About Joshua Cappuccilli Expertise I can answer most questions involving medication use, side effects, adverse effects, interactions and how drugs relate to specific disease states. Noone can answer all questions; I will respond as such if I cannot provide an answer. I will provide resources / references for the information that I use to formulate the answer given.
Experience I am a PharmD with my degree from the University of FLorida - currently I am preparing to take the state boards in Florida.
Organizations California Phamacist Association
American Pharmacy Assocaition
Education/Credentials BA University of South Florida
PharmD University of Florida
Question Hi,
I am aware that 300mg of manerix provides MAO-A (serotonin) inhibition at 80%. Does this give us an indication of how much serotonin is more available in the brain? For example, it's documented that 20mg of paroxetine provides 80% blockade of 5HT, suggesting the availability of serotonin is quite significant. I'm assuming the higher the does of the MAO the more inhibition on the destructive enzymes, the more available the neurotransmitters, but I'm trying to find actual documented data. If you could help me find it, it would be greatly appreciated.
Sincerely,
Jennifer
Answer I AM USING ALL CAPS TO DIFFERENTIATE FROM YOUR QUESTION:
I am aware that 300mg of manerix provides MAO-A (serotonin) inhibition at 80%. Does this give us an indication of how much serotonin is more available in the brain?
NO - FIRST THE MAO-I THAT YOU ARE DISCUSSING IS NOT SELECTIVE - IT HAS RELATIVE SELECTIVITY. I AM A LITTLE OUT OF MY ELEMENT HERE BECAUSE THERE IS NOT A REVERSIBLE MAO-I THAT IS AVAILABLE IN THE US - NOTHING FOR ME TO COMPARE THE DRUG YOU ARE ASKING ABOUT TO. IF* THE INFORMATION THAT YOU ARE GIVING ME ABOUT 80% INHIBITION OF MAO-A IS ACCURATE THERE IS STILL INHIBITION OF MAO-B IN A DOSE DEPENDENT MANNER. INHIBITION OF A>B STILL WILL RESULT IN ACCUMULATION OF NOREPINEPHRINE, DOPAMINE AND SERATONIN. THE MECHANISM OF ACTION IS DESCRIBED AS DOING THIS IN THE LEXI-COMP DATABASE. IN ANY EVENT...NO IT DOES NOT ALLOW US TO EXTRAPOLATE THE AMOUNT OF SERATONIN BECAUSE BY INHIBITING IT'S BREAKDOWN WE ARE MAKING MORE AVAILABLE - WE ALLOW THE AMOUNT THAT WOULD HAVE NORMALLY BEEN DEACTIVATED TO ACUMULATE BY REDUCING THE CAPACITY OF MAO BY 80% (AGAIN YOUR NUMBERS) PLUS WE ARE INHIBITING DEGREDATION OF THE OTHER COMPOUNDS AS WELL.
For example, it's documented that 20mg of paroxetine provides 80% blockade of 5HT,availability of serotonin is quite significant. I DO NOT FOLLOW THIS - IF THE DRUG REDUCES METABOLISM BY 80% TO EXERT IT'S EFFECT THAT MEANS THAT THE BODY IS ABLE TO DEGRADE AT LEAST 80% MORE THAN THE INDIVIDUAL REQUIRES TO OPERATE WITHOUT SYMPTOMS (DEPRESSION). THAT MEANS (TO ME) THAT THERE IS FAR FAR TO LITTLE SERATONIN.
I'm assuming the higher the does of the MAO the more inhibition on the destructive enzymes, the more available the neurotransmitters, but I'm trying to find actual documented data. WHAT YOU ARE SAYING IS DESCRIBED IN THE MECHANISM OF ACTION OF THE DRUGS - THERE IS NOT GOING TO BE ANY STUDIES OF THE INHIBITION AS IT RELATES TO THE AVAILABILITY OF THE NEUROTRANSMITTER THAT ARE ANYTHING BUT LAB BASED - PEOPLE ARE VARIABLE AND I CANNOT IMAGINE TAPPING A PATIENTS BRAIN TO GET THIS INFORMATION!
If you could help me find it, it would be greatly appreciated.
THE MECHANISM OF ACTION DESCRIBED IN THE PACKAGE INSERT FOR THE DRUGS THAT YOU ARE ASKING ABOUT ENUMERATE EXACTLY WHAT YOU ARE ASKING FOR - INHIBITION OF MAO RESULTS IN ACCUMULATION OF NOREPI, DOPAMINE AND SERATONIN.
