Combineren van klassieke monoamineoxidaseremmer en tricyclisch antidepressivum bij therapieresistente depressie: gevalsbeschrijving en literatuuroverzicht

Translated title of the contribution: Combining a classic monoamine oxidase inhibitor with a tricyclic antidepressant in therapy-resistant depression: a case report and literature review

P. Schipper, L. VANMOLKOT, Frank Peeters

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Combining a monoamine oxidase inhibitor (MAOI) with a tricyclic antidepressant (TCA) is considered to be contra-indicated because there is a risk that the recipient develops a serotonin syndrome. An accidental clinical observation motivated us to search and study publications relating to the risk and effectivity of combining these two types of antidepressants. AIM: To search and study articles on the risks and effectivity of combining the use of MAOIS and TCAS in the treatment of therapy-resistant depression. METHOD: We searched in PubMed and also studied relevant articles that papers referred to in the database. RESULTS Because many case-reports have been misinterpreted, the patients' risk of developing a serotonin syndrome and other complications as a result of the combined use of MAOIS and TCAS is overestimated. The literature provides some evidence that the combination therapy may be effective for some patients who have not responded to TCA or MAO-I monotherapy. Combination therapy seems to be safe if monitored carefully and if TCAS with marked serotonergic affinity are avoided. To enhance safety, the MAOI should be added to a TCA or both the TCA and MAOI should be started simultaneously and titrated slowly. CONCLUSION: The combination of a MAOI and a TCA can be a possible treatment for patients with treatment resistant depression when monotherapy with either a TCA or a MAOI has failed.

Translated title of the contributionCombining a classic monoamine oxidase inhibitor with a tricyclic antidepressant in therapy-resistant depression: a case report and literature review
Original languageDutch
Pages (from-to)886-890
JournalTijdschrift voor Psychiatrie
Volume58
Issue number12
Publication statusPublished - 2016

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