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60 Years of Combining Tranylcypromine: A Systematic Review of Available Evidence

Wagner, Elias ; Seemüller, Florian ; Hasan, Alkomiet

Journal of clinical psychopharmacology, 2022-01, Vol.42 (1), p.51-70 [Periódico revisado por pares]

United States

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  • Título:
    60 Years of Combining Tranylcypromine: A Systematic Review of Available Evidence
  • Autor: Wagner, Elias ; Seemüller, Florian ; Hasan, Alkomiet
  • Assuntos: Depressive Disorder, Treatment-Resistant - drug therapy ; Drug Interactions ; Drug Therapy, Combination ; Humans ; Mental Disorders - drug therapy ; Monoamine Oxidase Inhibitors - adverse effects ; Monoamine Oxidase Inhibitors - pharmacology ; Psychotropic Drugs - administration & dosage ; Psychotropic Drugs - adverse effects ; Psychotropic Drugs - pharmacology ; Tranylcypromine - administration & dosage ; Tranylcypromine - adverse effects ; Tranylcypromine - pharmacology
  • É parte de: Journal of clinical psychopharmacology, 2022-01, Vol.42 (1), p.51-70
  • Notas: ObjectType-Article-2
    SourceType-Scholarly Journals-1
    ObjectType-Undefined-1
    ObjectType-Feature-3
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  • Descrição: Tranylcypromine is the only irreversible monoamine oxidase inhibitor that is approved in the United States and in Europe for the management of treatment-resistant major depressive disorder. Comprehensive data in the literature regarding the efficacy and tolerability of tranylcypromine (TCP) combination strategies have not been systematically investigated yet. We conducted a systematic review of available literature based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Study types considered eligible for inclusion were studies that reported information on efficacy and/or tolerability/adverse effects of pharmacological TCP add-on or coadministration strategies among people with psychiatric disorders. Ninety-six articles were included in qualitative analyses. A relevant body of evidence shows that TCP combined with first- and second-generation antipsychotics seems relatively safe and might have beneficial effects in some patients with depressive disorders, although caution is needed with some second-generation antipsychotics that have proserotonergic activity. Although evidence is not entirely consistent, amitriptyline as add-on agent might be efficacious and associated with a low rate of severe adverse events. Although available data from case reports are scarce, certain other agents, such as trazodone, but also lithium, seem to have a good risk-benefit profile with regard to TCP that should be further investigated in the context of high-quality studies. Any combination of a psychotropic with TCP should be preceded by an evaluation of drug-to-drug interaction and an informed consent process and followed by close monitoring. Before any combination strategy, doctors should reevaluate factors of pseudo-treatment resistance, such as rapid-metabolizing status, noncompliance, trauma, alternative diagnosis, or drug abuse.
  • Editor: United States
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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