SAFETY AND EFFICACY OF MONOAMINE OXIDASE INHIBITORS IN THE TREATMENT OF ANXIETY DISORDERS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Notice bibliographique
Résumé
Abstract Background Monoamine oxidase inhibitors (MAOI) are well known for its effectiveness on major depressive disorder. MAOI’ s prescription has been declining since the arrival of new antidepressant drugs, and there are few studies on their efficacy and safety in the treatment of anxiety disorders. MAOI are controversial drugs because, in one hand, their efficacy is potentially superior to other antidepressants, due to their distinct mechanism of action. On the other hand, there are concerns about safety of these medications. Aims and Objectives The authors performed a systematic review and meta- analysis to investigate the efficacy and safety of MAOI. We also looked for evidence of superiority over other stablished drugs. Methods MEDLINE, PsycINFO, Web of Science, EMBASE, The Cochrane Library, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov were searched for clinical trials using MAOI on anxiety disorders treatment, from January 1980 to May 2023. Review Manager 5 was used to analyze the effect size data, used as primary outcome. Results Over 2,972 records, 24 studies were included in the review. 19 studies were on social anxiety disorder treatment, 7 on panic disorder treatment. The studied MAOI were moclobemide, phenelzine, brofaromine and tranylcypromine. MAOI were superior to placebo in all 13 randomized controlled trials (RCT), except 2. MAOI were not superior to other antidepressants in comparative trials. They were effective on all 7 comparative trials and 4 open trials. 1,535 patients were pooled, only 6 (0.4%) showed severe adverse effects during trials. The risk of bias was high among the studies. Discussion and Conclusion MAOIs are effective treatments for social anxiety and panic disorders, although literature is scarce and there is high risk of bias. These medications demonstrated to be safe and effective. More clinical trials, with more stringent methodology are needed. References Lam RW, Kennedy SH, Grigoriadis S, McIntyre RS, Milev R, Ramasubbu R, Parikh S V, Patten SB, Ravindran A V. Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. III. Pharmacotherapy. J Affect Disord. Netherlands; 2009 Oct;117 Suppl:S26-43. PMID: 19674794 Katzman MA, Bleau P, Blier P, Chokka P, Kjernisted K, Van Ameringen M, Antony MM, Bouchard S, Brunet A, Flament M, Rabheru K, Grigoriadis S, Richter PMA, Mendlowitz S, O’ Connor K, Robichaud M, Walker JR, Asmundson G, Klassen LJ, Lam RW, McIntyre RS, Szpindel I. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry. 2014. PMID: 25081580 Salzer HM, Lurie ML. Anxiety and depressive states treated with isonicotinyl hydrazide (isoniazid). Arch Neurol Psychiatry. 1953; Youdim MBH, Edmondson D, Tipton KF. The therapeutic potential of monoamine oxidase inhibitors. Nature Reviews Neuroscience. 2006. PMID: 16552415 Wimbiscus M, Kostenko O, Malone D. MAO inhibitors: Risks, benefits, and lore. Cleve Clin J Med. 2010; PMID: 21147941 ARNOT R. Calming effect of the monoamine oxidase inhibitors. Dis Nerv Syst. United States; 1960 Aug;21:448. PMID: 13794397Zisook S. A clinical overview of monoamine oxidase inhibitors. Psychosomatics. England; 1985 Mar;26(3):240-246,251. PMID: 3887453 Flockhart DA. Dietary restrictions and drug interactions with monoamine oxidase inhibitors: An update. Journal of Clinical Psychiatry. 2012. PMID: 22951238 Balon R, Mufti R, Arfken CL. A survey of prescribing practices for monoamine oxidase inhibitors. Psychiatr Serv. United States; 1999 Jul;50(7):945–947. PMID: 10402617 Fiedorowicz JG, Swartz KL. The role of monoamine oxidase inhibitors in current psychiatric practice. Journal of Psychiatric Practice. 2004.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,031 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,024 | 0,037 |
| Bibliométrie | 0,008 | 0,009 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».