Posted by Adam on February 15, 2000, at 22:24:04
In reply to Adam--what does NARI stand for?, posted by Abby on February 15, 2000, at 19:24:49
Hey,
I'm not sure if I'm Mr. Science either, but I'll give these questions a go. I guess I would just want to stress that while, yes, I do have a pretty good grasp of some scientific concepts, and I have tried over the past few months to accumulate as much accurate information as I can, I am by no means a specialist of any kind in psychopharmacology. My experience is a lot of reading as a layperson, and a lot of personal trials with various classes of drugs, plus the information I gather here.
Having said that, here's what I believe is relevant to your questions...
NARI = NorAdrenaline Reuptake Inhibitor - reboxetine is a good example, a drug that inhibits the transport of noradrenaline (also called norepinephrine, NA and NE for short, respectively) back into the presynaptic neurons that secrete it. This increases the amount of NA in the synapse, which, for a variety of reasons, can have an antidepresant effect.
RIMA = Reversible Inhibotor of Monoamine oxidase A - Yes, moclobemide is a good example of such a medication. Is has a high specificity for one of the two isoforms of monoamine oxidase (MAO) made by the body, MAO-A instead of MAO-B. It is reversible because when it binds to MAO-A, it does not do so permanently (unlike the older, non-specific, irreversible MAO inhibitors), and thus it does not destroy MAO-A, only interfere with its ability to break down various chemicals of the monoamine class, including serotonin and noradrenaline, and, to a lesser extent, dopamine. This is thought to increase the availablity of these neurotransmitters, giving an antidepressant effect. Because moclobomide spares MAO-B almost completely, tyramine, a monoamine/amino acid found in some spoiled or aged foods with lots of protein in them, can be broken down enough that the dietary restrictions necessary while taking the MAOIs need not be observed. While moclobemide looks good on paper, practical experience with it seems to indicate it is not as robust an antidepressant as its older, dirtier cousins.
Just for explicative/editorial purposes...I plug the old MAOIs for one reason: They work, and, quite often, they work very well. Some reputable doctors are of the oppinion that a robust response to an MAOI is superior to what is seen with other classes of antidepressants. Unfortunately, although they are still valuable, and often not as difficult to live with as some would have us believe, they are underutilized by most psychiatrists, sometimes solely because of fears of liability. I'm hoping education about the real dangers of MAOIs, creative forms of delivery (e.g. transdermal), and a greater focus and emphasis in research, will bring back to the forefront what is probably the most underhyped yet widely applicable and successful class of antidepressant, one which may not have been matched in efficacy by any class since their serendipitous discovery in the 1950s.> Adam you were giving a plug for the old drugs MAOIs.
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> I know that SNRIs are serotonin noradrenaline reuptake inhibitors, but I don't know what NARIs are?
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> Are RIMAs just reversible MAOIs? Is maclobemide a RIMA?
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> Abby
poster:Adam
thread:21666
URL: http://www.dr-bob.org/babble/20000209/msgs/21701.html