Jarrott B, Vajda F J
Med J Aust. 1987 Jun 15;146(12):634-8. doi: 10.5694/j.1326-5377.1987.tb120442.x.
The enzyme monoamine oxidase (MAO) plays an important role in the inactivation of both dietary amines and also of neurotransmitter amines. A study of the properties of irreversible inhibitors of this enzyme suggests that the enzyme exists in two broad types--MAO-A and MAO-B. Although irreversible inhibitors of MAO were once widely used as antidepressant agents, they fell from favour because of adverse reactions after the ingestion of amine-containing foodstuffs ("the cheese reaction"). However, these inhibitors (phenelzine and tranylcypromine) are probably best for the treatment of atypical depression providing the patient is aware of dietary reactions. A new series of reversible, MAO-A selective inhibitors are being developed which do not exhibit serious dietary interactions. These reversible inhibitors show promise as rapidly acting antidepressant agents. An atypical irreversible MAO-B selective inhibitor, selegiline (deprenyl) does not exhibit an adverse reaction on the ingestion of amine-containing foods. This drug has been used as an adjuvant in the treatment of Parkinson's disease since it allows the dose of L-dopa to be reduced by approximately 25%. More important, selegiline may slow the degeneration of dopaminergic neurons that is characteristic of Parkinson's disease.
单胺氧化酶（MAO）在膳食胺和神经递质胺的失活过程中都起着重要作用。一项关于该酶不可逆抑制剂性质的研究表明，该酶存在两种主要类型——MAO - A和MAO - B。尽管MAO的不可逆抑制剂曾被广泛用作抗抑郁药，但由于摄入含胺食物后会出现不良反应（“奶酪反应”），它们逐渐失宠。然而，如果患者了解饮食反应，这些抑制剂（苯乙肼和反苯环丙胺）可能最适合治疗非典型抑郁症。一系列新型的、可逆的、MAO - A选择性抑制剂正在研发中，它们不会表现出严重的饮食相互作用。这些可逆抑制剂有望成为快速起效的抗抑郁药。一种非典型的不可逆MAO - B选择性抑制剂，司来吉兰（丙炔苯丙胺）在摄入含胺食物时不会出现不良反应。这种药物自允许将左旋多巴的剂量减少约25%以来，一直被用作帕金森病治疗的辅助药物。更重要的是，司来吉兰可能会减缓帕金森病特有的多巴胺能神经元的退化。
