Abstract
The enhanced sensitivity to the pressor effects of tyramine, an indirect-acting sympathomimetic found abundantly in the diet, is a well-known potentially dangerous side effect occurring during treatment with commonly used nonselective monoamine oxidase (MAO) inhibitors. The effects of treatment with the selective MAO-A inhibitor clorgyline and the partially selective MAO-B inhibitors pargyline and deprenyl on tyramine's pressor effects were studied in depressed patients using an IV steady-state tyramine infusion technique. After 4 weeks of treatment, clorgyline produced a significantly greater increase in tyramine sensitivity in comparison to a medication-free baseline (29-fold) than did pargyline (12-fold) or deprenyl (1.7-fold). The pressor effects of tyramine were significantly prolonged after cessation of infusion during both clorgyline and pargyline, but not deprenyl treatment. These data from IV tyramine administrations suggest that intestinal MAO inhibition is not the major determinant of the enhanced tyramine pressor sensitivity produced by clorgyline and pargyline.
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References
Blackwell B (1963) Hypertensive crisis due to monoamine oxidase inhibitors. Lancet II:849–851
Byck R (1975) Drugs and the treatment of psychiatric disorders. In: Goodman LS, Gilman A (eds) The pharmacological basis of therapeutics. McMillan, New York, pp 152–200
Elis J, Laurence DR, Madie H, Prichard BN (1967) Modification by monoamine oxidase inhibitors of the effects of some sympathomimetics on blood pressure. Br Med J 2:75–78
Elsworth JD, Glover V, Reynolds GP, Sandler M, Lees AJ, Phuapradt P, Shaw KM, Stern GM, Kumar P (1978) Deprenyl administration in man: A selective monoamine oxidase-B inhibitor without the “cheese effect”. Psychopharmacology 57:33–38
Fuentes JA, Neff NH (1975) Selective monoamine oxidase inhibitor drugs as aids in evaluating the role of type-A and B enzymes. Neuropharmacology 14:819–825
Horwitz D, Lovenberg W, Engleman K, Sjoerdsma A (1964) Monoamine oxidase inhibitors, tyramine and cheese. JAMA 190:1108–1110
Houslay MD, Tipton KF, Youdim MBH (1976) Multiple forms of monoamine oxidase, fact and artifact. Life Sci 19:467–478
Innes RI, Nickerson M (1975) Norepinephrine, epinephrine and the sympathomimetic amines. In: Goodman LS, Gilman A (eds) The pharmacological basis of therapeutics. McMillan, New York, pp 514–532
Knoll J (1979) Structure-activity relationships of the selective inhibitors of MAO-B. In: Singer TP, Van Korff RW, Murphy DL (eds) Monoamine oxidase: Structure, function and altered functions. Academic, New York, pp 431–446
Kopin IJ (1966) Biochemical aspects of release of norepinephrine and other amines from sympathetic nerve endings. Pharmacol Rev 18:784–792
Kopin IJ, Gordon EF (1962) Metabolism of 3H-norepinephrine released by tyramine and reserpine. J Pharmacol Exp Ther 138:351–359
Lader MA, Sakalis G, Ansella M (1970) Interaction between sympathomimetic amines and a new monoamine oxidase inhibitor. Psychopharmacology 18:118–123
Lees AJ, Shaw KM, Kohout LF, Stern GM, Elsworth JD, Sandler M, Youdim MBH (1977) Deprenyl in Parkinson's disease. Lancet II:791–796
Liebowitz MR, Klein DF (1979) Hysteroid dysphoria in affective disorders: Special clinical forms. In: Akisdal, S (ed) The psychiatric clinics of North America. Saunders, New York, pp 555–575
Lipper S, Murphy DL, Slater S, Buchsbaum MS (1979) Comparative behavioral effects of clorgyline and pargyline in man: A preliminary report. Psychopharmacology 62:123–128
Marley E, Blackwell B (1970) Interactions of monoamine oxidase inhibitors, amines and foodstuffs. Adv Pharmacol Chemother 8:186–239
Murphy DL (1978) Substrate-selective monoamine oxidases: Inhibitor, tissue, species and functional differences. Biochem Pharmacol 27:1889–1893
Murphy DL, Lipper S, Slater S, Shilling S (1979) Selectivity of clorgyline and pargyline as inhibitors of monoamine oxidase A and B in vivo in man. Psychopharmacology 62:129–132
Neff NH, Yang HYT (1974) Another look at the monoamine oxidases and the monoamine oxidase inhibitor drugs. Life Sci 14:2061–2074
Pickar D, Cohen RM, Jimerson DC, Lake CR, Murphy DL (1981) Tyramine infusions and selective MAO inhibitor treatment. II. Interrelationships among pressor sensitivity changes, platelet MAO inhibition, and plasma MHPG reduction. Psychopharmacology 74:8–12
Pickar D, Cohen RM, Murphy DL (1979) Tyramine infusions in bipolar illness: Behavioral effects and longitudinal changes in pressor sensitivity. Am J Psychiatry 136:1460–1463
Sanders JC (1963) Treatment of hospitalized depressed and schizophrenic patients with monoamine oxidase inhibitors including reflections on pargyline. Ann NY Acad Sci 107:1081–1089
Sandler M, Glover V, Ashford A, Stern GM (1978) Absence of cheese effect during (-)deprenyl therapy: Some recent studies. J Neurol Transm 43:209–215
Singer TP, Von Korff RW, Murphy DL (1979) Monoamine oxidase: Structure, function and altered function. Academic, New York
Youdim MBH (1977) Tyramine and psychiatric disorders. In: Usdin E, Hamberg DA, Barchas ID (eds) Neuroregulators and psychiatric disorders. Oxford University Press, New York, pp 57–67
Youdim MBH, Riederer P, Birkmayer W, Medlewicz J (1979) The functional activity of monoamine oxidase: The use of deprenyl in the treatment of Parkinson's disease and depressive illness. In: Singer TP, Van Korff RW, Murphy DL (eds) Monoamine oxidase: Structure, function and altered functions. Academic, New York, pp 477–496
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Presently with the Biological Psychiatry Branch, NIMH
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Pickar, D., Cohen, R.M., Jimerson, D.C. et al. Tyramine infusions and selective monoamine oxidase inhibitor treatment. Psychopharmacology 74, 4–7 (1981). https://doi.org/10.1007/BF00431747
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DOI: https://doi.org/10.1007/BF00431747