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The Carlat Psychiatry Podcast
Stahl Goes Generic: 3 Reasons to use MAOIs
Jun 12, 2023
Stephen Stahl, a psychiatrist and author, discusses 3 reasons to use MAOIs: atypical depression, treatment-resistant depression, and social anxiety disorder. He explores the efficacy and comparison of MAOIs and tricyclic antidepressants, mentions different MAOIs for depression treatment, and highlights the importance of covering unsponsored topics in the psychiatric press.
26:24
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Quick takeaways
- MAOIs can be beneficial for certain cases of treatment-resistant depression, showing a higher response rate compared to tricyclic antidepressants.
- Understanding the specific features of depression, such as atypical or melancholic, is crucial in determining the appropriate usage of MAOIs.
Deep dives
Benefits of MAOIs in Treatment-Resistant Depression
MAOIs are considered a second or third line treatment option for treatment-resistant depression. While the evidence supporting their efficacy is anecdotal, a 1993 study compared phenelzine, an MAOI, with amitriptyline, a tricyclic antidepressant, in patients with chronic non-melancholic treatment-resistant depression. The study showed that switching to phenelzine resulted in a higher response rate (67%) compared to switching to amitriptyline (41%), indicating the potential benefits of MAOIs in certain cases of treatment-resistant depression.
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