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Reversible inhibitor of monoamine oxidase A

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Title: Reversible inhibitor of monoamine oxidase A  
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Subject: Monoamine oxidase inhibitor, Amiflamine, Brofaromine, Moclobemide, Antidepressant
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Reversible inhibitor of monoamine oxidase A

Skeletal formula of moclobemide, the prototypical RIMA.
outer membrane of a mitochondrion. From PDB 2BXS.

Reversible inhibitors of monoamine oxidase A (RIMAs) are a class of drugs which selectively and reversibly inhibit the enzyme monoamine oxidase A (MAO-A). They are used clinically in the treatment of depression and dysthymia, though they have not gained widespread market share due to limited efficacy relative to other antidepressants. Because of their reversibility and selectivity, RIMAs are safer than the older monoamine oxidase inhibitors (MAOIs) like phenelzine and tranylcypromine.

RIMAs are displaced from MAO-A in the presence of tyramine,[1] rather than inhibiting its breakdown in the liver as general MAOIs do. Additionally, MAO-B remains free and continues to metabolize tyramine in the stomach, although this is less significant than the liver action. Thus, RIMAs are unlikely to elicit tyramine-mediated hypertensive crisis, and a special diet does not need to be so strictly adhered to, although eating excessively large amounts of tyramine-containing foods is still not advisable.

While safer than general MAOIs, RIMAs still have highly dangerous and sometimes fatal interactions with many common drugs; in particular, they can cause serotonin syndrome or hypertensive crisis when combined with almost any antidepressant or stimulant, common migraine medications, certain herbs, or even most cold medicines (including decongestants, antihistamines, and cough syrup)

List of RIMAs

Pharmaceutical Drugs

Research Compounds

Herbal Drugs

See also

References

  1. ^ Lotufo-Neto F, Trivedi M, Thase ME (March 1999). "Meta-analysis of the reversible inhibitors of monoamine oxidase type A moclobemide and brofaromine for the treatment of depression". Neuropsychopharmacology 20 (3): 226–47.  
  2. ^ Donskaya, N.S.; Antonkina, O.A.; Glukhan, E. N.; Smirnov, S. K. (2004-07-01). "Antidepressant Befol Synthesized Via Interaction of 4-Chloro-N-(3-chloropropyl)benzamide with Morpholine". Pharmaceutical Chemistry Journal. 0091-150X (Kluwer Academic Publishers-Plenum Publishers) 38 (7): 381–384.  


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