochemical effects of L-deprenyl in atypical depressives . Biol Psychiatry 1985;20:558-565.Crossref 20. Mendis N, Pare CMB, Sandler M, Glover V, Stern M: Is the failure of (-) deprenyl, selective monoamine oxidase B inhibitor, to alleviate depression related to freedom from the cheese effect? Psychopharmacology 1981;73:87-90.Crossref 21. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Press Inc, 1980. 22. Hamilton M: Development of a rating scale for primary depressive illness . Br J Soc Psychol 1967;6:278-296.Crossref 23. Gurney C: Diagnostic Scales for Affective Disorders, abstracted. Proceedings of the Fifth World Congress of Psychiatry. Mexico City, 1971, Abstract No 663, p 330. 24. Sheehan DV, Davidson J, Manschreck T, Van Wyck Fleet J: Lack of efficacy of a new antidepressant (bupropion) in the treatment of panic disorder with phobias . J Clin Psychopharmacol 1983;3:28-31.Crossref 25. Robinson DS, Nies A, Ravaris CL, Lamborn KR: The monoamine oxidase inhibitor, phenelzine, in the treatment of depressive-anxiety states . Arch Gen Psychiatry 1973;29:407-413.Crossref 26. Kayser A, Robinson DS, Nies A, Howard D: Response to phenelzine among depressed patients with features of hysteroid dysphoria . Am J Psychiatry 1985;142:486-488. 27. McGrath PJ, Stewart JW, Harrison W, Wager S, Quitkin FM: Phenelzine treatment of melancholia . J Clin Psychiatry 1986;47:420-422. 28. Himmelhoch JM, Detre TA, Kupfer DJ, Swartzburg M, Byck R: Treatment of previously intractable depression with tranylcypromine and lithium . J Nerv Ment Dis 1972;155:216-220.Crossref

Journal

Archives of General Psychiatry – American Medical Association

Published: Jan 1, 1989

There are no references for this article.