This article is a clinical guide which discusses the “state-of-the-art” usage of the classic monoamine oxidase inhibitor (MAOI) antidepressants (phenelzine, tranylcypromine, and isocarboxazid) in modern psychiatric practice. The guide is for all clinicians, including those who may not be experienced MAOI prescribers. It discusses indications, drug-drug interactions, side-effect management, and the safety of various augmentation strategies. There is a clear and broad consensus (more than 70 international expert endorsers), based on 6 decades of experience, for the recommendations herein exposited. They are based on empirical evidence and expert opinion—this guide is presented as a new specialist-consensus standard. The guide provides practical clinical advice, and is the basis for the rational use of these drugs, particularly because it improves and updates knowledge, and corrects the various misconceptions that have hitherto been prominent in the literature, partly due to insufficient knowledge of pharmacology. The guide suggests that MAOIs should always be considered in cases of treatment-resistant depression (including those melancholic in nature), and prior to electroconvulsive therapy—while taking into account of patient preference. In selected cases, they may be considered earlier in the treatment algorithm than has previously been customary, and should not be regarded as drugs of last resort; they may prove decisively effective when many other treatments have failed. The guide clarifies key points on the concomitant use of incorrectly proscribed drugs such as methylphenidate and some tricyclic antidepressants. It also illustrates the straightforward “bridging” methods that may be used to transition simply and safely from other antidepressants to MAOIs.

We report the current status of birds at the Namuli Massif, northern Mozambique. Despite being the only known locality for the Namuli Apalis Apalis lynesi and the nominate race of the Dapplethroat Arcanator orostruthus, the mountain is very little known ornithologically. Prior to our survey it had only been visited by an ornithologist in 1932, when Jack Vincent collected in the area for three weeks. During our week-long survey in November-December 1998 we recorded 130 bird species from the Namuli area, including all three globally threatened species reported by Vincent (Thyolo Alethe Alethe choloensis, Dapplethroat and Namuli Apalis). The higher-elevation (>1,500 m) forests are still largely intact, but most of those at lower elevations have been cleared for agriculture. The alethe and apalis are common, occurring in remnant forest patches and secondary scrub as well as pristine forest from 1,160 to 2,000 m. The Dapplethroat is restricted to large, intact forests above 1,500 m, but also is fairly common (up to 2–3 singing males per hectare; greater densities than recorded elsewhere). Red-rumped Swallow Hirundo daurica was recorded for the first time in Mozambique, and was suspected of breeding at 1,400 m. We estimate that some 1,300 ha of pristine forest remains on the main massif between Gurue and Mount Namuli, but this area is being reduced by burning and “subsistence” logging. Approximately 7,000 people currently live in the area east of the main forest. Grazing by goats and pigs on the montane grasslands surrounding the forests is another problem, but the gravest threat is posed by improved road access to the area, which could open the forests to commercial logging. In addition to being the sole locality known for the Namuli Apalis and the nominate race of Dapplethroat, the Namuli forests probably support the largest single populations of Thyolo Alethe and the well-marked belcheri race of Green Barbet. These populations make Namuli arguably the most critical Important Bird Area for Mozambique, and the remaining forests have a high priority for conservation action.