A clinical comparison of phenelzine and electro-convulsive therapy in the treatment of depressive illness

The mono-amine oxidase inhibitors, of which phenelzine (“Nardil”) is one example, were introduced for the treatment of depressive illness as a result of the observation that iproniazid, which is a mono-amine oxidase inhibitor, produced euphoria and increased mental alertness in some tuberculous patients to whom it was given. Trials of iproniazid in mental illness were carried out (Loomer et al., 1957; Cesarman, 1959), but it was found to be very liable to give rise to side-effects, being particularly toxic to the liver. Other less toxic mono-amine oxidase inhibitors such as phenelzine, which is chemically related to iproniazid, were later developed.

EFFECT OF PHENELZINE AND SOME RELATED COMPOUNDS ON PREGNANCY AND ON SEXUAL DEVELOPMENT

The effects of phenelzine and several of its derivatives in interrupting pregnancy, and on sexual development, were investigated in mice.

At dose levels of one-fifth LD 50 given on days 1–6 of pregnancy, phenelzine had a low but significant activity and some derivatives were more active. There was no evidence that monoamine oxidase inhibitory activity was related to the anti-fertility activity of these compounds.

The effects of two of the compounds investigated for this purpose (WL 27 and LON 41) were partially reversed by either progesterone or prolactin.

WL 27 interrupted the normal oestrous cycle, delayed the onset of oestrus in immature female mice and depressed the weights of sex organs in immature and in non-pregnant adult mice, and in immature male mice.

These effects suggest that these compounds produce a depression of pituitary gonadotrophic activity. However, the depression is not complete since WL 27 did not interrupt pseudopregnancy.