Psycho-Babble Medication | about biological treatments | Framed
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Re: Help..severe anger.... undopaminergic

Posted by SLS on September 17, 2021, at 3:45:40

In reply to Re: Help..severe anger.... SLS, posted by undopaminergic on September 16, 2021, at 13:08:18

> > >
> > > Why would clorgyline be more effective than the non-selective MAOIs? Is MAO-B inhibition harmful to the treatment of depression?
> >
> > That's a really good question. I don't know the answer to it. I'm guessing that you are referring to a scenario similar to that of citalopram and escitalopram?
> >
> I hadn't thought of it like that, but I guess there is an analogy. Just to clarify, I'm wondering why specific MAO-A inhibition with clorgyline would be better than dual MAO-A and MAO-B inhibition with classic MAOIs. MAO-B contributes to dopamine breakdown, so one would think that inhibiting it in addition to MAO-A would be beneficial, rather than the opposite, that is MAO-B inhibition being detrimental.

I'm sure there is a biological reason for why we see this. I just don't know what it is. Selegiline (including EMSAM) does not exert antidepressant effects until the dosage is high enough to lose its selectivity. Both MAO-A and MAO-B become inhibited, yet this drug sucks as an antidepressant. By comparison, the reversible inhibitor of MAO-A (RIMA), moclobemide, produces an antidepressant far more robust than selegiline. Unfortunately, the improvement is farily brief. My guess is that reversibility is a liability. Moclobemide yields a progressive dosage escalation and ultimate failure. In my experience, moclobemide is more anhedonic and motivating than tranylcypromine while it lasts. I was always under the impression that Nardil inhibits more MAO-A than tranylcycpromine does. Maybe you can look into that. I'm a little short on time.

Psychiatry: So many questions. So few answers.

- Scott

Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.




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