Inhibitors of Monoamine Oxidase

MAOIs increase synaptic availability of serotonin, noradrenaline and dopamine by inhibiting their intracellular metabolism. The classical MAOIs phenelzine and tranylcypromine bind irreversibly to monoamine oxidase, whilst the newer drug moclobemide is a reversible inhibitor of monoamine oxidase A (RIMA). The long history of use of MAOIs in panic disorder, PTSD and social anxiety disorder is supported by controlled trials (Sheehan et al. 1980 Frank et al. 1988 Versiani et al. 1992). The evidence...

Stroke

There are a number of microdialysis studies in animals indicating that there is a consistent increase in extracellular glutamate concentration during experimental ischaemia (Benveniste et al. 1984 Globus et al. 1988). In man, there is also an increase in CSF and plasma content of glutamate and glycine in patients with progressive, but not with stable stroke (Castillo et al. 1997). Considering the shortage of energy in neurons during ischaemia, an increase in extracellular glutamate...

Discontinuation Problems

The major controversy surrounding the use of benzodiazepines has concerned the risks of long-term treatment, specifically tolerance, abuse, dependence and withdrawal effects. From being the most widely prescribed psychotropic drug they suffered a major backlash, but a more balanced view of their place in treatment is emerging (Williams and McBride 1998). After 40 years of clinical experience there is little evidence of tolerance to the anxiolytic effects of benzodiazepines (Rickels and...

The Sequence of the Human Genome

The knowledge of the sequence of the human genome, which has been publicly available to all researchers since February 2001 (Lander et al. 2001 Venter et al. 2001), has dramatically changed the possibilities for genetic approaches. It is now possible to screen the whole genome in a hypothesis- free approach for any association with drug response. To be able to investigate the whole genome, frequent and evenly distributed genetic markers are needed. In the last few years, single nucleotide...

Anxiolytic Comprtive Table

These drugs increase synaptic serotonin by selectively blocking the serotonin reuptake transporter. In preclinical and human studies acute doses tend to be anxiogenic Bell and Nutt 1998 but chronic administration has anxiolytic effects, possibly due to downregulation of presynaptic autoreceptors Blier et al. 1990 . There are five SSRIs widely available citalopram, fluoxetine, fluvoxam-ine, paroxetine and sertraline. Escitalopram, the S-enantiomer of citalopram, Table 3 Antidepressants in...