The article describes the results from an open study in patients with resistant depression, when in their treatment the classical MAO-inhibitor tranylcypromine was replaced by the MAO-A-inhibitor moclobemide. All patients were nonresponders to other antidepressants and had subsequently responded to tranylcypromine.

28 patients were studied: 15 prospectively and 13 retrospectively. In 15 patients treatment with moclobemide had to be stopped within the study period of two months: in 9 of them because of recurrence of depression, in 6 patients because of adverse effects. A possible, partial explanation is the withdrawal from tranylcypromine. Subsequently, alle these patients were put back on tranylcypromine with good result. 4 patients showed improvement, especially concerning adverse effects.

It is concluded that moclobemide does not appear to be an effective alternative to tranylcypromine in patients with resistant depression. For the time being, the classical MAO-inhibitors (especially tranylcypromine) maintain their place in the treatment strategy of major depression.