Psycho-Babble Medication Thread 670756

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What exactly does Irreversible mean with MAOI's?

Posted by theo on July 26, 2006, at 12:34:50

Does irreversible mean while you are taking the MAOI it's irreversible or even after you discontinue? Just curious as I'm thinking about starting Emsam.

Re: What exactly does Irreversible mean with MAOI's?

Posted by silvercoin on July 26, 2006, at 12:52:48

In reply to What exactly does Irreversible mean with MAOI's?, posted by theo on July 26, 2006, at 12:34:50

> Does irreversible mean while you are taking the MAOI it's irreversible or even after you discontinue? Just curious as I'm thinking about starting Emsam.

Irreversible MAO inhibitors form a strong covalent bond with MAO and render it permanently useless. MAO activity is not recovered until new MAO is synthesized by the body to replace it. Reversible MAO inhibitors do not bind as tightly and have the ability to detach and allow the MAO to metabolize the relevant substrates such as serotonin and norepinephrine. While this is better from a safety perspective, reversible MAO inhibitors tend to be inferior antidepressants compared to irreversible MAOIs.

Marplan, Nardil, Parnate, and EMSAM/selegiline are all considered to be irreversible MAO inhibitors; although, it should be pointed out that Parnate is not 100% irreversible and has a shorter half life of MAO inhibition than Nardil does. However, Parnate still binds far longer and more tightly than does the reversible MAOI moclobemide, for instance. Marplan is similar to Nardil in this regard, but I am not sure exactly how selegiline compares.

Todd

Re: What exactly does Irreversible mean with MAOI's? » silvercoin

Posted by theo on July 26, 2006, at 14:27:51

In reply to Re: What exactly does Irreversible mean with MAOI's?, posted by silvercoin on July 26, 2006, at 12:52:48

So once you stop the med, your body returns to normal?

Re: What exactly does Irreversible mean with MAOI's?

Posted by silvercoin on July 26, 2006, at 15:47:22

In reply to Re: What exactly does Irreversible mean with MAOI's? » silvercoin, posted by theo on July 26, 2006, at 14:27:51

> So once you stop the med, your body returns to normal?

Yes, but it takes a few weeks to regain normal MAO activity. Generally, a minimum of 14 days is suggested before starting another antidepressant.

Todd

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