Journal article

MAOIs - does the evidence warrant their resurrection?

David Menkes, Peter Bosanac, David Castle

Australasian Psychiatry | SAGE PUBLICATIONS LTD | Published : 2016


OBJECTIVE: The place of monoamine oxidase inhibitors (MAOIs) in psychiatry is reviewed, and the question posed as to whether they are now justifiably disregarded by prescribers. METHOD: Multiple databases (PubMed, Medline, Embase, Cochrane) were interrogated to provide an overview regarding the use, efficacy and toxicity of MAOIs. Data regarding funded use of these agents in New Zealand were obtained from PHARMAC. RESULTS: Evidence supports the use of MAOIs in major depressive disorder, certain anxiety disorders and, to lesser extent, bipolar depression. Older non-selective agents, such as phenelzine and tranylcypromine, have distinctive efficacy in 'atypical' and treatment-resistant depress..

View full abstract


Funding Acknowledgements

David Castle has received grant monies for research from Eli Lilly, Janssen Cilag, Roche, Allergen, Bristol-Myers Squibb, Pfizer, Lundbeck, Astra Zeneca, Hospira; travel support and honoraria for talks and consultancy from Eli Lilly, Bristol-Myers Squibb, Astra Zeneca, Lundbeck, Janssen Cilag, Pfizer, Organon, Sanofi-Aventis, Wyeth, Hospira, Servier; and is a current Advisory Board Member for Lu AA21004: Lundbeck; Varenicline: Pfizer; Asenapine: Lundbeck; Aripiprazole LAI: Lundbeck; Lisdexamfetamine: Shire; Lurasidone: Servier. He has no stocks or shares in any pharmaceutical company.In 2013-2014, David Menkes was a paid Data Safety Monitoring Board member for a phase 1B clinical study of noribogaine in opiate addiction (sponsored by DemeRx, Inc.). He has previously had research support from and/or conducted contract research for Roche (moclobemide, 1987), Eli Lilly (fluoxetine, 1989-90), and Douglas Pharmaceuticals (clozapine, 2011). Between 2003 and 2011, he served as a paid expert witness on behalf of plaintiffs in civil cases defended by Eli Lilly (fluoxetine), Roche (clonazepam), GSK (paroxetine), Pfizer (sertraline), Lundbeck (escitalopram) and Wyeth (venlafaxine).