July 1976

Combining Tricyclic and Monoamine Oxidase Inhibitor Antidepressants

Author Affiliations

From the Department of Psychiatry, Washington University School of Medicine (Drs Spiker and Pugh); and the Malcolm Bliss Mental Health Center, St Louis (Dr Pugh). Dr Spiker is now with the University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, Pittsburgh.

Arch Gen Psychiatry. 1976;33(7):828-830. doi:10.1001/archpsyc.1976.01770070058005

• The charts of 150 inpatients and 51 outpatients treated with a monoamine oxidase inhibitor (MAOI)-tricyclic antidepressant combination were reviewed. The incidence and severity of side effects among the patients on the combined regimen were essentially the same as those seen in the control groups. There were no deaths or strokes resulting from use of this regimen. The most frequent troublesome side effect was orthostatic hypotension.

We conclude that the use of a MAOI-tricyclic combination in oral therapeutic doses is safe. However, the efficacy of this combination has not yet been proved, and it may be particularly toxic if taken in an overdose.