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Monoamine oxidase inhibitor : ウィキペディア英語版
Monoamine oxidase inhibitor

Monoamine oxidase inhibitors (MAOIs) are chemicals which inhibit the activity of the monoamine oxidase enzyme family. They have a long history of use as medications prescribed for the treatment of depression. They are particularly effective in treating atypical depression. They are also used in the treatment of Parkinson's disease and several other disorders.
Because of potentially lethal dietary and drug interactions, monoamine oxidase inhibitors have historically been reserved as a last line of treatment, used only when other classes of antidepressant drugs (for example selective serotonin reuptake inhibitors and tricyclic antidepressants) have failed.〔(Mayo Clinic Staff, "Depression (major depression): Treatment and drugs" )〕 New research into MAOIs indicates that much of the concern over their dangerous dietary side effects stems from misconceptions and misinformation, and that despite proven effectiveness of this class of drugs, it is underutilized and misunderstood in the medical profession.
New research also questions the validity of the perceived severity of dietary reactions, which has historically been based on outdated research.
However this research also notes that many practitioners have a poor understanding of drug interactions, and 'drug interactions can be serious, and concomitant medication use must be stringently overseen' as they 'can cause a dangerous or fatal serotonin syndrome/ toxicity'.〔
==Indications==
Newer MAOIs such as selegiline (typically used in the treatment of Parkinson's disease) and the reversible MAOI moclobemide provide a safer alternative〔 and are now sometimes used as first-line therapy.
MAOIs have been found to be effective in the treatment of panic disorder with agoraphobia, social phobia,〔Versiani M, Nardi AE, Mundim FD, Alves AB, Liebowitz MR, Amrein R. Pharmacotherapy of social phobia. A controlled study with moclobemide and phenelzine. BJP (). 1992 Sep 1 (2013 Oct 4 );161(3):353–60. Available from: http://bjp.rcpsych.org/content/161/3/353〕 atypical depression or mixed anxiety and depression, bulimia,〔Rothschild R, Quitkin HM, Quitkin FM, Stewart JW, Ocepek-Welikson K, McGrath PJ, et al. "A double-blind placebo-controlled comparison of phenelzine and imipramine in the treatment of bulimia in atypical depressives. ''International Journal of Eating Disorders'' 15(1):1–9. 〕 and post-traumatic stress disorder, as well as borderline personality disorder. MAOIs appear to be particularly effective in the management of bipolar depression according to a recent retrospective-analysis. There are reports of MAOI efficacy in obsessive-compulsive disorder (OCD), trichotillomania, dysmorphophobia, and avoidant personality disorder, but these reports are from uncontrolled case reports.
MAOIs can also be used in the treatment of Parkinson's disease by targeting MAO-B in particular (therefore affecting dopaminergic neurons), as well as providing an alternative for migraine prophylaxis. Inhibition of both MAO-A and MAO-B is used in the treatment of clinical depression and anxiety.
MAOIs appear to be particularly indicated for outpatients with dysthymia complicated by panic disorder or hysteroid dysphoria, which involves repeated episodes of depressed mood in response to feeling rejected.〔http://www.psycom.net/hysteroid.html 〕

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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