Abstract
Brofaromine, a selective and reversible inhibitor of monoamine oxidase-A (MAO-A) was given to 19 women while 17 received placebo for 8 weeks. All met DSM III-R criteria for bulimia nervosa, a psychiatric disorder in which uncontrolled overeating episodes are accompanied by purging activities and extreme concerns about body shape and weight. The following indices were measured: plasma and urinary phenylacetic acid (PAA), homovanillic acid (HVA), vanillylmandellic acid (VMA); plasma tryptamine (T), β phenylethylamine (PE), and 5-hydroxyindoleacetic acid (5-HIAA) and urinary 6-sulphatoxymelatonin (aMT6s). PE levels remained the same but T showed a trend toward elevation over time. Twenty-four hour levels of urinary aMT6s in BN patients were higher at week 4 when compared to baseline and week 8. There was a significant reduction in plasma VMA and HVA over time during treatment with brofaromine and both plasma HVA and VMA were significantly lower for the brofaromine group compared to placebo at week 4. Plasma 5-HIAA was significantly higher for the brofaromine group after 8 weeks when compared to placebo. Urinary VMA decreased significantly from baseline to week 4 with a partial elevation at 8 weeks. Urinary VMA was also significantly lower in patients on brofaromine at week 4. This study verifies that brofaromine complies with predicted MAO-A inhibiting patterns in a clinical population.
Similar content being viewed by others
References
American Psychiatric Association 1987. Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev). Author, Washington, D.C.
Kaye, W. H., Ballenger, J. C., Lydiard, R. B., Stuart, G. W., Laraia, M. T., O'Neil, P., Fossey, M. D., Lesser, S. and Hsu, G. CSF monoamine levels in normal-weight bulimia: Evidence for abnormal noradrenergic activity. Am. J. Psychiatry, 147:225–229.
Goldbloom, D. S. and Garfinkel, P. E. 1990. The serotonin hypothesis of bulimia nervosa: theory and evidence. Can. J. Psychiatry, 35:741–744.
Kaye, W. H. 1992. Neurotransmitter abnormalities in anorexia and bulimia nervosa. Pages 105–134.in G. H. Anderson and S. H. Kennedy (eds). The Biology of Feast and Famine: Relevance to Eating Disorders. San Diego: Academic Press.
Beck-Friis, J., Kjellman, B. F., Aperia, B., Unden, F., von Rosen, D., Lunggren, J.-G. and Wetterberg, L. Serum melatonin in relation to clinical variables and a hypothesis of a low melatonin syndrome. Acta Psychiat. Scand. 71:319–330.
Brown, R. P., Kocsis, J. H., Caroff, S., Amsterdam, J., Winokur, A., Stokes, P. E. and Frazer, A. Differences in nocturnal melatonin secretion between melancholic depressed patients and control subjects. Am J. Psychiatry, 142:811–816.
Kennedy, S. H., and Brown, G. M. 1992. The effect of chronic antidepressant treatment with adinazolam and desipramine on melatonin output. Psychiatry Res., 43:177–185.
Kennedy, S. H., Garfinkel, P. E., Parienti, V., Costa, D. and Brown, G. M. Changes in melatonin, but not cortisol are associated with depression in eating disorder patients. Arch. Gen. Psychiatry, 46:73–78.
Sabelli, H. C., Fawcett, J., Gusovsky, F., Javaid, J., Edwards, J. and Jeffriess, H. 1983. Urinary phenylacetate: A diagnostic test for depression? Science, 22:1187–1188.
Sabelli, H. C., Javaid, J. I., Fawcett, J., Kravitz, H. M. and Wynn, P. 1990. Urinary phenylacetic acid in panic disorder with and without depression. Acta Psychiat. Scand. 82:14–16.
Linnoila, M., Karoum, F. and Potter, W. Z., 1982. Effect of low-dose clorgyline on 24-hour urinary monoamine excretion in patients with rapidly cycling bipolar affective disorder. Arch. Gen. Psychiatry, 39:513–516.
Robinson, D. S., Johnson, G. A., Nies, A., Corcella, J., Cooper, T. B., Albright, D. and Howard, D. 1983. Plasma level of catecholamines and dihydroxyphenylglycol during antidepressant drug treatment. J. Clin. Psychopharm. 3:282–287.
Major, L. F., Murphy, D. L., Lipper, S., and Gordon, E. 1979. Effects of clorgyline and pargyline on deaminated metabolites or norepinephrine, dopamine, and serotonin in human cerebrospinal fluid. J. Neurochem. 32:229–231.
Waldmeier, P. C. and Baumann, P. A. 1983. Effects of CGP 11305A, a new reversible and selective inhibitor of MAOA, on biogenic amine levels and metabolism in the rat brain. Naunyn-Schmiodeberg's Arch Pharmacol. 324:20–26.
Walsh, T., Gladis, M., Roose, S. P., Stewart, J. W., Stetner, F. and Glassman, A. H. 1988. Phenelzine vs placebo in 50 patients with bulimia. Arch. Gen. Psychiatry. 45:471–475.
Kennedy, S. H., Piran, N., Warsh, J. J., Prendergast, P., Mainprize, E., Whynot, C. and Garfinkel, E. 1988. A trial of isocarboxazid in the treatment of bulimia nervosa. J. Clin. Psychopharm. 8:391–396.
Kennedy, S. H., Goldbloom, D. S., Ralevski, E., D'Souza, J. and Lofchy, J. Is there a role for selective MAO-inhibitor therapy in bulimia nervosa? A placebo controlled trial of brofaromine. J Clin Psychopharm (in press).
Davis, B. A., Kennedy, S. H., Durden, D. A., D'Souza, J., Goldbloom, D. S. and Boulton, A. A. 1993. The effect of the MAO-A selective inhibitor brofaromine on the plasma and urine concentrations of some biogenic amines and their acidic metabolites in bulimia nervosa. Progr. Neuro-Psychopharmacol. & Biol. Psychiat. (in press).
Waldmeier, P. C., Antonin, K. H., Feldtrauer, J. J., Grunenwald, C., Paul, E., Lauber, J. and Bieck, P. 1983. Urinary excretion of O-methylated catecholamines, tyramine and phenylethylamine by volunteers treated with tranylcypromine and CGP 11305 A. Eur. J. Clin. Pharmacol. 25:361–368.
Bieck, P. R., Antonin, K. H., Balon, R., and Oxenkrug, G. 1988. Effect of brofaromine and pargyline on human plasma melatonin concentrations. Prog. Neuro-psychopharm. Biol. Psychiat. 12:93–101.
van Vliet, I. M., Westenberg, H. and DenBoer, J. 1991. The efficacy of a reversible MAO inhibitor, brofaromine, in panic disorder. Biol. Psychiatry, 29(11S):266S-267S.
Murphy, D. L., Tamarkin, L., Sunderland, T., Garrick, N. A. and Cohen, R. M. 1986. Human plasma melatonin is elevated during treatment with the monoamine oxidase inhibitors clorgyline and tranylcypromine but not deprenyl. Psychiatry Res. 17:119–127.
Checkley, S. A., Thompson, C., Burton, S., Franey, C. and Arendt, J. 1985. Clinical studies of the effect of (+) and (−) oxaprotiline upon noradrenaline uptake. Psychopharm. 87:116–118.
Fritze, J., Laux, G., Sofic, E., Koronakis, P., Schoerlin, M. P., Riederer, P. and Beckmann, H. 1989. Plasma moclobemide and metabolites: lack of correlation with clinical response and biogenic amines. Psychopharmacol. 99:252–256.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kennedy, S.H., Davis, B.A., Brown, G.M. et al. Effects of chronic brofaromine administration on biogenic amines including sulphatoxymelatonin and acid metabolites in patients with bulimia nervosa. Neurochem Res 18, 1281–1285 (1993). https://doi.org/10.1007/BF00975048
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00975048