Noradrenaline Nialamide

Adrenaline, apomorphine, ascorbic acid, benserazide, dihydralazine, dobutamine, dodecyl gallate, dopamine, ethylnoradren-aline, hexoprenaline, hydralazine, iproniazid, isocarboxazid, isoetharine, isoniazid, isoprenaline, levodopa, meban-azine, methyldopa, methyldopate, nialamide, noradrenaline, phenelzine, procarbazine, protokylol, rimiterol... 

During clinical studies of iproniazid (201) in the treatment of tuberculosis it was found to have a mood-elevating effect. It was later found to be an inhibitor of monoamine oxidase (MAO), the enzyme which oxidatively deaminates such neurotransmitters as noradrenaline and serotonin, and it was tried in the treatment of depression in 1957. Other MAO inhibitors were introduced later, most of them being hydrazine derivatives. Heterocyclic examples include isocarboxazid (202) and nialamide (203). They are toxic and cause dangerous hypertensive crises if food with a high tyramine content is eaten, and on this account their use is limited. 

In contrast, in a study in hypertensive patients who had postural hypotension after being given either pheniprazine (a formerly investigational older MAOI) (6 patients) or tranylcypromine (one patient), the dose of noradrenaline required to produce a 25 mmHg rise in systolic pressure was reduced by 62 to 87%. In three of these patients on pheniprazine the dose of methoxamine was reduced by 61 to 70% compared with that required in the absence of an MAOI. Three patients were later given nialamide augmentation of the pressor response of noradrenaline or methoxamine only occurred in the one patient who had developed postural hypotension. ... 

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