TY - JOUR
T1 - Revisiting monoamine oxidase inhibitors for the treatment of depressive disorders
T2 - A systematic review and network meta-analysis
AU - Suchting, Robert
AU - Tirumalajaru, Vaishali
AU - Gareeb, Rida
AU - Bockmann, Taya
AU - de Dios, Constanza
AU - Aickareth, Jacob
AU - Pinjari, Omar
AU - Soares, Jair C.
AU - Cowen, Phil J.
AU - Selvaraj, Sudhakar
N1 - Funding Information:
Research supplement funds from The University of Texas Health Science Center at Houston to SS were utilized for this study. The University of Texas Health Science Center at Houston had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The authors would like to thank Ms. Amy Taylor, MLS, Liaison Librarian at Texas Medical Center Library (Houston, TX), for her guidance and invaluable support in building the search strategy.
Publisher Copyright:
© 2021
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Background: Monoamine oxidase inhibitors (MAOIs) were the first class of modern antidepressants; however, they are under-utilized as compared to the newer antidepressants. Methods: In this systematic review, network meta-analysis was used to investigate the comparative efficacy and acceptability of MAOIs for depressive disorders. Overall, the network meta-analysis included 52 double-blind, randomized controlled trials (RCTs) that compared 14 antidepressants or placebo. Across studies, the mean arm size was n = 58 participants from a total N = 6462 (5309 active drug; 1153 placebo). Results: Except fluvoxamine, all antidepressants demonstrated superior efficacy to placebo, and none demonstrated substantially better or worse all-cause dropout rates. Phenelzine demonstrated superior evidence for efficacy compared to all other treatments, and clomipramine demonstrated superior evidence for acceptability compared to all other treatments. Limitations: The study is primarily limited by low estimate precision due to a relative paucity of studies for some of the included treatment conditions. Further evidence is required to study the relative efficacy of MAOIs against newer antidepressants. Conclusions: The results of this analysis largely support the re-evaluation of the use of MAOIs as antidepressant agents in the treatment algorithm of depression.
AB - Background: Monoamine oxidase inhibitors (MAOIs) were the first class of modern antidepressants; however, they are under-utilized as compared to the newer antidepressants. Methods: In this systematic review, network meta-analysis was used to investigate the comparative efficacy and acceptability of MAOIs for depressive disorders. Overall, the network meta-analysis included 52 double-blind, randomized controlled trials (RCTs) that compared 14 antidepressants or placebo. Across studies, the mean arm size was n = 58 participants from a total N = 6462 (5309 active drug; 1153 placebo). Results: Except fluvoxamine, all antidepressants demonstrated superior efficacy to placebo, and none demonstrated substantially better or worse all-cause dropout rates. Phenelzine demonstrated superior evidence for efficacy compared to all other treatments, and clomipramine demonstrated superior evidence for acceptability compared to all other treatments. Limitations: The study is primarily limited by low estimate precision due to a relative paucity of studies for some of the included treatment conditions. Further evidence is required to study the relative efficacy of MAOIs against newer antidepressants. Conclusions: The results of this analysis largely support the re-evaluation of the use of MAOIs as antidepressant agents in the treatment algorithm of depression.
KW - Anti-depressants
KW - MAOI
KW - Monoamine oxidase inhibitors
KW - Network meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85099610973&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85099610973&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2021.01.021
DO - 10.1016/j.jad.2021.01.021
M3 - Article
C2 - 33601690
AN - SCOPUS:85099610973
SN - 0165-0327
VL - 282
SP - 1153
EP - 1160
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -