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Efficacy of Tranylcypromine in Bipolar Depression

A Systematic Review

Heijnen, Willemijn T. MD*; De Fruyt, Jürgen MD; Wierdsma, André I. PhD*; Sienaert, Pascal MD, PhD; Birkenhäger, Tom K. MD, PhD*

Journal of Clinical Psychopharmacology: December 2015 - Volume 35 - Issue 6 - p 700–705
doi: 10.1097/JCP.0000000000000409
Review Article
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Objective Currently, there is a paucity of treatment options with limited efficacy for bipolar depression. The monoamine oxidase inhibitor tranylcypromine might be an effective form of treatment. The current systematic review reassesses the efficacy and safety of tranylcypromine in bipolar depression.

Methods For this systematic review comparing tranylcypromine with placebo or active comparators in bipolar depression, relevant randomized controlled trials were identified from systematic searches of PubMed, EMBASE, and Cochrane library databases. A manual search of the references of the included studies was also performed.

Results Four studies with a total of 145 participants were identified. Response rates were higher in patients treated with tranylcypromine (60.0%–80.7%; overall response rate, 73.7%) compared with placebo, imipramine, and lamotrigine (the latter as add-on to a mood stabilizer) (12.9%–47.6%; overall response rate, 27.5%). The overall switch rate was 6.3% for patients treated with tranylcypromine and 18.4% for patients in the control group.

Conclusions This systematic review provides evidence for the efficacy and safety of tranylcypromine treatment in bipolar depression. Additional research is required to establish the efficacy of tranylcypromine as add-on to a mood stabilizer.

From the *Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands; and †Department of Psychiatry, General Hospital Sint-Jan Brugge-Oostende AV, Brugge; and ‡ECT Department, University Psychiatric Center–Catholic University Leuven, Campus Kortenberg, Kortenberg, Belgium.

Received January 22, 2015; accepted after revision July 28, 2015.

Reprints: Willemijn T. Heijnen, MD, Department of Psychiatry, Erasmus Medical Centre, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands (e-mail: w.heijnen@erasmusmc.nl).

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.