MONOAMINE-OXIDASE INHIBITORS IN POSTTRAUMATIC-STRESS-DISORDER - PROMISE AND PROBLEMS IN INDO-CHINESE SURVIVORS OF TRAUMA

An examination of the available literature supports the efficacy of monoamine oxidase inhibitors (MAOIs) in treating posttraumatic stress disorder (PTSD). This effect may or may not be independent of the response of symptoms of major depression; there is suggestive but inconclusive evidence supporting both. Additionally, evidence is accumulating that the avoidance symptoms of PTSD respond less reliably to chemotherapy and may be less important in characterizing this entity than the intrusive recollection of traumatic events and hyperarousal symptoms; clinical cases from the Indochinese Psychiatry Clinic support this assertion. Concerns about the clinical use of MAOIs in the Indochinese population are raised, as is work in progress on reversible inhibitors of monoamine oxidase-A that may effectively address those concerns. A recent suggestion that PTSD may be one of a family of affective disorders is discussed in light of the treatment effects of MAOIs and clinical experience with Southeast Asian survivors of mass violence.