Young J P, Lader M H, Hughes W C
Br Med J. 1979 Nov 24;2(6201):1315-7. doi: 10.1136/bmj.2.6201.1315.
A study was carried out in which 135 mildly or moderately depressed outpatients were randomly allocated to one of five groups receiving six weeks' treatment weith antidepressant drugs. The groups received a tricyclic antidepressant (trimipramine; mean dose 106 mg at night) or a monoamine oxidase inhibitor (MAOI) (phenelzine or isocarboxazid; mean doses 45 and 32 mg/day respectively), or a combination of the two (phenelzine plus trimipramine or isocarboxazid plus trimipramine). Various scales were used to measure depression before and at one, three, and six weeks of treatment, and results were assessed blindly. The tricyclic antidepressant was found to be consistently superior to the MAOIs and the combined treatments. Some differential indicators of response to the various antidepressants were found--for example, patients with initial complaints of dizziness, suicidal ideas, irritability, and insomnia and a longer duration of illness were more likely to respond to trimipramine--but these were of only modest significance. Side effects were not troublesome in any group. It is concluded that neither MAOIs nor MAOIs combined with tricyclic antidepressants are the treatment of first choice in unselected outpatients with mild or moderate depression.
开展了一项研究，将135名轻度或中度抑郁的门诊患者随机分配到接受六周抗抑郁药物治疗的五组中的一组。这些组分别接受三环类抗抑郁药（曲米帕明；夜间平均剂量106毫克）或单胺氧化酶抑制剂（MAOI）（苯乙肼或异卡波肼；平均剂量分别为45毫克/天和32毫克/天），或两者联合使用（苯乙肼加曲米帕明或异卡波肼加曲米帕明）。在治疗前以及治疗1周、3周和6周时使用各种量表测量抑郁情况，并对结果进行盲法评估。发现三环类抗抑郁药始终优于MAOI和联合治疗。发现了一些对各种抗抑郁药反应的差异指标——例如，最初有头晕、自杀念头、易怒和失眠主诉且病程较长的患者对曲米帕明的反应更可能较好——但这些指标的意义不大。任何一组的副作用都不严重。得出的结论是，无论是MAOI还是MAOI与三环类抗抑郁药联合使用，都不是未经过挑选的轻度或中度抑郁门诊患者的首选治疗方法。
