The Classic MAOIs: Our Capsule Summaries

Arguably, the most confusing thing about MAOIs is keeping track of which medication is tranylcypromine and which is phenelzine. The following mnemonics work for me, and perhaps they will for you:

 Why We Should be Interested in Natural MAO Inhibitors

Fortunately, in recent years there have been several plant-based MAO inhibitors that have so far shown low side effects, despite therapeutic doses of MAO inhibition.

 “Much ado about nothing”: monoamine oxidase inhibitors, drug interactions, and dietary tyramine

What explains this discrepancy between the published literature and the view of experienced practitioners contrasted with the reality of the near-total lack of use of MAOIs? (Current usage is about 0.1% of all antidepressant scripts.Reference O’Brien 7 ) The purpose of this editorial is to address this discrepancy, to draw attention to recent data, to encourage doctors to consider these drugs earlier in the illness-course of patients, and most particularly to illuminate issues that are perceived as major hurdles. These hurdles cause doctors to shy away from using MAOIs, but they are largely illusory.

Extended Use of MAO-B Inhibitors Slows Decline in Parkinson’s Disease Patients

Results of this study are consistent with several early, small, prospective double-blind trials suggesting increasing benefit with increasing duration of administration of MAO-B inhibitors.

Irreversible Monoamine Oxidase Inhibitors Revisited

As with many psychiatric drugs, the discovery of irreversible MAOIs was serendipitous. While being used as an antitubercular agent in the 1950s, iproniazid—a derivative of the hydrazine compound isocarboxazid—was observed to have significant antidepressant properties. Almost at the same time as the discovery of TCAs such as amitriptyline and imipramine (which were also discovered by chance), MAOIs began to be widely used as the first effective antidepressants.

MAOIs and diet: Is it necessary to restrict tyramine?

Tyramine (TIE-ruh-meen) is an amino acid that helps regulate blood pressure. It occurs naturally in the body and it's found in certain foods. Medications called monoamine oxidase inhibitors (MAOIs) block an enzyme known as monoamine oxidase, which breaks down excess tyramine in the body. Blocking this enzyme helps relieve depression. If you take an MAOI and you eat high-tyramine foods, tyramine can quickly reach dangerous levels.

MAOIs: Drug Interactions

Indeed, most professionals I talk to consider the diet to be the principal danger, when in fact the interaction with other truly contraindicated drugs produce the most dangerous reactions.

Monoamine Oxidase Inhibitors (MAOIs) - Warning

MAO inhibitors can be divided in MAOIs that work by blocking either the MAO-A enzyme that is normally associated with serotonergic neurons and the MAO-B enzyme that is associated with dopaminergic neurons. Both have links with the clinical treatment of depression, but they can be subdivided even further into reversible MAOIs and irreversible MAOIs.

Serotonin Syndrome and the Libby Zion Affair

In over a decade of legal proceedings that followed, it became apparent that most physicians were unaware of serotonin toxicity and of the potentially fatal interaction of meperidine and monoamine oxidase inhibitors.

Why This Shrink Doesn't Prescribe MAOI's

What a great question, I've been thinking about this one for a bit and this is what I've come to. I don't use Monoamine Oxidase Inhibitors (MAOI's) to treat depression or anxiety, though from time to time, I think about it.

Moving on With Monoamine Oxidase Inhibitors

MAOIs are among the oldest medications in the psychiatric pharmacopeia, with demonstrated efficacy in unipolar and bipolar depression, social anxiety disorder, posttraumatic stress disorder, and panic disorder. The four MAOIs approved in the United States for depression are phenelzine, tranylcypromine, isocarboxazid, and transdermal selegiline, which all irreversibly inhibit monoamine oxidase (MAO).

The Role of Monoamine Oxidase Inhibitors in Current Psychiatric Practice

The use of monoamine oxidase inhibitors (MAOIs) by psychiatrists has declined over the past several decades with the expansion of psychiatrists’ pharmacologic armamentarium. This trend has also been driven by concern about food and drug interactions and side effects, as well as waning physician experience with these medications. Many psychiatrists, in fact, never prescribe MAOIs.