Phenelzine (“Nardil”) in the Treatment of Endogenous Depression

Abstract

“Let him take a course of chymistry, or a course of rope dancing or a course of anything he is inclined at the time.”(Boswell'sLife of Johnson) (1) To many minds there can be but little change in the treatment of depression since Johnson prescribed these remedies in 1776. Indeed the place of chemistry is now prominent, although its application is apparently more important to the patient than its study. It is believed that an enzyme, mono-amine oxidase, found in cerebral tissues, plays a part in the genesis of depression. Amphetamine inhibits the destruction of adrenaline by amine oxidase (McIlwain, 6) and amphetamine is of value in the treatment of mild depression (Guttmann and Sargant, 5). Another substance is 5-hydroxytryptamine, or serotonin, which is said to excite cerebral neurones briefly between its liberation and destruction; it is a cerebral vasoconstrictor and is destroyed rapidly by amine oxidase (McIlwain, 6). Iproniazid (Marsilid) is a drug which inhibits amine oxidase and has been used in the treatment of depression (West and Dally, 10). Its central actions are considered to be similar to those of 5-hydroxytryptamine. Recently, Chessin (3) has described yet another amine oxidase inhibitor, phenelzine, which is the study of this paper.