To the Editor The Review by Dr Simon and colleagues on management of depression in adults1 provides many treatment options for depressive illnesses. However, we were surprised and disappointed that monoamine oxidase inhibitors (MAOIs), a well-established treatment, were not included among the third-line treatment options for nonresponding depression. There are more than 6 decades of data confirming MAOIs鈥� efficacy in controlled trials and meta-analyses. In addition, MAOIs are included in national and international treatment guidelines and expert reviews for refractory mood disorders.2-4