This Letter to the Editor comments on A.J. Rothschild & C.A. Locke’s case treatment of a depressed woman who also needed pain medication (see SIEC AN 920236), & notes that for patients taking monoamine oxidase inhibitors (MAOIs), narcotic treatment should be initiated from 20% to 50% of the usual dosage & dosages be titrated cautiously based on clinical response. The authors also believe that MAOIs have been underutilized in psychiatry and list analgesics that can be safely used with MAOIs.