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Biology of MDD: Elevated MAO-A Levels in the Brain While the monoamine theory of depression suggests that monoamine levels are lowered in depression, it does not explain how monoamine lowering takes place.22 Because the enzyme MAO-A metabolizes and regulates serotonin, norepinephrine, and dopamine in the brain, it is a logical contributor to the pathophysiology of depression.22,23 Meyer et al22 studied 17 healthy individuals and 17 individuals with MDD to determine if MAO-A levels in the brain are elevated during episodes of untreated depression