moclobemide (MAOI), diet info

Source: Wikipedia


The reversible binding to MAO-A by moclobemide allows amines such as tyramine to displace moclobemide from MAO-A allowing its metabolism and removing the risk of a hypertensive crisis that occurs with irreversible MAO inhibition.[86] 2300 people in multiple clinical trials who were treated with moclobemide in doses up to 600 mg with no dietary restrictions, none experienced a tyramine-mediated hypertensive reaction.[54]

The potentiation of the pressor effect of tyramine by moclobemide is only one seventh to one tenth of that of irreversible MAOIs.[88]

Reversible MAOIs were developed in the hope that they would exert efficacy in depressive disorders but with less of the toxicity of the older irreversible compounds; moclobemide's discovery and marketing brought the renewed interest in MAOIs due to an absence of dangerous tyramine food interactions and potent antidepressant effects.[7][113]

There is no need for dietary restrictions in contrast to people on irreversible MAOIs and apart from an important interaction with other serotonergic enhancing agents such as SSRI's and pethidine, there are few serious drug interactions

No significant rise in blood pressure occurs when moclobemide is combined with amines such as tyramine containing foods or pressor amine drugs, unlike the older non-selective irreversible MAOIs which cause a severe rise in blood pressure with such combination.[3]

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86. Lavian, G.; Finberg, JP.; Youdim, MB. (1993). "The advent of a new generation of monoamine oxidase inhibitor antidepressants: pharmacologic studies with moclobemide and brofaromine.". Clin Neuropharmacol 16 Suppl 2: S1-7. PMID 8313392

54. Versiani M, Nardi AE, Figueira IL, Stabl M (1990). "Tolerability of moclobemide, a new reversible inhibitor of monoamine oxidase-A, compared with other antidepressants and placebo". Acta Psychiatr Scand Suppl 360: 24–8. PMID 2123366

88. Zimmer R (1990). "Relationship between tyramine potentiation and monoamine oxidase (MAO) inhibition: comparison between moclobemide and other MAO inhibitors". Acta Psychiatr Scand Suppl 360: 81–3. PMID 2248084

7. Roth M, Guelfi JD (September 1992). "The efficacy of reversible monoamine oxidase inhibitors in depressive illness". Can J Psychiatry 37 Suppl 1: 18–24. PMID 1394027

113. Rudorfer MV (1992). "Monoamine oxidase inhibitors: reversible and irreversible". Psychopharmacol Bull 28 (1): 45–57. PMID 1609042

3. Fulton B, Benfield P (September 1996). "Moclobemide. An update of its pharmacological properties and therapeutic use". Drugs 52 (3): 450–74. PMID 8875133
 
As a long time user of MAOI''s (the only antidepressant that seems to even half work on me), I had high hopes for these new types, but they didn't work at all I'm afraid. So it's back to Parnate. To be fair, the pathetically small dose I'm allowed under NHS rules is nowhere near enough, so I save them up for the weekend and suffer the rest of the week - better half a life than none at all? Although I have high BP, it is under control, and I have carelessly eaten and drank whatever I fancy - as well as taking large quantities of ephedrine and recently amphetamine - with no ill effects at all. That's just me though, I have a very unusual body/brain chemistry - don't try iy anyone else!
 
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