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Clinical and Pharmacokinetic Factors Affecting Response to Phenelzine

Published online by Cambridge University Press:  29 January 2018

Peter Tyrer ,
Martin Gardner ,
John Lambourn  and
Mervyn Whitford
Peter Tyrer
Affiliation:
University Department of Psychiatry, Royal South Hants Hospital, Graham Road, Southampton SO9 4PE
Martin Gardner
Affiliation:
Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO9 4XY
John Lambourn
Affiliation:
Knowle Hospital, Fareham, Hants
Mervyn Whitford
Affiliation:
Warner-Lambert (UK) Limited, Eastleigh, Hants
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Summary

Sixty patients, 30 with depressive neurosis, 15 with anxiety neurosis and 15 with phobic anxiety states, were treated with the monoamine oxidase inhibitor, phenelzine, in two different dosage schedules for four weeks. All patients received an initial dose of 15 mg daily, increasing to 30 mg daily between the third and seventh day, but subsequently, using double-blind procedure, one group took the commonly prescribed dose of 45 mg daily and the other took 90 mg daily. Acetylator status was independently determined before the start of treatment. Each diagnostic group showed a similar response to treatment, but patients taking the higher dose improved significantly more than those taking normal dosage, and the rate of improvement, measured by weekly self-ratings, was also more rapid with higher dosage. Acetylator status did not affect clinical response. The results suggest that dosage is more important in determining clinical response to phenelzine in neurotic disorder than specific diagnosis or acetylator status.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 136 , Issue 4 , April 1980 , pp. 359 - 365
Copyright
Copyright © Royal College of Psychiatrists, 1980 

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References

Davidson, J., McLeod, M. N. & Blum, R. (1978) Acetylation phenotype, platelet monoamine oxidase inhibition, and the effectiveness of phenelzine in depression. American Journal of Psychiatry, 135, 467–9.Google Scholar
Davidson, J., McLeod, M. N. & White, H. L. (1978) Inhibition of platelet monoamine oxidase in depressed subjects treated with phenelzine. American Journal of Psychiatry, 135, 470–2.Google Scholar
Evans, D. A. P. (1969) An improved and simplified method of detecting the acetylator phenotype. Journal of Medical Genetics, 6, 405–7.Google Scholar
Evans, D. A. P., Davidson, K. & Pratt, R. T. C. (1965) The influence of acetylator phenotype on the effects of treating depression with phenelzine. Clinical Pharmacology and Therapeutics, 6, 430–5.Google ScholarPubMed
Fullerton, A. G. (1979) Acetylator phenotype and response to treatment with monoamine oxidase inhibitors in phobics. To be published.Google Scholar
Hallam, R. S. (1978) Agoraphobia: a critical review. British Journal of Psychiatry, 133, 314–9.Google Scholar
Hamilton, M. (1959) The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 50–5.Google Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–96.Google Scholar
Johnstone, E. C. & Marsh, W. (1973) Acetylator status and response to phenelzine in depressed patients. Lancet, i, 567–70.Google Scholar
Johnstone, E. C. (1976). The relationship between acetylator status and inhibition of monoamine oxidase excretion of free drug and antidepressant response in depressed patients on phenelzine. Psychopharmacologia, 46, 289–94.Google Scholar
Lader, M. & Marks, I. (1971) Clinical Anxiety, pp 99–101. London: Heinemann.Google Scholar
Lipsedge, M. S., Hajioff, J., Huggins, P., Napier, L., Pearce, J., Pike, D. J. & Rich, M. (1973) The management of severe agoraphobia: a comparison of iproniazid and systematic desensitisation. Psychopharmacologia, 32, 67–80.Google Scholar
Marshall, E. F. (1976) The myth of phenelzine acetylation. British Medical Journal, ii, 817.Google Scholar
Marshall, E. F., Mountjoy, C. Q., Campbell, I. C., Garside, R. F., Leitch, I. M. & Roth, M. (1978) The influence of acetylator phenotype on the outcome of treatment with phenelzine, in a clinical trial. British Journal of Clinical Pharmacology, 6, 247–54.Google Scholar
Medical Research Council (1965) Clinical trial of the treatment of depressive illness: report by MRC Clinical Psychiatry Committee. British Medical Journal, i, 881–6.Google Scholar
Mountjoy, C. Q., Roth, M., Garside, R. F. & Leitch, I. M. (1977) A clinical trial of phenelzine in anxiety, depressive and phobic neuroses. British Journal of Psychiatry, 131, 486–92.CrossRefGoogle ScholarPubMed
Paykel, E. S., Parker, R. R., Penrose, R. S. & Rassaby, E. R. (1979) Depressive classification and prediction of response to phenelzine. British Journal of Psychiatry, 134, 572–81.Google Scholar
Ravaris, C. L., Nibs, A., Robinson, D. S., Ives, J. O., Lamborn, K. R. & Korson, L. (1976) A multiple dose, controlled study of phenelzine in depression-anxiety states. Archives of General Psychiatry, 33, 347–50.Google Scholar
Rees, L. & Davies, B. (1961) A controlled trial of phenelzine in the treatment of severe depressive illness. Journal of Mental Science, 107, 560–6.Google Scholar
Robinson, D. S., Nies, A., Ravaris, C. L., Ives, J. O. & Bartlett, D. (1978) Clinical pharmacology of phenelzine. Archives of General Psychiatry, 35, 629–35.Google Scholar
Robinson, D. S., Nies, A., Ravaris, C. L. & Lamborn, K. R. (1973) The monoamine oxidase inhibitor, phenelzine, in the treatment of depressive-anxiety states: a controlled clinical trial. Archives of General Psychiatry, 29, 407–13.Google Scholar
Salkind, M. R. (1972) Anxiety neurosis in general practice. Postgraduate Medical Journal, 48, Supplement 4, 34–41.Google Scholar
Salkind, M. R. (1973) The Morbid Anxiety Inventory , Ph.D., University of London.Google Scholar
Schapira, K., Roth, M., Kerr, T. A. & Gurney, C. (1972) The prognosis of affective disorders: the differentiation of anxiety states from depressive illnesses. British Journal of Psychiatry, 121, 175–81.Google Scholar
Schroder, H. (1972) Simplified method for determining acetylator phenotype. British Medical Journal, iii, 506–7.Google Scholar
Shaw, D. (1977) The practical management of affective disorder. British Journal of Psychiatry, 130, 432–51.Google Scholar
Snaith, R. P., Ahmed, S. N., Mehta, S. & Hamilton, M. (1971) Assessment of the severity of primary depressive illness. Psychological Medicine, 1, 143–9.CrossRefGoogle ScholarPubMed
Solyom, L., Heseltine, G. F., McClure, D. J., Solyom, C., Ledwidge, B. & Steinberg, G. (1973) Behaviour therapy versus drug therapy in the treatment of phobic neurosis. Canadian Psychiatric Association Journal, 18, 25–32.Google Scholar
Tilstone, W. J., Margot, P. & Johnstone, E. C. (1979) Acetylation of phenelzine. Psychopharmacology, 60, 261–3.Google Scholar
Tilstone, W. J. & Johnstone, E. C. (1978) Acetylator status and response to phenelzine. Lancet, ii, 1151–2.Google Scholar
Tyrer, P. (1975) Length of treatment with monoamine oxidase inhibitors in phobic anxiety states. Proceedings of Ninth Congress of the Collegium Internationale Neuropsychapharmacologicum, 800–7. Excerpta Medica, Amsterdam.Google Scholar
Tyrer, P. (1976) Towards rational therapy with monoamine oxidase inhibitors. British Journal of Psychiatry, 128, 354–60.Google Scholar
Tyrer, P., Candy, J. & Kelly, D. (1973) A study of the clinical effects of phenelzine and placebo in the treatment of phobic anxiety. Psychopharmacologia, 32, 237–54.Google Scholar
Tyrer, P. & Lader, M. H. (1973) Effects of beta adrenergic blockade with sotalol in chronic anxiety. Clinical Pharmacology and Therapeutics, 14, 418–26.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
Woodruff, R. A. Jr., Murphy, G. E. & Herjanic, M. (1967) The natural history of affective disorders—1. Symptoms of 72 patients at the time of index hospital admission. Journal of Psychiatric Research, 5, 255–63.Google Scholar
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