吗氯贝胺的临床应用  

Clinical application of moclobemide

作　　者：王红星[1] 王祖承[1] 张明岛[1] 

机构地区：[1]上海第二医科大学精神医学教研室,上海200030

出　　处：《中国新药与临床杂志》2004年第6期378-381,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：吗氯贝胺是一种可逆性选择性单胺氧化酶A抑制剂 ,对抑郁症 (不同亚型 )的疗效肯定 ,与三环类 (或一些杂环类药物 )和 5 羟色胺再摄取抑制剂相当。吗氯贝胺有效治疗量为 30 0～ 6 0 0mg·d- 1,分 2～ 3次服用。另外吗氯贝胺对社交恐惧症、惊恐障碍的疗效与氟西汀和氯米帕明相当。吗氯贝胺的不良反应最常见的是恶心和失眠。在治疗剂量 ,吗氯贝胺对精神运动性表现、认知功能和心血管系统没有显著不良反应。其耐受性好。吗氯贝胺的剂量在小于 90 0mg·d- 1时 ,不必考虑饮食限制。吗氯贝胺是CYP2C19的底物 ,其血浆T1/2 短 ,在 2 4h内可换用其他药物。Moclobemide is a selective reversible inhibitor of monoamine-oxidase-A. Most comparative studies indicated that it was more efficacious than placebo and as efficacious as tricylic (or some heterocyclic) antidepressants or selective serotonin reuptake inhibitors (SSRIs) in the treatment of subtypes of depression. The effective therapeutic dose range for moclobemide was 300 to 600 mg·d -1 and taken in 2 to 3 times. It was also found that moclobemide was efficacious as fluoxetine or clomipramine in patients suffering from social phobia and panic disorder. Nausea and insomnia were the most conventional adverse reaetions of moclobemide. Moclobemide was better tolerated than tricylic(or heterocyclic) antidepressants due to its negligible anticholinergic and antihistaminic actioins. Gastrointestinal adverse reactions and sexual dysfunction occured much less frequently with moclobemide than with SSRIs. At therapeutic doses, moclobemide had no significant adverse reactions to psychomotor performance, cognitive function or cardiovascular system. At a dose of moclobemide up to 900 mg·d -1, no dietary tyramine restriction is required. Moclobemide is a substrate for CYP2C19 and has a relatively short plasma elimination half-life, which allows non-responders to change to use an alternative antidepressants within 24 h.

关 键 词：吗氯贝胺 单胺氧化酶抑制剂 抑郁症 细胞色素P450 药物相互作用 药物不良反应 

分 类 号：R971.43[医药卫生—药品]