title: Resistant geriatric depressions and therapeutic response to monoamine oxidase inhibitors.
abstract: Elderly depressed patients who met the research diagnostic criteria (RDC) for major depressive illness, resistant to other types of treatment, were treated with phenelzine, a nonselective monoamine oxidase (MAO) inhibitor, for a period of 2 to 7 weeks, following 2 weeks of placebo washout period. Dosage ranged from 15-75 mg daily. Clinical status of patients as well as vital signs, EKG, and platelet MAO inhibition were measured weekly. All responders at the end of this period were followed for 1 to 2 years. Analysis of the results showed a 65% response rate as measured by Hamilton, Global, and Self-rating Scales. No significant drug effect in cognitive functioning, as measured by objective cognitive tests, was observed. Clinical improvement was sustained for all participants throughout the follow-up period with no side effects. A direct relationship between platelet MAO inhibition and clinical response was found. The majority of the responders (70%) had achieved high platelet MAO inhibition values (greater than 80%), while most of the nonresponders had platelet MAO inhibition values of less than 80%. These findings have potential clinical and research implications for treating geriatric depression, especially the ones resistant to other forms of treatment.
mesh_terms: D000368:Aged; D001792:Blood Platelets / Q000201:enzymology; D003866:Depressive Disorder / Q000188:drug therapy* / Q000201:enzymology / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D008995:Monoamine Oxidase / Q000097:blood; D010624:Phenelzine / Q000009:adverse effects / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales
chemical_list: D008995:Monoamine Oxidase; D010624:Phenelzine