Meta-analysis of the reversible inhibitors of monoamine oxidase type A moclobemide and brofaromine for the treatment of depression
by
Lotufo-Neto F, Trivedi M, Thase ME
Instituto de Psiquiatria da Faculdade de Medicina
da Universidade de Sao Paulo, Brazil.
Neuropsychopharmacology 1999 Mar; 20(3):226-47


ABSTRACT

The reversible inhibitors of monoamine oxidase type A (RIMAs) are a newer group of antidepressants that have had much less impact on clinical psychopharmacology than another contemporary class of medications, the selective serotonin reuptake-inhibitors (SSRIs). The RIMAs agents are distinguished from the older monoamine oxidase inhibitors (MAOIs) by their selectivity and reversibility. As a result, dietary restrictions are not required during RIMA therapy, and hypertensive crises are quite rare. In this article, we describe a series of meta-analyses of studies of the two most widely researched RIMAs, moclobemide (MOC; Aurorex) and brofaromine (BRO). Our findings confirm that both BRO and MOC are as effective as the tricyclic antidepressants, and they are better tolerated. However, BRO is not being studied at present for reasons unrelated to efficacy or side effects. MOC, which is available throughout much of the world (but not the United States), is significantly more effective than placebo and, at the least, comparable to the SSRIs in both efficacy and tolerability. For MOC, higher dosages may enhance efficacy for more severe depressions. We also found evidence that supports clinical impressions that MOC is somewhat less effective, albeit better tolerated, than older MAOIs, such as phenelzine or tranylcypromine. Little evidence has yet emerged to suggest that the RIMAs share older MAOIs' utility for treatment of depressions characterized by prominent reverse neurovegetative features. Based on available evidence, the RIMAs appear to have a limited, but useful, role in the differential therapeutics of the depressive disorders.
MAO
RIMAs
MAOIs
Reward
TV3326
Phenelzine
Brofaromine
Befloxatone
Moclobemide
The MAOI diet
Isocarboxazid
Tranylcypromine
New antidepresants
MAO, emotion and stress
MAOIs, stress and aggression
Phenelzine (Nardil) v tranylcypromine (Parnate)
Genetic variation in MAO-A and human personality


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