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Pirlindole is a small molecule antidepressant classified as a selective and reversible inhibitor of monoamine oxidase A (MAO-A), also known as a RIMA drug. It was developed and is primarily used in Russia and several European and non-European countries for the treatment of major depression. Its chemical structure is similar to metralindole. The main mechanism of action involves selective inhibition of MAO-A, leading to increased levels of norepinephrine and serotonin (5-hydroxytryptamine) by preventing their breakdown. Additionally, pirlindole inhibits the reuptake of noradrenaline and serotonin. It has demonstrated efficacy in treating major depressive disorder as well as fibromyalgia syndrome[1][2][4][8]. Clinical studies have shown that its efficacy is comparable to other antidepressants with a favorable safety profile[7][10].
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