Berlin I, Zimmer R, Cournot A, Payan C, Pedarriosse A M, Puech A J
Department of Clinical Pharmacology, Hôpital Pitié-Salpétrière, Paris, France.
Clin Pharmacol Ther. 1989 Sep;46(3):344-51. doi: 10.1038/clpt.1989.149.
Monoamine oxidase inhibitors can elicit increases in systolic blood pressure after tyramine ingestion (cheese effect). Moclobemide is a new, reversible, preferential monoamine oxidase A inhibitor with antidepressant properties. Its potentiation of the tyramine pressor effect during 200 mg t.i.d. chronic treatment was compared with tranylcypromine, 10 mg b.i.d., in a double-blind, parallel-group, placebo-controlled study (n = 16). Tyramine was mixed with food and ingested in increasing daily doses, during a normal meal, until a systolic blood pressure increase of at least 30 mm Hg was achieved (tyramine 30). When compared with the usual fasting oral tyramine tests performed in the same subjects, the mean tyramine 30 dose with a meal was 2.8 times higher. The mean tyramine 30 dose with a meal decreased from 1450 mg (range, 800 to 2000 mg) during placebo to 306 mg (range, 150 to 500 mg) during moclobemide (factor, 5.0) and from 1200 mg (range, 1000 to 1600 mg) during placebo to 35 mg (range, 20 to 50 mg) during tranylcypromine (factor, 38.2). The duration of the systolic blood pressure increase was longer with tranylcypromine (126 minutes) than with moclobemide (69 minutes) (p less than 0.01).
单胺氧化酶抑制剂在摄入酪胺后可引起收缩压升高（奶酪效应）。吗氯贝胺是一种新型、可逆、选择性单胺氧化酶A抑制剂，具有抗抑郁特性。在一项双盲、平行组、安慰剂对照研究（n = 16）中，将其在200mg每日三次的慢性治疗期间对酪胺升压效应的增强作用与反苯环丙胺（10mg每日两次）进行了比较。酪胺与食物混合，在正常进餐期间以递增的每日剂量摄入，直至收缩压升高至少30mmHg（酪胺30）。与在同一受试者中进行的常规空腹口服酪胺试验相比，进餐时酪胺30的平均剂量高出2.8倍。进餐时酪胺30的平均剂量从安慰剂期间的1450mg（范围800至2000mg）降至吗氯贝胺期间的306mg（范围150至500mg）（系数为5.0），从安慰剂期间的1200mg（范围1000至1600mg）降至反苯环丙胺期间的35mg（范围20至50mg）（系数为38.2）。反苯环丙胺引起的收缩压升高持续时间（126分钟）比吗氯贝胺（69分钟）长（p<0.01）。
