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1.
Melatonin was measured in plasma collected between 8:00 and 8:30 a.m. from 27 depressed patients studied before and after 21- to 24-day treatment with three monoamine oxidase (MAO) inhibitors. Baseline plasma melatonin concentrations determined by radioimmunoassay were 4.0 +/- SD 4.7 pg/ml. Tranylcypromine, a nonselective MAO inhibitor given in doses of 20-40 mg/day for 3 weeks, significantly elevated plasma melatonin to 10.6 +/- SD 2.0 pg/ml. Clorgyline, given in doses of 15-30 mg/day for 3 weeks, produced a significant, approximately three-fold increase in plasma melatonin (13.6 +/- SD 13.5 pg/ml). This clorgyline dose was selective for MAO type A inhibition, as MAO-B activity measured in platelets from the same blood samples was unaffected by clorgyline. In contrast, the selective MAO-B inhibitor deprenyl (10-30 mg/day for 3 weeks) led to a 96 +/- 4% inhibition of platelet MAO-B activity but no significant change in plasma melatonin (5.1 +/- SD 4.2 pg/ml). As both serotonin and norepinephrine are preferentially metabolized by MAO-A rather than MAO-B, an increased availability of serotonin (the precursor of melatonin) or enhanced noradrenergic function might mediate the melatonin changes observed to follow MAO-A but not MAO-B inhibition.  相似文献   

2.
Summary Utilizing the cerebral microdialysis technique, we have compared in vivo the effects of selective MAO-A, MAO-B, and nonselective MAO inhibitors on striatal extracellular levels of dopamine (DA) and DA metabolites (DOPAC and HVA). The measurements were made in rats both under basal conditions and following L-DOPA administration. Extracellular levels of dopamine were enhanced and DA metabolite levels strongly inhibited both under basal conditions and following L-DOPA administration by pretreatment with the nonselective MAO inhibitor pargyline and the MAO-A selective inhibitors clorgyline and Ro 41-1049. The MAO-B inhibitor deprenyl had no effect on basal DA, HVA, or DOPAC levels. Nervertheless, deprenyl significantly increased DA and decreased DOPAC levels following exogenous L-DOPA administration, a finding compatible with a significant glial metabolism of DA formed from exogenous L-DOPA. We conclude that DA metabolism underbasal conditions is primarily mediated by MAO-A. In contrast, both MAO-A and MAO-B mediate DA formation when L-DOPA is administered exogenously. The efficacy of newer, reversible agents which lack the cheese effect such as Ro 41-1049 are comparable to the irreversible MAO-A inhibitor clorgyline. The possible relevance of these findings for the treatment of Parkinson's disease is discussed.  相似文献   

3.
Although nicotine is considered to be responsible for the addictive properties of tobacco, growing evidence underlines the importance of non-nicotine components in smoking reinforcement. It has been shown that tobacco smoke contains monoamine oxidase (MAO) A and B inhibitors and decreases MAO-A and MAO-B activity in smokers. Here, we investigated the effects of clorgyline hydrochloride (irreversible MAO-A inhibitor; 2 mg/kg/day), selegiline (irreversible MAO-B inhibitor; 4 mg/kg) and the beta-carboline norharmane hydrochloride (reversible MAO-B inhibitor; 5 mg/kg/day) treatments on nicotine self-administration (30 microg/kg/infusion, free base) in rats. Independent of the responsiveness to novelty and locomotor activity stimulation, only clorgyline hydrochloride treatment increased the intake of nicotine in a fixed-ratio schedule (FR5) of reinforcement. When a progressive-ratio schedule was implemented, both clorgyline hydrochloride and norharmane hydrochloride treatments potentiated the reinforcing effects of nicotine, whereas selegiline had no effect. Taken together, these results indicate that MAO-A inhibition interacts with nicotine to enhance its rewarding effects in rats and suggest that other compounds present in tobacco, such as beta-carboline, may also play an important role in sustaining smoking behavior in humans.  相似文献   

4.
5.
Catecholamines and other biogenic amines may play a role in early embryogenesis in addition to functioning as neurotransmitters after neuronal differentiation. Regulation of amine levels is mediated by several different parameters including activity levels of degradative enzymes. Since monoamine oxidase (EC 1.4.3.4) is the primary degradative enzyme for these biogenic amines, we have begun to characterize MAO activity during quail embryogenesis. Our results demonstrate that MAO activity is present at all stages of development examined (stages 2–22) and that the MAO specific activity levels are highest during the earliest stages (stages 2–6). Two types of MAO activity similar to adult avian and mammalian MAO-A and MAO-B have been demonstrated by differential clorgyline sensitivity of tryptamine deamination. In addition, SDS-PAGE of embryonic quail [3H]pargyiine-labeled MAO demonstrates that the quail MAO-A and MAO-B flavin-containing subunits have apparent molecular weights of 63,000 and 62,000 respectively.We have begun to assess the functional significance of embryonic quail MAO activity by daily injection of MAO inhibitors (clorgyline or clorgyline plus deprenyl) into fertilized eggs. Clorgyline injection selectively and completely inhibited MAO-A activity, while injection of clorgyline and deprenyl inhibited both MAO-A and MAO-B activities when embryos were assayed after either 2 or 7 days of embryonic development. This paradigm will allow a detailed examination of the effects of MAO inhibition on the developing embryo.  相似文献   

6.
1. Plasma melatonin concentrations were determined after administration of single oral doses (100, 200 and 300 mg) of moclobemide, a reversible inhibitor of monoamine oxidase (MAO) with predominant effects on the A-type of the enzyme, to eight young, healthy male volunteers in a double-blind, random-order, placebo-controlled study. The investigation was later continued in an open fashion by giving a single 10 mg dose of the MAO-B inhibitor deprenyl to the same subjects. 2. Neither drug had any effects on plasma melatonin levels, in spite of very marked MAO-A inhibition after moclobemide (as evidenced by up to 79% average decreases in the plasma concentrations of 3,4-dihydroxyphenylglycol, a deaminated metabolite of noradrenaline) and over 90% inhibition of MAO-B activity in blood platelets after deprenyl. 3. It is concluded that daytime human plasma melatonin levels do not accurately reflect MAO-A inhibition in acute drug studies.  相似文献   

7.
Nagatsu T 《Neurotoxicology》2004,25(1-2):11-20
Monoamine oxidase (MAO) is an enzyme that oxidizes various physiologically and pathologically important monoamine neurotransmitters and hormones such as dopamine, noradrenaline, adrenaline, and serotonin. Two types of MAO, i.e. type A (MAO-A) and type B (MAO-B), were first discovered pharmacologically. MAO-A is inhibited by clorgyline; and MAO-B, by deprenyl. cDNAs MAO-A and MAO-B were cloned and their structures determined. MAO-A and MAO-B are made of similar but different polypeptides and encoded by different nuclear genes located on the X chromosome (Xp11.23). MAO-A and MAO-B genes consist of 15 exons with identical intron-exon organization, suggesting that they were derived from a common ancestral gene. Both enzymes require a flavin cofactor, flavin adenine dinucleotide (FAD), which binds to the cysteine residue of a pentapeptide sequence (Ser-Gly-Gly-Cys-Tyr). Both enzymes exist on the outer membrane of mitochondria of various types of cells in various tissues including the brain. In humans, MAO-A is abundant in the brain and liver, whereas the liver, lungs and intestine are rich in MAO-B. MAO-A oxidizes noradrenaline and serotonin; and MAO-B, mainly beta-phenylethylamine. In the human brain, MAO-A exists in catecholaminergic neurons, but MAO-B is found in serotonergic neurons and glial cells. MAO-A knockout mice exhibit increased serotonin levels and aggressive behavior, whereas MAO-B knockout mice show little behavioral change. The gene knockout mice of MAO-A or MAO-B, together with the observation that some humans lack MAO-A, MAO-B, or both have contributed to our understanding of the function of MAO-A and MAO-B in health and disease. MAO-A and MAO-B may be closely related to various neuropsychiatric disorders such as depression and Parkinson's disease, and inhibitors of them are the subject of drug development for such diseases.  相似文献   

8.
9.
The localization in the guinea pig enteric nervous system (ENS) of monoamine oxidase (MAO) types A and B was investigated at the light and electron microscopic levels. Immunocytochemistry was used to visualize the enzyme protein and histochemistry was employed to study catalytic activity. Type specificity was achieved in histochemical studies by using deprenyl (0.5 microM) to inhibit MAO-B or clorgyline (0.1 microM) to inhibit MAO-A. The distribution of MAO-B immunoreactivity in the ENS corresponded to that of the sites of MAO activity found histochemically to be inhibited by deprenyl, but not clorgyline. MAO-B was observed to be the primary type of MAO found in the intrinsic elements of the ENS and was located in subsets of neurons in both submucosal and myenteric plexuses. MAO-B was not demonstrated immunocytochemically or histochemically in enteric glia, nor, at the light microscopic level, was there significant MAO-B activity or immunoreactivity in serotonin (5-HT)-immunoreactive neuronal cell bodies. In the submucosal plexus about 50% of the neurons expressed MAO-B; these neurons also contained neuropeptide y (NPY) and/or calcitonin gene related peptide (CGRP), but not substance P or vasoactive intestinal polypeptide (VIP). About 10% of myenteric neurons were intensely reactive for MAO-B; again MAO-B was co-localized with NPY and/or CGRP. In contrast to intrinsic neurons, extrinsic CGRP-immunoreactive nerve fibers contained no demonstrable MAO activity or immunoreactivity. Moreover, the sympathetic innervation, identified as varicose axons that degenerated after administration of 6-hydroxydopamine, contained abundant MAO-A, but no MAO-B activity or immunoreactivity. It is concluded that MAO-B is characteristic of a subset of intrinsic enteric neurons, while MAO-A is confined to the sympathetic innervation, which is extrinsic. At the electron microscopic level individual cells varied greatly in their degree of immuno- or cytochemically demonstrable MAO-B, which was most concentrated on the outer membranes of mitochondria. MAO-B immunoreactivity (but not cytochemical activity) was found on mitochondria in some serotoninergic perikarya identified by the simultaneous radioautographic detection of the uptake of 3H-5-HT. Mitochondria in most serotoninergic axon terminals displayed both MAO-B activity and immunoreactivity. Neurons receiving serotoninergic synapses often, but not invariably, contained MAO-B. Inhibition of neither MAO-B nor MAO-A appeared to slow the disappearance of 3H-5-HT loaded into enteric neurons significantly, even when intraneuronal storage of 5-HT was inhibited with tetrabenazine.(ABSTRACT TRUNCATED AT 400 WORDS)  相似文献   

10.
Summary The enzyme monoamine oxidase was labelled in the rat striatum or substantia nigra with locally injected radioactive pargyline. The binding was prevented by a pretreatment with non-radioactive pargyline, or with a combination of clorgyline and deprenyl. Most of the MAO labelled with3H-pargyline was of the B-type, but also some MAO-A was labelled, as shown in rats pretreated with clorgyline or deprenyl separately.Seven days after the injection of (3H)-pargyline into the striatum a significant labelling was observed in the substantia nigra. This labelling was clorgyline sensitive, indicating type A MAO, and was not present when striatal neurons were destroyed with kainic acid. Labelling of the striatum following3H-pargyline injection into the substantia nigra was also less in kainate intoxicated striata. Damage of nigral dopamine neurons with 6-hydroxydopamine did not influence the distribution of the label.Thus by using3H-pargyline, specific labelling and axonal transport of type A MAO in striatal neurons projecting to the substantia nigra was demonstrated.  相似文献   

11.
Rasagiline and (−)deprenyl (selegiline), irreversible type B monoamine oxidase (MAO-B) inhibitors, protect neuronal cells through gene induction of pro-survival Bcl-2 and neurotrophic factors in the cellular models of neurodegenerative disorders. In this paper, the role of MAO in the up-regulation of neuroprotective Bcl-2 gene by these inhibitors was studied using type A MAO (MAO-A) expressing wild SH-SY5Y cells and the transfection-enforced MAO-B overexpressed cells. Rasagiline and (−)deprenyl, and also befloxatone, a reversible MAO-A inhibitor, increased Bcl-2 mRNA and protein in SH-SY5Y cells. Silencing MAO-A expression with short interfering (si) RNA suppressed Bcl-2 induction by rasagiline, but not by (−)deprenyl. MAO-B overexpression inhibited Bcl-2 induction by rasagiline and befloxatone, but did not affect that by (−)deprenyl, suggesting the different mechanisms behind Bcl-2 gene induction by these MAO-B inhibitors. The novel role of MAO-A in Bcl-2 induction by rasagiline is discussed with regard to the molecular mechanism underlying neuroprotection by the MAO inhibitors.  相似文献   

12.
Monoamine oxidase A (MAO-A) inhibition was investigated both in vitro and in vivo in rat brains by using the radioligand, 18F-fluoroclorgyline (N-[3-(2',4'-dichlorophenoxy)-2-18F-fluoropropyl]-N-methylpropa rgylamine). In vitro binding affinities of six compounds, clorgyline, Ro 41-1049, deprenyl, fluoxetine, norfluoxetine and citalopram, were studied. Fluoxetine and norfluoxetine showed in vitro affinities of 36.5 and 68 microM for MAO-A, respectively. Fluoxetine and norfluoxetine also significantly inhibited (more than 20%) the binding of the radioligand in vivo while citalopram and deprenyl showed very poor affinities in vitro for MAO-A and had no effect in vivo. The in vivo effects of the various drugs were directly comparable to their in vitro affinities for binding to MAO-A as seen in the correlation plot of percent control in vivo binding of 18F-fluoroclorgyline and binding affinity, -log IC50 (R2 = 0.979). An acute dose of 20 mg/kg of fluoxetine inhibited binding of 18F-fluoroclorgyline by more than 20%, while lower doses had some significant effects. These results provide evidence on the in vitro and in vivo inhibition of monoamine oxidase A by fluoxetine.  相似文献   

13.
Brain amine system parameters were investigated in Wistar rats sacrificed 7 months following portocaval shunt or sham operation. After removal of the cerebellum and pons, the hypothalamus and remaining parts of the brain were examined. Histamine was assayed radioenzymatically; indoles and catechols by HPLC with electrochemical detection; spermidine and spermine by HPLC with fluorometry. MAO-A and MAO-B activities were estimated with radioassays employing serotonin and beta-phenylethylamine, respectively and specific inhibitors, clorgyline and deprenyl. Long-term portocaval shunt did not significantly alter cerebral catecholamines, serotonin, spermidine or spermine concentrations. However, brain histamine and 5-hydroxyindoleactic acid were significantly raised. Of the MAO enzymes only MAO-B activity was elevated (ca. 25%, p < 0.05) in the hypothalamus but not in the rest of the brain. The kinetic measurements suggest an adaptive change in MAO-B protein synthesis. The data suggest changes evoked by portocaval shunt in brain amine systems are permanent and there are species differences in MAO enzymes' response to higher substrate supply.  相似文献   

14.
The effect of ethanol consumption on the sensitivity of rat brain mitochondrial monoamine oxidases to the inhibition by pargyline in vivo and in vitro was investigated. Administration of pargyline (10 mg/kg, s.c.) produced significantly higher inhibition of MAO-A in alcoholised rats, whereas MAO-B inhibition did not differ from that observed in control animals. The concentration-response curve for the inhibition of brain mitochondrial MAO-A and MAO-B by pargyline in vitro did not reveal higher sensitivity of MAO from alcoholised rats to pargyline. This probably means that more pronounced inhibition by pargyline of brain MAO-A in alcoholised rats in vivo can be attributed to decreased content of compounds reversibly interacting with the its catalytic site. Taking into consideration some ethanol-induced decrease of brain tribulin content we suggest that the reduced level of endogenous inhibitors (tribulin components?) may have some importance in the development of alcoholism.  相似文献   

15.
The possible mechanisms of action of (-)deprenyl in Parkinson's disease   总被引:5,自引:0,他引:5  
Summary (-)Deprenyl, a selective inhibitor of MAO-B, was found to be 60 times less potent in inhibiting intestinal MAO in the rat than clorgyline, the selective inhibitor of MAO-A. This is one of the reasons why (-)deprenyl is safe with respect to the hazards involved in combination with a variety of foods and drugs and its administration is not contraindicated in parkinsonian patients.(-)Deprenyl is a potent inhibitor of the uptake of amines into the nerve endings of catecholaminergic neurons. By the aid of N-methyl-N-propargyl-/l-indenyl/-ammonium. HCl (J-508), a newly developed highly potent MAO inhibitor, devoid of uptake-inhibitory and releasing effects, a tyramine-uptake model for testing the effects of MAO inhibitors on uptake, using different isolated noradrenergic organs (cat nictitating membrane, perfused ear artery and strip of pulmonal artery of the rabbit, rat vas deferens), was introduced. In contrast to the nonselective and A-selective MAO inhibitors, as well as to the newly developed selective MAO-B inhibitors (J-508, U-1424), (-)deprenyl was unique in inhibiting tyramine-uptake in all the tests.(-)Deprenyl was found to inhibit the release of acetylcholine in isolated striatal slices of the rat, owing to its blocking effect on the uptake of dopamine. N-methyl-N-propargyl-/2-furyl-1-methyl/-ethylammonium (U-1424), a new selective inhibitor of MAO-B devoid of uptake-inhibitory effect did not significantly influence the ouabain induced striatal acetylcholine release.The release of dopamine from the synaptosomes of the rat striatum was found to be enhanced by clorgyline and tyramine and only slightly influenced by (-)deprenyl.The advantage of the combination of levodopa and (-)deprenyl in the treatment of Parkinson's disease was summarized as follows. Levodopa exerts its therapeutic effect by stimulating the postsynaptic dopaminergic receptors of the caudate interneurons, thereby it suppresses, by stimulating also the presynaptic autoreceptors, the activity of nigrostriatal dopaminergic neurons. (-)Deprenyl acts as an activator of the nigrostriatal dopaminergic neurons. As these neurons contain MAO-B in man, (-)deprenyl increases the dopamine content of the nerve terminals and as a potent inhibitor of the re-uptake of dopamine it intensifies the physiological control on the cholinergic caudate neurons.  相似文献   

16.
L L Martin  R F Neale  P L Wood 《Brain research》1987,419(1-2):239-243
Chronic treatment with clorgyline, a type A monoamine oxidase (MAO) inhibitor (1 mg/kg/day for 11 days), reduced the number (Bmax) but not the affinity (Kd) of [3H]tryptamine binding sites in rat frontal/parietal cortical membranes. Binding was reduced for at least 36 days following the last injection. The reduction in [3H]tryptamine binding was dose-related and appeared to be maximal following a daily dose of 3 mg/kg. Chronic treatment with deprenyl, a type B MAO inhibitor (1 mg/kg/day for 11 days), did not affect [3H]tryptamine binding. Acute clorgyline administration (11 mg/kg) also had no effect. These data suggest that [3H]tryptamine binds to neurotransmitter receptors for tryptamine since mere chemical recognition sites would not be expected to be modulated by chronic drug treatment. Also, since [3H]tryptamine binding was down-regulated by a type A, but not a type B, MAO inhibitor, tryptamine may be selectively metabolized by type A MAO in vivo.  相似文献   

17.
On the mode of action of L-deprenyl in the human central nervous system   总被引:4,自引:0,他引:4  
Summary It has been shown that 5 or 10 mg (-)deprenyl after i.v. application inhibited platelet MAO within 30 min. This effect correlated with the improvement of parkinsonian patients disability. Platelet MAO is purely of type B, thus resembling the human brain enzyme, which is 80% of type B. In other organs of the human MAO-A is of higher activity, thus it can oxidatively deaminate 5-HT, noradrenaline and tyramine in the periphery. The rather low peripheral side effects of (-)deprenyl can be explained by this fact. In vitro studies demonstrated that (-)deprenyl in comparison to d, l-tranylcypromine, clorgyline and harmaline is by far the most potent inhibitor of human brain MAO. Post-mortem studies in different human brain areas showed that there are differences in the behaviour of (-)deprenyl (10 mg) between short- and long-term treatment. Both show sufficient inhibition of DA-sensitive MAO (85–90%). However, when 5-HT is used as a substrate short-term treatment inhibits by about 40–50% whereas long-term treatment inhibits by about 65% which is higher than that mentioned before but not sufficient to increase brain 5-HT or decrease 5-HIAA. Therefore, long-term treatment with more than 1 mg/10 kg body weight could result in an accumulation of (-)deprenyl in the brain. Evidence for this derives from one parkinsonian patient, who was treated with 100 mg (-)deprenyl in which case both forms of the enzyme were inhibited sufficiently to increase DA and 5-HT in several brain regions.  相似文献   

18.
Summary. The present study examined the effect of the highly potent and selective MAO B inhibitor PF9601N on L-DOPA-induced rotational behavior in unilateral nigrostriatal 6-hydroxydopamine lesioned rats. Three doses of PF9601N (20, 40 and 60 mg/kg) were administered 30 min before an injection of L-DOPA (25 mg/kg), and both contralateral and ipsilateral rotational behavior was measured. In addition, we also studied the effect produced by another MAO B inhibitor, deprenyl (20 mg/kg), the MAO A inhibitor, clorgyline (20 mg/kg), and the dopamine reuptake inhibitor, GBR2909 (7.5 mg/kg) on L-DOPA-induced rotational behavior. The results showed that PF9601N plus L-DOPA significantly enhanced the duration of contralateral rotational behavior with respect to L-DOPA plus vehicle in a dose-related manner. At the dose of 40 and 60 mg/kg, PF9601N produced significantly more overall contralateral turning than L-DOPA plus vehicle, and at the dose of 60 mg/kg, PF9601N produced significantly more turning behavior than L-DOPA plus deprenyl. These results suggest that PF9601N may be used as a novel tool in the treatment of Parkinson's disease. Received March 18, 1999; accepted September 23, 1999  相似文献   

19.
Monoamine oxidase (MAO) inhibitors were the first antidepressant drugs to be prescribed and are still used today with great success, especially in patients resistant to other antidepressants. In this study, we evaluated the MAO inhibitory properties and the potential antidepressant action of 2-(3,4-dimethoxy-phenyl)-4,5-dihydro-1H-imidazole (2-DMPI) in mice. We found that 2-DMPI inhibited both MAO isoforms (K(i) values were 1.53 (1.3-1.8) μM and 46.67 (31.8-68.4) μM for MAO-A and MAO-B, respectively) with 30-fold higher selectivity toward MAO-A. In relation to the nature of MAO-A inhibition, 2-DMPI showed to be a mixed and reversible inhibitor. The treatment with 2-DMPI (100-1000 μmol/kg, s.c.) caused a significant decrease in immobility time in the tail suspension test (TST) without affecting locomotor activity, motor coordination or anxiety-related activities. Conversely, moclobemide (1000 μmol/kg, s.c.) caused a significant increase in immobility time in the TST, which appeared to be mediated by a nonspecific effect on motor coordination function. 2-DMPI (300 μmol/kg, s.c.) decreased serotonin turnover in the cerebral cortex, hippocampus and striatum, whereas dopamine turnover was diminished only in the striatum, and norepinephrine turnover was not changed. The antidepressant-like effect of 2-DMPI was inhibited by the pretreatment of mice with methysergide (2 mg/kg, s.c., a non-selective serotonin receptor antagonist), WAY100635 (0.1 mg/kg, s.c., a selective 5-HT(1A) receptor antagonist) or haloperidol (0.05 mg/kg, i.p., a non-selective dopamine receptor antagonist). These results suggest that 2-DMPI is a prototype reversible and preferential MAO-A inhibitor with potential antidepressant activity, due to its modulatory effect on serotonergic and dopaminergic systems.  相似文献   

20.
Monoamine oxidase (MAO) inhibitors are being investigated as possible medications for cocaine dependence, but there are potential problems with this approach. In the present study, we tested the hypothesis that inhibition of catecholamine metabolism with the MAO-A inhibitor, clorgyline, might enhance cocaine-induced increases in extracellular dopamine and norepinephrine in rat nucleus accumbens. Male rats were pretreated with clorgyline (1 mg/kg, s.c.) or its saline vehicle (1 ml/kg, s.c.), and microdialysis probes were inserted into previously implanted guide cannulae. After overnight perfusion of the probes in situ, rats received an acute challenge injection of either cocaine (1 mg/kg, i.v.) or its saline vehicle (1 ml/kg, i.v.). Clorgyline pretreatment alone caused significant elevations in basal levels of dialysate norepinephrine but not dopamine. Cocaine administration elicited significant increases in extracellular dopamine and norepinephrine in all groups of rats, and this effect was not altered by clorgyline pretreatment. The 1 mg/kg dose of clorgyline decreased dopamine metabolites in postmortem brain tissue by more than 80%. Our data are consistent with clinical studies that demonstrate pretreatment with the MAO-B selective inhibitor, selegeline, fails to alter cocaine-induced subjective effects in human drug users. Moreover, these findings suggest that adverse consequences related to altered catecholamine transmission would not occur if patients taking phenelzine, a non-selective MAO inhibitor, relapsed and used cocaine.  相似文献   

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