Schmauss M, Erfurth A
Psychiatrische Klinik der Universität München.
Psychiatr Prax. 1989 Aug;16 Suppl 1:2-6.
The MAOIs have been an underutilized and overly feared class of medical compounds potentially useful for a wide spectrum of disorders. At one end of the spectrum they have been found effective for several anxiety disorders, especially when phobic or panic reactions are part of the symptoms. At the other end of the spectrum, they are effective in patients with melancholic depressions, especially outpatients who have lack of energy, a history of bipolar disorder, or a nonresponse to conventional treatment with TCAs. However, their major role for psychiatric patients appears to be in the large heterogeneous group of ambulatory depressives who have symptoms of both anxiety and depression. The danger of side effects or toxicity associated with MAOIs has been exaggerated. Most side effects are relatively mild and are controllable by dose reduction or other supportive measures. The adverse reaction of most concern, hypertensive crisis, is great extent preventable with appropriate dietary restrictions. Selective and reversible MAOI's may have a better safety profile compared to classical MAOI's.
单胺氧化酶抑制剂(MAOIs)一直是一类未得到充分利用且被过度恐惧的医学化合物,可能对多种疾病有用。在这一范围的一端,已发现它们对几种焦虑症有效,尤其是当恐惧或惊恐反应是症状的一部分时。在另一端,它们对患有忧郁症的患者有效,特别是那些缺乏精力、有双相情感障碍病史或对三环类抗抑郁药(TCAs)常规治疗无反应的门诊患者。然而,它们对精神病患者的主要作用似乎在于一大类具有焦虑和抑郁症状的非住院抑郁症患者。与MAOIs相关的副作用或毒性风险被夸大了。大多数副作用相对较轻,可通过减少剂量或其他支持措施加以控制。最令人担忧的不良反应,即高血压危象,在很大程度上可通过适当的饮食限制来预防。与经典的MAOIs相比,选择性和可逆性MAOIs可能具有更好的安全性。