Phenelzine Atenolol

Liebowitz et al. [1992] conducted a double-blind, placebo-controlled study of 74 subjects meeting DSM-lll-R (American Psychiatric Association 1987] criteria for social phobia with phenelzine, atenolol, or placebo for 8 weeks. Phenelzine daily doses were 60-100 mg. Phenelzine was found to be superior to both atenolol and placebo, and atenolol was not significantly different from placebo in measures of responsiveness of social phobia symptoms. 

D PP, Tam YK, Young LT, et al Dthium decreases Gs, Gi-1 and Gi-2 alpha-subunit mRNA levels in rat cortex. Eur J Pharmacol 206 165-166, 1991 Debhch I, Yirmiya R Naltrexone reverses a long term depressive effect of a toxic lithium injection on saccharin preference. Physiol Behav 39 547-550, 1987 DebowitzMR Social phobia. Mod Probl Pharmacopsychiatry 22 141-173, 1987 Debowitz MR, Quitkin EM, Stewart JW, et al Phenelzine vs. imipramine in atypical depression a preliminary report. Arch Gen Psychiatry 41 669-677, 1984 liebowitz MR, Quitkin EM, Stewart JW, et al Antidepressant specificity in atypical depression. Arch Gen Psychiatry 45 129-137, 1988 Liebowitz MR, Schneier F, Campeas R, et al Phenelzine vs atenolol in social phobia. Arch Gen Psychiatry 49 290-300, 1992... 

Although behavioral treatments for social phobia have been well studied, there are very limited data on its pharmacological management, b- Blockers (propranolol, atenolol) have been recommended, but available evidence indicates their effect may be no different than that of placebo ( 78). In a controlled study, the monoamine oxidase inhibitor (MAOl) phenelzine has been shown to be more effective than placebo (78, 79). Anecdotal reports have also described efficacy with alprazolam, clonidine, and fluoxetine, but systematic data are lacking (80, 81, 82 and 83). 

Liebowitz MR, Gorman JM, Fyer AJ, et al. Pharmacotherapy of social phobia an interim report of a placebo-controlled comparison of phenelzine and atenolol. J Clin Psychiatry 1988 49 252-258. 

Clinically important, potentially hazardous interactions with albuterol, alpha-blockers, amitriptyline, amoxapine, atenolol, beta-blockers, carteolol, chlorpromazine, clomipramine, cocaine, desipramine, doxepin, ephedra, ergotamine, furazolidone, halothane, imipramine, insulin detemir, MAO inhibitors, metoprolol, nadolol, nortriptyline, oxprenolol, penbutolol, phenelzine, phenoxybenzamine, phenylephrine, pindolol, prazosin, propranolol, protriptyline, sympathomimetics, terbutaline, thioridazine, timolol, tranylcypromine, tricyclic antidepressants, trimipramine, vasopressors... 

Bradycardia has been reported in two patients taking nadolol or metoprolol with phenelzine. MAOIs common cause hypotension, and might reasonably be expected to have additive hypotensive effects with antihypertensive drugs, although this was not seen with phenelzine and atenolol in a study in normotensive patients. In one small study, the RIMA, moclobemide increased the hypotensive effect of metoprolol, but did not alter the effect of nifedipine or hydrochlorothiazide on blood pressure. 

---