Tranylcypromine: patterns and predictors of response.

Data on 58 patients with major depressive episodes treated with tranylcypromine in the course of two controlled, 4-week trials were examined for clinical predictors of favorable response and patterns of symptom improvement and side effects. Predictors of positive outcome with tranylcypromine were associated with greater initial severity on the Hamilton Rating Scale for Depression (HAM-D) ratings of depressed mood, psychomotor retardation, and weight loss, and with lower initial severity on ratings of middle and late insomnia. Distinct quality of depressed mood predicted poorer response; endogenicity, as defined by Research Diagnostic Criteria or the Nies-Robinson Diagnostic Index, failed to predict outcome. Analysis of improvement on individual symptom items of the HAM-D and Zung Self-Rating Depression Scale indicated a generalized patholysis except in a few areas such as appetite/weight loss and insomnia, which may reflect specific side effects of tranylcypromine.