Over the last five years the use of MAO inhibitors in the treatment of depression has been rising in the Netherlands. For this reason, the authors reviewed the literature concerning some aspects of the use of MAO inhibitors as antidepressants.

In the treatment of major depression with melancholia tricyclic antidepressants were not found to be superior to MAO inhibitors. With reference to the treatment of atypical depression no significant difference was found between MAO inhibitors and (tri)cyclics. However, most studies appeared to have several methodological weaknesses, for instance no information was given regarding previous treatment with tricyclics, so that selection bias cannot be excluded.

Rather frequent side-effects and the risk of developing a hypertensive reaction are the main disadvantages of the use of non-selective MAO inhibitors.

Moclobemide and brofaromine, both recently developed selective MAO-A inhibitors, proved to be safe drugs. Moclobemide appeared to be an effective antidepressant. Although the antidepressant activity of brofaromine is considered promising, its effectiveness is not yet fully established.