White K, Simpson G
J Clin Psychopharmacol. 1981 Sep;1(5):264-82. doi: 10.1097/00004714-198109000-00002.
Recent studies have shown that monoamine oxidase inhibitors (MAOIs), in appropriate patients and with proper precautions, are not as dangerous as once thought, especially in comparison to alternative antidepressants. We review the literature regarding the combined use of MAOIs and tricyclic antidepressants, which has been reported to be both highly toxic and highly effective. A large number of reports of adverse effects and their management, uncontrolled clinical trials, and animal studies are summarized. We also discuss the three controlled studies of combined MAOI-tricyclic therapy that have been undertaken. We conclude that the hazards of combination therapy have been exaggerated and that MAOI-tricyclic therapy is a reasonable approach in patients found resistant to standard antidepressant treatment if certain precautions are observed.
近期研究表明，对于合适的患者并采取适当的预防措施，单胺氧化酶抑制剂（MAOIs）并不像曾经认为的那样危险，尤其是与其他抗抑郁药相比。我们回顾了关于MAOIs与三环类抗抑郁药联合使用的文献，据报道这种联合使用既具有高毒性又具有高效性。总结了大量关于不良反应及其处理的报告、非对照临床试验和动物研究。我们还讨论了已开展的三项MAOI-三环类联合治疗的对照研究。我们得出结论，联合治疗的风险被夸大了，并且如果遵守某些预防措施，MAOI-三环类治疗对于那些对标准抗抑郁治疗耐药的患者来说是一种合理的方法。
