January 1989

A Controlled Study of the Antidepressant Efficacy and Side Effects of ( — )-DeprenylA Selective Monoamine Oxidase Inhibitor

Author Affiliations

From the Laboratory of Psychopharmacology, Department of Psychiatry, Cornell University Medical College, New York. Dr Pearlstein is now with the University of Pittsburgh School of Medicine, and Dr Brown is now with The New York State Psychiatric Institute, New York.

Arch Gen Psychiatry. 1989;46(1):45-50. doi:10.1001/archpsyc.1989.01810010047007

• Monoamine oxidase (MAO) inhibitors are effective antidepressants whose use is limited because of unwanted side effects and the possibility of a tyramine-induced hypertensive crisis (cheese reaction). ( - )-Deprenyl (the official nonproprietary name for this substance is selegiline), a selective MAO type B inhibitor, may be safer and have fewer side effects, but its antidepressant efficacy is uncertain. A double-blind placebo-controlled study was carried out in depressed outpatients who were treated with ( - )-deprenyl in an MAO type B selective dose range and at a higher nonselective dose range. (-)-Deprenyl did not have a statistically significant antidepressant effect after three weeks of treatment at doses of 10 mg/d. However, after six weeks and at higher doses (averaging about 30 mg/d for the second three weeks), ( - )-deprenyl was superior to placebo in antidepressant effect with a positive response rate of 50% vs 13.6% and with a 41% reduction in the Hamilton Depression Rating Scale mean score vs 10% in the placebo-treated group. No hypertensive crises were seen. The rate of occurrence of side effects with (-)-deprenyl was no greater than with placebo. It was concluded that (-)-deprenyl is an effective antidepressant in a dose range where it is distinguished by the absence of many of the side effects typical of nonselective MAO inhibitors.