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Previous research has shown that monoamine oxidase inhibitors (MAOIs) are superior to tricyclics for treating atypical depression (characterized by mood reactivity plus at least two of the following symptoms: hyperphagia, hypersomnia, leaden paralysis, and rejection sensitivity). But are MAOIs an effective prophylactic treatment for patients with chronic atypical depression? This double-blind study randomized 60 patients with chronic atypical depression (for at least two years) who had improved with phenelzine or imipramine and had stabilized for six months to either continue their initial medication or switch to placebo for the next six months.
The phenelzine-treated patients were more chronically depressed than imipramine-treated patients,…