Efficacy and tolerability of monoamine oxidase inhibitors for the treatment of depressive episodes in mood disorders: A systematic review and network meta-analysis

Anna Giménez-Palomo; Anjli K Chamdal; Natalie Gottlieb; Mojtaba Lotfaliany; Tahir Jokinen; Eslam M Bastawy; Katherine Adlington; Nawal Benachar; Seetal Dodd; Isabella Pacchiarotti; Eduard Vieta; Michael Berk; Paul R A Stokes

doi:10.1111/acps.13728

Efficacy and tolerability of monoamine oxidase inhibitors for the treatment of depressive episodes in mood disorders: A systematic review and network meta-analysis

Anna Giménez-Palomo, Anjli K Chamdal, Natalie Gottlieb, Mojtaba Lotfaliany, Tahir Jokinen, Eslam M Bastawy, Katherine Adlington, Nawal Benachar, Seetal Dodd, Isabella Pacchiarotti, Eduard Vieta, Michael Berk, Paul R A Stokes

Research output: Contribution to journal › Review article › peer-review

2 Citations (Scopus)

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Abstract

BACKGROUND: Monoamine oxidase inhibitors (MAOIs) are considered third-line treatments for treatment resistant depression; however, they are underused in clinical practice.

AIMS: This study aimed to assess the efficacy, tolerability, and acceptability of MAOIs for the treatment of depression in comparison with other antidepressant treatments.

METHODS: A systematic review and network meta-analysis of randomised clinical trials was performed to compare the efficacy, tolerability and acceptability between MAOIs and other antidepressant treatments for the treatment of depressive episodes.

RESULTS: A total of 83 double-blinded, randomised controlled trials were included in the analysis, with 7765 participants assigned to an active treatment and 1844 assigned to placebo. Several MAOIs, including isocarboxazid, phenelzine, tranylcypromine and moclobemide, showed significantly higher efficacy compared with placebo. The tolerability and acceptability of MAOIs was comparable to other antidepressants.

LIMITATIONS: A disproportionate number of studies investigating the most commonly used MAOIs, such as moclobemide and phenelzine, and a lack of specific studies focusing on treatment-resistant and atypical depression.

CONCLUSIONS: MAOIs are similar in efficacy to other antidepressants for the treatment of depression. However, more studies are needed comparing MAOI treatment in people with treatment-resistant, atypical and bipolar depression.

Original language	English
Pages (from-to)	500-515
Number of pages	16
Journal	Acta Psychiatrica Scandinavica
Volume	150
Issue number	6
Early online date	12 Jul 2024
DOIs	https://doi.org/10.1111/acps.13728
Publication status	Published - Dec 2024

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10.1111/acps.13728

MAOI network meta-analysis_Acta_Stokes_2024Accepted author manuscript, 781 KBLicence: CC BY

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Giménez-Palomo, A., Chamdal, A. K., Gottlieb, N., Lotfaliany, M., Jokinen, T., Bastawy, E. M., Adlington, K., Benachar, N., Dodd, S., Pacchiarotti, I., Vieta, E., Berk, M., & Stokes, P. R. A. (2024). Efficacy and tolerability of monoamine oxidase inhibitors for the treatment of depressive episodes in mood disorders: A systematic review and network meta-analysis. Acta Psychiatrica Scandinavica, 150(6), 500-515. https://doi.org/10.1111/acps.13728

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title = "Efficacy and tolerability of monoamine oxidase inhibitors for the treatment of depressive episodes in mood disorders: A systematic review and network meta-analysis",

abstract = "BACKGROUND: Monoamine oxidase inhibitors (MAOIs) are considered third-line treatments for treatment resistant depression; however, they are underused in clinical practice.AIMS: This study aimed to assess the efficacy, tolerability, and acceptability of MAOIs for the treatment of depression in comparison with other antidepressant treatments.METHODS: A systematic review and network meta-analysis of randomised clinical trials was performed to compare the efficacy, tolerability and acceptability between MAOIs and other antidepressant treatments for the treatment of depressive episodes.RESULTS: A total of 83 double-blinded, randomised controlled trials were included in the analysis, with 7765 participants assigned to an active treatment and 1844 assigned to placebo. Several MAOIs, including isocarboxazid, phenelzine, tranylcypromine and moclobemide, showed significantly higher efficacy compared with placebo. The tolerability and acceptability of MAOIs was comparable to other antidepressants.LIMITATIONS: A disproportionate number of studies investigating the most commonly used MAOIs, such as moclobemide and phenelzine, and a lack of specific studies focusing on treatment-resistant and atypical depression.CONCLUSIONS: MAOIs are similar in efficacy to other antidepressants for the treatment of depression. However, more studies are needed comparing MAOI treatment in people with treatment-resistant, atypical and bipolar depression.",

author = "Anna Gim{\'e}nez-Palomo and Chamdal, {Anjli K} and Natalie Gottlieb and Mojtaba Lotfaliany and Tahir Jokinen and Bastawy, {Eslam M} and Katherine Adlington and Nawal Benachar and Seetal Dodd and Isabella Pacchiarotti and Eduard Vieta and Michael Berk and Stokes, {Paul R A}",

note = "Publisher Copyright: {\textcopyright} 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",

year = "2024",

month = dec,

doi = "10.1111/acps.13728",

language = "English",

volume = "150",

pages = "500--515",

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issn = "0001-690X",

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Giménez-Palomo, A, Chamdal, AK, Gottlieb, N, Lotfaliany, M, Jokinen, T, Bastawy, EM, Adlington, K, Benachar, N, Dodd, S, Pacchiarotti, I, Vieta, E, Berk, M & Stokes, PRA 2024, 'Efficacy and tolerability of monoamine oxidase inhibitors for the treatment of depressive episodes in mood disorders: A systematic review and network meta-analysis', Acta Psychiatrica Scandinavica, vol. 150, no. 6, pp. 500-515. https://doi.org/10.1111/acps.13728

Efficacy and tolerability of monoamine oxidase inhibitors for the treatment of depressive episodes in mood disorders: A systematic review and network meta-analysis. / Giménez-Palomo, Anna; Chamdal, Anjli K; Gottlieb, Natalie et al.
In: Acta Psychiatrica Scandinavica, Vol. 150, No. 6, 12.2024, p. 500-515.

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - Efficacy and tolerability of monoamine oxidase inhibitors for the treatment of depressive episodes in mood disorders

T2 - A systematic review and network meta-analysis

AU - Giménez-Palomo, Anna

AU - Chamdal, Anjli K

AU - Gottlieb, Natalie

AU - Lotfaliany, Mojtaba

AU - Jokinen, Tahir

AU - Bastawy, Eslam M

AU - Adlington, Katherine

AU - Benachar, Nawal

AU - Dodd, Seetal

AU - Pacchiarotti, Isabella

AU - Vieta, Eduard

AU - Berk, Michael

AU - Stokes, Paul R A

PY - 2024/12

Y1 - 2024/12

N2 - BACKGROUND: Monoamine oxidase inhibitors (MAOIs) are considered third-line treatments for treatment resistant depression; however, they are underused in clinical practice.AIMS: This study aimed to assess the efficacy, tolerability, and acceptability of MAOIs for the treatment of depression in comparison with other antidepressant treatments.METHODS: A systematic review and network meta-analysis of randomised clinical trials was performed to compare the efficacy, tolerability and acceptability between MAOIs and other antidepressant treatments for the treatment of depressive episodes.RESULTS: A total of 83 double-blinded, randomised controlled trials were included in the analysis, with 7765 participants assigned to an active treatment and 1844 assigned to placebo. Several MAOIs, including isocarboxazid, phenelzine, tranylcypromine and moclobemide, showed significantly higher efficacy compared with placebo. The tolerability and acceptability of MAOIs was comparable to other antidepressants.LIMITATIONS: A disproportionate number of studies investigating the most commonly used MAOIs, such as moclobemide and phenelzine, and a lack of specific studies focusing on treatment-resistant and atypical depression.CONCLUSIONS: MAOIs are similar in efficacy to other antidepressants for the treatment of depression. However, more studies are needed comparing MAOI treatment in people with treatment-resistant, atypical and bipolar depression.

AB - BACKGROUND: Monoamine oxidase inhibitors (MAOIs) are considered third-line treatments for treatment resistant depression; however, they are underused in clinical practice.AIMS: This study aimed to assess the efficacy, tolerability, and acceptability of MAOIs for the treatment of depression in comparison with other antidepressant treatments.METHODS: A systematic review and network meta-analysis of randomised clinical trials was performed to compare the efficacy, tolerability and acceptability between MAOIs and other antidepressant treatments for the treatment of depressive episodes.RESULTS: A total of 83 double-blinded, randomised controlled trials were included in the analysis, with 7765 participants assigned to an active treatment and 1844 assigned to placebo. Several MAOIs, including isocarboxazid, phenelzine, tranylcypromine and moclobemide, showed significantly higher efficacy compared with placebo. The tolerability and acceptability of MAOIs was comparable to other antidepressants.LIMITATIONS: A disproportionate number of studies investigating the most commonly used MAOIs, such as moclobemide and phenelzine, and a lack of specific studies focusing on treatment-resistant and atypical depression.CONCLUSIONS: MAOIs are similar in efficacy to other antidepressants for the treatment of depression. However, more studies are needed comparing MAOI treatment in people with treatment-resistant, atypical and bipolar depression.

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U2 - 10.1111/acps.13728

DO - 10.1111/acps.13728

M3 - Review article

C2 - 39001570

SN - 0001-690X

VL - 150

SP - 500

EP - 515

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

IS - 6

ER -

Efficacy and tolerability of monoamine oxidase inhibitors for the treatment of depressive episodes in mood disorders: A systematic review and network meta-analysis

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