Posted by SLS on September 16, 2021, at 12:26:00
In reply to Re: Help..severe anger.... » SLS, posted by undopaminergic on September 15, 2021, at 4:05:42
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> > Personally, I think MAO-A is essential for an MAOI to work for depression,
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> I agree.
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> > In my early research, I came upon an MAOI called clorgyline. It is a remarkably potent and specific inhibitor of MAO-A. Unlike moclobemide, it is irreversible. It was never developed for marketing. However, it was (and probably still is) the gold standard for manipulating and tagging the MAO-A enzyme. I caught wind that the NIH was using it on their most treatment-resistant cases. My doctor there called it their "ace-in-the-hole". At a time when I was totally unresponsive to all treatments, including Nardil and Parnate, clorgyline kicked a few bricks out of the wall that allowed me to regain some responsivity to future treatments. I was on it for awhile, but the improvement was at best moderate, and very episodic. Before leaving the NIH, asked the head of the department, William Z. Potter, if he would add desipramine. He said yes, but only 10 mg/day. I didn't bother. Perhaps I made a mistake, but ultimately, it wouldn't have made a difference. Unfortunately, there were some reports that among the very, very few people who were taking clorgyline, cardiac side effects emerged in a few of them. They withdrew clorgyline from their patient population. Clorgyline had been considered the most efficacious antidepressant on Earth.
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> 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?
A long time ago, I read that Parnate (tranylcypromine) is actually partially reversible.
I found this, but one has to assume that the pharmacological effect being referred to is MAO inhibition. I imagine it is, but I don't see how this would be of consequence.
"However, recent research has demonstrated that tranylcypromine can produce direct and reversible pharmacologic effects"
https://pubmed.ncbi.nlm.nih.gov/1813896/
- 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.
poster:SLS
thread:1116908
URL: http://www.dr-bob.org/babble/20210723/msgs/1116966.html