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Re: What to do if Nardil and Parnate were discontinued » linkadge

Posted by Tomatheus on December 28, 2005, at 1:02:23

In reply to Re: What to do if Nardil and Parnate were discontinued » Tomatheus, posted by linkadge on December 27, 2005, at 21:32:18

Linkadge,

See below for my responses to sections of your post...

> But moclobemides lack of efficacy may be more due to the fact that it inhibits the MAO-A enzyme reversably, as opposed to nardil and parnate.

I agree. As I mentioned in my post, I suspect that moclobemide's lackluster efficacy is likely at least partially due to its reversibility and/or the lack of consistency in its MAO-A inhibition.

> Nardil and parnate, also have some secondary properties which may boost their antidepressant efficacy.
>
> Nardil affects gaba, and parnate actually does some weird things with monoamine transporters (it acutally poseses some serotonin uptake inhibition)

True.

> Cause, I think we have some irreversable inhibitors of MAO-A, that are more effective than moclobemide.

I think you're right. Clorgyline, an irreversible inhibitor of MAO-A used exclusively for research purposes, has never been compared directly against moclobemide -- or at least it hasn't been done to my knowledge. But based on the limited body of information available on clorgyline, there is little doubt in my mind that it would end up being more effective than moclobemide, even though both drugs basically do the same thing on paper. I think it's unfortunate that no irreversible inhibitors of MAO-A were ever pursued because I think there's a good chance that some patients might have ended up becoming uniquely responsivee to them. At one point, Eli Lilly was apparently testing an irreversible MAO-A inhibitor called "Lilly 51641," but it is my understanding that the irreversible MAO-A inhibitors were never introduced because of their capacity to potentiate a hypertensive crisis. Thus, this subclass of MAOIs was not seen as a significant advance over drugs such as Nardil and Parnate.

Tomatheus


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poster:Tomatheus thread:591969
URL: http://www.dr-bob.org/babble/20051221/msgs/592666.html