Posted by SLS on September 29, 2022, at 17:48:52
In reply to Re: Clorgyline is a MAOI specific for MAO-A. » undopaminergic, posted by linkadge on September 29, 2022, at 16:14:46
* Great post, Linkadge. I wish my hippocampus was as big as yours. Your posts are always a wealth of information and understanding (critical thinking).
* UD, your information regarding MAOIs is certainly more current than mine.
> To add to the conversation:
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> New research suggests that MAO-B doesn't break down dopamine as previously thought (at least not to any appreciable extent). However, as mentioned, it does metabolize PEA and it seems to be involved in the formation of GABA. Inhibiting MAO-B reduces the synthesis of GABA which may have motor improving effects. Also, alpha-synuclein clumping is reduced by inhibiting MAO-B and this may produce some of the therapeutic effects in Parkinsons.
>
> A recent study showed that MAO-B was elevated in the prefrontal cortex of depressed patients. Hence, some degree of MAO-B inhibition may be therapeutic in depression (even if it doesn't produce an immediate mood boost). There is also some evidence that COVID may increase MAO-B levels which may contribute to some of the brain fog / loss of energy in long COVID.
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> Linkadge
As far as the necessity to block both MAO subtypes to treat depression, I haven't come across anything that would lead me to believe that an antidepressant response requires that MAO-B be inhibited. In fact, selegiline and clorgyline demonstrate the reverse. I like to mention clorgyline because it is specific for MAO-A. It doesn't affect MAO-B at all. So, for a bunch of treatment resistant cases of depression, the NIH provided clorgyline for people who responded to nothing else. Many of these patients went home happy for the first time. As the doctors at NIH liked to say, "Clorgyline is our ace-in-the-hole." As for selegiline, an antidepressant response occurs only when the dosage is high enough to inhibit MAO-A as well as MAO-B. The manufacturer's package label is explicit regarding this.It seems that heterogeneity in mood disorders is more the rule than the exception. I would not reject research demonstrating that a subset of patients need MAO-B to inhibited in order to achieve remission.
Some see things as they are and ask why.
I dream of things that never were and ask why not.The only thing necessary for the triumph of evil is that good men do nothing.
poster:SLS
thread:1120765
URL: http://www.dr-bob.org/babble/20220917/msgs/1120821.html