Posted by SLS on June 29, 2008, at 10:28:51
In reply to Re: +++ MAO-A or B ? Gerovital (procaine) selectivity » SLS, posted by Marty on June 28, 2008, at 20:09:44
Hi Marty.
First of all, I can all but guarantee you that it is not the selectivity for MAO-A that is the culprit with making a minority of people feel worse while taking moclobemide. I am trying to find the abstract on Medline that I often come across regarding moclobemide and dopaminergic neurotransmission, but there is a property of this drug that reduces the tone of dopamine neurons in certain regions of the brain (I don't recall how). Other RIMA drugs don't seem to display this property. Despite this, MAO-A *does* prevent the deamination of dopamine in several key regions of the brain, which significantly increases DA outflow there.
That's right. A selective MAO-A inhibitor *does* increase the levels of all three of the monoamines thought to be involved with depression: dopamine, norepinephrine, and serotonin. There is no need to inhibit MAO-B. I do not believe that a selective MAO-B inhibitor carries with it the same potency as a MAO-A inhibitor. That said, it seems that reversibility equates with inferior clinical effect. The selective irreversible MAO-A inhibitor, clorgyline, is at least as potent as the mixed irreversible MAOIs, if not more so.
MAO-A rules!
- Scott
poster:SLS
thread:836966
URL: http://www.dr-bob.org/babble/20080626/msgs/837131.html