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By David S Baldwin; Jon Birtwistle

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Extra resources for An atlas of depression

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Rare side-effects of mianserin include arthritis and hepatitis Monoamine oxidase inhibitors (MAOIs) Phenelzine Isocarboxazid Tranylcypromine Hypertensive crisis occurs with tyraminecontaining foods and some drugs. g. anesthetics: CNS depression Insulin: impared blood glucose control Reversible inhibitors of monoamine oxidase type A isoenzyme (RIMA) Moclobemide Tyramine pressor response (lower risk than MAOIs) Agitation, anxiety and excitability, dizziness, nausea and sleep disturbances Potentiates ephedrine and the serotonergic effects of pethidine.

In some countries moclobemide has a license for the treatment of social phobia (social anxiety disorder)5,6, although only two out of four randomized controlled trials found it to be significantly more effective than placebo7. Studies in healthy volunteers have shown that shortterm treatment with high doses of moclobemide (900–1200 mg/day) can produce an exaggerated tyramine pressor response, and that a standard dose (300 mg twice-daily) can potentiate the effects of ephedrine on heart rate and blood pressure8,9.

G. fear of flying courses run by the large airline companies). Antidepressant drugs can be used in patients with persistent and disabling specific phobias that have proven resistant to behavioral treatments. MANAGEMENT OF SOCIAL PHOBIA SSRIs are recommended as first-line pharmacologic therapy, and treatment is suggested for at least 12 months66. Several SSRIs have been found efficacious in the shortterm treatment of patients with social phobia, the most studied drugs being paroxetine and sertraline.

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