Abstract：
This article is a clinical guide which discusses the \"state-of-the-art\" usage of the classic monoamine oxidase inhibitor (MAOI) antidepressants (phenelzine, tranylcypromine, and isocarboxazid) in modern psychiatric practice. The guide is for all clinicians, including those who may not be experienced MAOI prescribers. It discusses indications, drug-drug interactions, side-effect management, and the safety of various augmentation strategies. There is a clear and broad consensus (more than 70 international expert endorsers), based on 6 decades of experience, for the recommendations herein exposited. They are based on empirical evidence and expert opinion-this guide is presented as a new specialist-consensus standard. The guide provides practical clinical advice, and is the basis for the rational use of these drugs, particularly because it improves and updates knowledge, and corrects the various misconceptions that have hitherto been prominent in the literature, partly due to insufficient knowledge of pharmacology. The guide suggests that MAOIs should always be considered in cases of treatment-resistant depression (including those melancholic in nature), and prior to electroconvulsive therapy-while taking into account of patient preference. In selected cases, they may be considered earlier in the treatment algorithm than has previously been customary, and should not be regarded as drugs of last resort; they may prove decisively effective when many other treatments have failed. The guide clarifies key points on the concomitant use of incorrectly proscribed drugs such as methylphenidate and some tricyclic antidepressants. It also illustrates the straightforward \"bridging\" methods that may be used to transition simply and safely from other antidepressants to MAOIs.
摘要：
本文是一份临床指南，讨论了经典单胺氧化酶抑制剂（MAOI）抗抑郁药（苯乙嗪，tranylcypromine,和异卡波肼）在现代精神病学实践中。该指南适用于所有临床医生，包括那些可能没有经验的MAOI处方者。它讨论了适应症，药物-药物相互作用，副作用管理，以及各种增强策略的安全性。达成了明确和广泛的共识(70多位国际专家代言人),根据60年的经验，对于此处披露的建议。它们基于经验证据和专家意见-该指南作为新的专家共识标准提出。指南提供实用的临床建议,是合理使用这些药物的基础，特别是因为它改进和更新了知识，纠正了迄今为止文献中突出的各种误解，部分原因是药理学知识不足。该指南建议，在难治性抑郁症（包括性质上的忧郁症）的情况下，应始终考虑MAOIs，并且在电惊厥治疗之前-同时考虑到患者的偏好。在某些情况下，在治疗算法中，它们可能比以前习惯的更早被考虑，并且不应该被视为万不得已的药物；当许多其他治疗失败时，它们可能被证明是决定性的有效。该指南阐明了伴随使用不正确的违禁药物如哌醋甲酯和一些三环抗抑郁药的要点。它还说明了直接的“桥接”方法，可用于简单安全地从其他抗抑郁药过渡到MAOIs。
