Continuation and maintenance treatments in major depression: the neglected role of monoamine oxidase inhibitors

Abstract

The importance of continuation and maintenance antidepressant therapy has been increasingly recognized, but usually focuses on tricyclic and selective serotonin reuptake inhibitor (SSRI) antidepressants. This review examines the evidence in support of classical monoamine oxidase inhibitor (MAOI) agents and the selective reversible monoamine oxidase type A inhibitor moclobemide in continuation and maintenance therapy. Phenelzine and tranylcypromine have demonstrated long-term efficacy but often cause intolerable side effects. Moclobemide is a well-tolerated alternative antidepressant, but there is a need for prospective controlled trials to evaluate its long-term efficacy.