Priest R G, Gimbrett R, Roberts M, Steinert J
Department of Psychiatry, St Mary's Hospital Medical School, Imperial College of Science, Technology and Medicine, University of London, United Kingdom.
Acta Psychiatr Scand Suppl. 1995;386:40-3. doi: 10.1111/j.1600-0447.1995.tb05923.x.
The clinically tested reversible inhibitors of monoamine oxidase A (RIMAs) include brofaromine, moclobemide and toloxatone. Moclobemide has shown unequivocal antidepressant activity against serious depressive illness in 4 placebo-controlled double-blind trials. It has been compared with amitriptyline, imipramine, clomipramine, desipramine, maprotiline, fluoxetine, fluvoxamine, tranylcypromine, toloxatone, mianserin and amineptine in the treatment of depressive disorders. Meta-analysis showed convincing evidence of moclobemide efficacy, comparable with the most potent antidepressants available. The efficacy of moclobemide has been demonstrated in psychotic and non-psychotic depression, in depression with and without melancholia, in endogenous depression (both unipolar and bipolar), in retarded depression and in agitated depression. The efficacy of moclobemide, allied to the unusually benign side effect profile, has led to exploration of its use in other disorders. Two small studies have given encouraging results in the treatment of attention-deficit hyperactivity disorder. Large placebo-controlled studies have shown the activity of moclobemide in the depression that accompanies dementia (such as senile dementia of Alzheimer type). The results also suggested that, in this patient population, cognitive ability improved in parallel. Social phobia has also been shown to improve on treatment with either moclobemide or brofaromine. Clinical trials are in progress on the effect of moclobemide in chronic fatigue syndrome. Moreover, there are encouraging results with the use of brofaromine and moclobemide in panic disorder. Other disorders in which treatment with RIMA is of interest include agoraphobia, bulimia, borderline personality disorder, post-traumatic stress disorder, compulsive hair pulling (trichotillomania), dysmorphophobia, kleptomania as well as various anxiety syndromes.
经临床测试的单胺氧化酶A可逆抑制剂（RIMAs）包括溴法罗明、吗氯贝胺和托洛沙酮。在4项安慰剂对照双盲试验中，吗氯贝胺已显示出针对严重抑郁症的明确抗抑郁活性。它已与阿米替林、丙咪嗪、氯米帕明、地昔帕明、马普替林、氟西汀、氟伏沙明、反苯环丙胺、托洛沙酮、米安色林和阿密替林进行了比较，用于治疗抑郁症。荟萃分析显示了吗氯贝胺疗效的确凿证据，与现有的最有效的抗抑郁药相当。吗氯贝胺的疗效已在精神病性和非精神病性抑郁症、伴有或不伴有 melancholia的抑郁症、内源性抑郁症（单相和双相）、迟发性抑郁症和激越性抑郁症中得到证实。吗氯贝胺的疗效，加上其异常良性的副作用谱，已促使人们探索其在其他疾病中的应用。两项小型研究在治疗注意力缺陷多动障碍方面取得了令人鼓舞的结果。大型安慰剂对照研究表明吗氯贝胺在伴有痴呆的抑郁症（如阿尔茨海默病型老年痴呆症）中具有活性。结果还表明，在这一患者群体中，认知能力也随之提高。社交恐惧症也已显示在使用吗氯贝胺或溴法罗明治疗后有所改善。关于吗氯贝胺对慢性疲劳综合征影响的临床试验正在进行中。此外，在惊恐障碍中使用溴法罗明和吗氯贝胺也取得了令人鼓舞的结果。其他对RIMA治疗感兴趣的疾病包括广场恐惧症、贪食症、边缘型人格障碍、创伤后应激障碍、强迫性拔毛（拔毛癖）、畸形恐惧症、偷窃癖以及各种焦虑综合征。
