Reversible inhibitors of monoamine oxidase A in anxiety disorders

Classical irreversible monoamine oxidase (MAO) inhibitors are efficacious in anxiety disorders. However, their side-effect profile and the risk for a potentially fatal hypertensive crisis caused by interactions with dietary tyramine limit their use. New, reversible inhibitors of monoamine oxidase A (RIMAs), such as moclobemide and brofaromine, show less tyramine potentiation and can be taken with only minimal dietary restriction. Their broad spectrum of antidepressant activity and their better tolerability than tricyclic antidepressants indicate a potential advantage in the treatment of anxiety disorders as well, Results from placebo-controlled and open-label studies with moclobemide demonstrate that the drug is efficacious in patients with social phobia and panic disorder. Because of their low toxicity and the benign safety profile, RIMAs may become the drugs of choice in patients with anxiety disorders.