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Re: RIMAs vs MAOIs

Posted by Tomatheus on August 15, 2010, at 8:55:09

In reply to RIMAs vs MAOIs, posted by bearfan on August 15, 2010, at 3:53:18

Bearfan,

I tried moclobemide and noticed a reduction in some of my depressive symptoms that lasted a few days, but nothing significant after that. Like you, I also noticed some agitation the last time I took the medication. To date, Nardil is the only antidepressant I've taken that's put my depressive symptoms into remission for more than a few days. Goldshield Parnate and enteric-coated Marplan also put my symptoms into remission, but not for more than three days. I also noticed a response from oral selegiline that was weaker than my responses to Nardil, Parnate, and Marplan, and like the latter two medications my response only lasted a few days.

I could be wrong, but my guess is that moclobemide is less effective than Nardil and Parnate because it's reversible, not because it's selective to MAO-A. Selegiline primarily inhibits MAO-B, but begins to exert antidepressant activity at doses that inhibit MAO-A. This, coupled with a study that found clorgyline (an irreversible MAO-A inhibitor) to be a more effective antidepressant than pargyline (an irreversible MAO-B inhibitor), actually supports the notion that MAO-A inhibition is more important than MAO-B inhibition when it comes to the treatment of depression. I personally think that an antidepressant that inhibits MAO-A both selectively and irreversibly would be more effective than any MAOI or RIMA (or possibly even any antidepressant) that's currently available. Unfortunately, no such antidepressant has ever been made available as a prescription antidepressant, as far as I'm aware.

Tomatheus


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poster:Tomatheus thread:958646
URL: http://www.dr-bob.org/babble/20100811/msgs/958656.html