The clinically tested reversiblc inhibitors of monoamine oxidase A (RIMAs) include brofaromine, moclobemide and toloxatone. Moclobemide has shown unequivocal antidepressant activity against serious deprcssivc illness in 4 placebo‐controlled double‐blind trials. It has been compared with amitriptyline, imipramine, clomipramine, desipramine, maprotiline, fluoxetine, fluvoxamine, tranylcypromine. toloxatone, mianserin and amineptine in the treatment of depressive disorders. Meta‐analysis showed convincing evidence of moclobemide efficacy, comparable with the most potent antidepressants available. The efficacy of moclobemide has been demonstrated in psychotic and non‐psychotic depression, in depression with and without melancholia, in endogenous depression (both unipolar and bipolar), in retarded depression and in agitated depression. The efficacy of moelobemide, allied to the unusually benign side effect profile, has led to exploration of its use in other disorders. Two small studies have given encouraging results in the treatment of attention‐deficit hyperactivity disorder. Large placebo‐controlled studies have shown the activity of moclobemide in the depression that accompanies dementia (such as senile dementia of Alzheimer type). The results also suggested that, in this patient population, cognitive ability improved in parallel. Social phobia has also been shown to improve on treatment with either moclobemide or brofaromine. Clinical trials are in progress on the effect of moclobemide in chronic fatigue syndrome. Moreover, there are encouraging results with the use of brofaromine and moclobemide in panic disorder. Other disorders in which treatment with RIMA is of interest include agoraphobia, bulimia, borderline personality disorder, post‐traumatic stress disorder, compulsive hair pulling (trichotillomania), dysmorphophobia, kleptomania as well as various anxiety syndromes.

Psychiatrists are becoming increasingly involved in the assessment of candidates for genetic testing for Huntington's disease (HD) in which their role ranges from diagnosing conventional psychiatric disorder to identifying ‘new odd behaviours'. They are also expected to predict dysfunctional response to test results (e.g. self-harm). This paper describes the psychiatric component of the Cambridge HD Clinic and its assessment protocols. Practical concepts, useful to the understanding of the clinical problems that may be encountered, are also discussed.