I am not sure wheter it has already been cited in the drug's review
recently posted by John Cottingham; anyhow I recently read this abstract
about moclobemide (in Europe manufactured by Roche,if I don't fail) a MAO-A
inihibitor (deprenyl is a MAO-B) which seems to be useful in treating
depression in PD patients without aggravating PD itself.
Journal of Clinical Psychopharmacology 15: 4 Suppl. 2 (AUG 1995)
K Sieradzan, S Channon, C Ramponi, GM Stern, AJ Lees, MBH Youdim
The therapeutic potential of moclobemide, a reversible selective monoamine
oxidase A inhibitor in Parkinson's disease
Dopamine is equally well deaminated oxidatively by monoamine oxidase (MAO)
A and B types. Selegiline (L-deprenyl), a selective inhibitor of MAO-B,
ameliorates the ''wearing off'' akinesia and delays the need for levodopa
in mild, previously untreated Parkinson's disease. The therapeutic
potential of selective inhibition of MAO-A in Parkinson's disease has not
been examined in detail. MAO-A accounts for only about 20% of total MAO
activity in the human basal ganglia, and it differs from MAO-B in
distribution. In contrast to MAO-B, which is confined to the extraneuronal
compartment, MAO-A is found both extraneuronally and within the presynaptic
dopaminergic terminals. The inhibition of MAO-A might alter the
intraneuronal handling of dopamine reuptaken from synaptic clefts and
thereby prolong oral levodopa benefit. We have given moclobemide, a
selective, reversible inhibitor of MAO-A, to nondepressed patients with
Parkinson's disease receiving standard levodopa/peripheral decarboxylase
inhibitor or levodopa with dopaminergic agonist (bromocriptine, pergolide).
Selegiline was discontinued at least 8 weeks earlier. A standard oral
levodopa challenge was performed at the patient's entry to the study and
repeated on the 22nd day of moclobemide treatment (150 mg thrice daily).
The overall time spent ''on'' and ''off'' before the onset of treatment and
during the last week on the drug was estimated from the patients' diaries.
Neuropsychological assessments were also made before and after 3 weeks of
moclobemide to measure possible effects on cognitive performance and mood.
In acute levodopa challenge, the latency of motor response was
significantly shortened and its duration was prolonged during moclobemide
treatment. Similarly, the Webster's scores in ''off'' state after overnight
withdrawal of dopaminergic medication improved on moclobemide. In
nondepressed parkinsonian patients, moclobemide did not alter mood and
cognitive measures. The mild symptomatic effect and good tolerance with
standard therapy suggest that moclobemide may be a particularly useful
antidepressant in Parkinson's disease.
On the New England Journal of Medicine, 14th of September issue, there are
two letters concerning fetal tissue trasplant in PD written by
neurosurgeons from Denver (University of Colorado) and Chicago
(Rush-Presbyterian) .The interesting fact is the statement that, in the
future, tissue from a single embryo might tbe adequate to replace lost
cells.It is an opinion, not a matter of fact, but important for all of us
in the list.
Alessandro Pelosio,[log in to unmask],P,43,2
