Nolen W A, Hoencamp E, Bouvy P F, Haffmans P M
Department of Biological Psychiatry, Psychiatric Centre Bloemendaal, The Hague, The Netherlands.
Clin Neuropharmacol. 1993;16 Suppl 2:S69-76.
Monoamine oxidase (MAO) inhibitors (MAOIs) provide effective alternative therapy for those patients with major depression who do not respond to tricyclic antidepressants or such related compounds as the selective serotonin reuptake inhibitors. This article reviews studies on the efficacy of both the classical MAOIs and the new, selective monoamine oxidase-A (MAO-A) inhibitor brofaromine in patients with resistant major depression. Brofaromine appears to be as effective as the older MAOIs in these patients, but is better tolerated and safer to use. Brofaromine was also found to be better tolerated than lithium when added to treatment with the tetracyclic antidepressant maprotiline. More studies on the benefits of the new MAO-A inhibitors in resistant depression are indicated, not only with brofaromine but also with moclobemide, which to date has not been studied in this indication. Studies to determine their place in the overall treatment strategy of major depression are also needed.
单胺氧化酶（MAO）抑制剂（MAOIs）为那些对三环类抗抑郁药或诸如选择性5-羟色胺再摄取抑制剂等相关化合物无反应的重度抑郁症患者提供了有效的替代疗法。本文回顾了关于经典MAOIs和新型选择性单胺氧化酶-A（MAO-A）抑制剂溴法罗明对难治性重度抑郁症患者疗效的研究。在这些患者中，溴法罗明似乎与较老的MAOIs一样有效，但耐受性更好且使用更安全。当与四环类抗抑郁药马普替林联合使用时，还发现溴法罗明比锂盐耐受性更好。不仅需要对新型MAO-A抑制剂（不仅是溴法罗明，还有至今尚未在此适应症中进行研究的吗氯贝胺）在难治性抑郁症中的益处开展更多研究。还需要开展研究以确定它们在重度抑郁症整体治疗策略中的地位。
