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The new generation of monoamine oxidase inhibitors

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Abstract

The development of monoamine oxidase (MAO) inhibitors has followed a winding path. At the origin was the finding of E. A. Zeller that iproniazid, a hydrazine derivative designed to improve the tuberculostatic action of isoniazid, caused potent inhibition of MAO in vitro and in vivo. The inhibitor also exerted in vivo activity in the brain, subsequent pharmacological research indicating that this inhibition led to changes of cerebral functions [1]. Although the drug had no overt behavioral effects in animals when given alone, it modified the action of reserpine, one of the first modern psychotropic drugs. Thus, administration of iproniazid prior to reserpine unexpectedly antagonized the decreases in locomotor activity and in 5-hydroxy-tryptamine (5 HT) levels induced by reserpine in the brain, the animals sometimes even showing locomotor stimulation [1]. Since one serious side effect of reserpine in man was known to be mental depression, the antagonism of reserpine by iproniazid hinted at the possibility that this drug might be of use in the treatment of mood disorders. However, the actual breakthrough for the development of iproniazid as an antidepressant came from clinical observations. Various investigators had reported psychostimulant side effects of the MAO inhibitor in patients with tuberculosis and other chronic diseases.

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Abbreviations

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

DHPG:

3,4-Dihydroxyphenylglycol

DOPAC:

3,4-Dihydroxyphenylacetic acid

DSM:

Diagnostic and statistical manual of mental depression

FAD:

Flavin-adenine diphosphate

HAMD:

Hamilton depression rating scale

5 HIAA:

5-Hydroxyindoleacetic acid

5 HT:

5-Hydroxytryptamine

HVA:

Homovanillic acid

ICD:

International classification of diseases (WHO)

L-Dopa:

L-3,4-Dihydroxyphenylalanine (levodopa)

MAO:

Monoamine oxidase

MHPG:

3-Methoxy-4-hydroxyphenylglycol

MPDP+ :

1 -Methyl-4-phenyl-dihydropyridinium

MPP+ :

1 -Methyl-4-phenylpyridinium

MPTP:

l-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine

PET:

Positron emission tomography

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Cesura, A.M., Pletscher, A. (1992). The new generation of monoamine oxidase inhibitors. In: Jucker, E. (eds) Progress in Drug Research / Fortschritte der Arzneimittelforschung / Progrès des recherches pharmaceutiques. Progress in Drug Research / Fortschritte der Arzneimittelforschung / Progrès des recherches pharmaceutiques, vol 38. Birkhäuser Basel. https://doi.org/10.1007/978-3-0348-7141-9_3

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