MAOIs in Adolescent Major Depression Unresponsive to Tricyclic Antidepressants

Many adolescents with major depressive disorder have at most partial response to standard tricyclic antidepressants despite appropriate dosage and adequate length of treatment. This paper reports a series of 23 such adolescents who were treated with monoamine oxidase inhibitors (MAOIs). Seventy-four percent of this group achieved good or fair antidepressant response, 57% had both good or fair response and continued dietary compliance. There were few serious side effects. Special attention must be paid to subject selection for treatment with MAOIs because of the risk of impulsive or accidental dietary transgression. This retrospective chart review strongly suggests the need for controlled studies of MAOI treatment in adolescents with tricyclic antidepressant refractory major depression.