Side effects of isocarboxazid.

Three double-blind, placebo controlled studies found isocarboxazid (40-50 mg/day) to be efficacious and safe for the treatment of atypical depression. The few instances of liver function elevations were generally borderline; one patient had a marked increase of both SGOT and SGPT (with normal bilirubin and alkaline phosphatase) at Week 6 which normalized over the next several months. Another patient had a mild, temporary hypertensive reaction after eating cheese but did not require any treatment alterations. Drops in both systolic and diastolic blood pressures, as well as orthostatic changes, were common but generally mild and well-tolerated. The most frequently noted side effects were dizziness, headache, dry mouth, insomnia, and constipation. Clinical adverse reactions tended to be mild and to respond to dosage decreases. Isocarboxazid appears to be an underutilized and potentially valuable agent for the treatment of depressed patients.