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Minerva Psichiatrica 2013 September;54(3):185-95

language: English

Monoamine oxidase inhibitors combined with tianeptine for treatment of major depressive disorder

Tobe E. H. 1, 2

1 Department of Psychiatry Cooper Medical School of Rowan University Camden, NJ, USA;
2 Department of Psychiatry Rowan University School of Osteopathic Medicine, Stratford, NJ, USA


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Major depressive disorder (MDD) is a disabling disease that can be difficult to treat and achieve response, 50% decrement of score using a well validated measure such as the 17 item Hamilton Depression Rating Scale (HDRS-17), or preferably remission, asymptomatic or a HDRS-17 score ≤7. MDD is a non-homogeneous organic disorder of brain that impairs cellular and tissue morphology. The etiological diversity of its pathology challenges establishing a biologic marker that offers selectivity, specificity and predictability. Obstacles to research and treatment of MDD include medical and lay dismissal of the disease, diagnostic language that confuses lay versus medical meaning, and the overlapping diversity of signs and symptoms with other neuropsychiatric diseases. MDD is complicated by recurrence and disability. Treatment of MDD may include a monoamine oxidase inhibitors (MAOI) or tianeptine. There are no known adverse interactions between these drugs. Case studies show that combination therapy with MAOI and tianeptine may be useful in safely achieving remission in patients who suffer MDD that is resistant to treatment.

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