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Pirlindole is a tetracyclic reversible inhibitor of monoamine oxidase A, developed in the Soviet Union and still used in Russia and a few other countries for depression.
- Reversible monoamine oxidase A inhibition, no dietary policing
- Still used in Russia for depression
- Muted cheese reaction, since tyramine displaces it from the enzyme
- Raises serotonin, noradrenaline and dopamine together
- Same logic that made moclobemide viable in the West
- Weak serotonin reuptake inhibition layered on top
Mechanism
Reversible selective MAO-A inhibition raises , noradrenaline and , and it weakly inhibits serotonin reuptake as well. Because the enzyme block is reversible, dietary tyramine can displace the drug rather than accumulate, which is why the classic cheese reaction is muted rather than absent.
Safetyrisks and cautions, not medical advice
a reversible MAO-A inhibitor, so serotonergic and sympathomimetic interactions still apply even though the tyramine pressor reaction is far weaker than with the irreversible MAOIs
Subjective profileweighing the evidence above
Pirlindole is a more interesting drug than its obscurity suggests. Reversible MAO-A inhibition captures much of the monoamine oxidase effect without the dietary policing the irreversible inhibitors demand, because tyramine can displace the drug from the enzyme instead of finding nowhere to go, and that same reasoning is what made moclobemide viable in the West. Reversibility softens the tyramine reaction and changes nothing about serotonin, so combining it with serotonergic drugs still risks serotonin syndrome; that is the caution that actually applies, and the muted cheese reaction is the one most people get wrong.
Where to buy
Suppliers
Vendors carrying Pirlindole, with live product details and codes. Links are affiliate links that support the wiki at no cost to you.
RUPharma🌐
Pirlindole