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Copyright 2006 www.stopdepressiontoday.com
Monoamine Oxidase Inhibitor Antidepressants (MAOI's)
MAOI’s are thought to exert their antidepressant effect by slowing the breakdown of neurotransmitters that may be reduced in amount in people with depression. This explanation is an oversimplification, but it provides a rationale for the use of these medications, which have been shown to be effective antidepressants.
There are three MAOI antidepressants currently available in the United States: isocarboxazid (Marplan) phenelzine (Nardil), and tranylcypromine (Parnate).
In contrast to tricyclic antidepressants, which are often taken in a single dose at bedtime, MAOI’s are usually taken in divided does and avoided at bedtime. This is because many persons find these drugs to be activating, and insomnia can be a side effect.
MAOI’s are thought to exert their antidepressant effect by slowing the breakdown of neurotransmitters that may be reduced in amount in people with depression. This explanation is an oversimplification, but it provides a rationale for the use of these medications, which have been shown to be effective antidepressants.
There are three MAOI antidepressants currently available in the United States: isocarboxazid (Marplan) phenelzine (Nardil), and tranylcypromine (Parnate).
In contrast to tricyclic antidepressants, which are often taken in a single dose at bedtime, MAOI’s are usually taken in divided does and avoided at bedtime. This is because many persons find these drugs to be activating, and insomnia can be a side effect.
Other MAOI side effects include
restlessness, dizziness (including the type of dizziness caused by a
drop in blood pressure when standing), and weight gain.
Occasionally people experience extreme afternoon drowsiness as a side
effect from these drugs.
There is one uncommon but potentially dangerous adverse reaction that is unique to MAOI antidepressants.
These drugs inhibit the oxidase enzyme that breaks down
“monoamines” at many places in the body, including the
intestine. Consequently, people taking MAOI’s may absorb
more “monoamine” than usual. Certain foods contain
large amounts of tyramine, a monoamine that affects blood
pressure. Large amounts of tyramine may lead to extreme
elevations in blood pressure (a hypertensive reaction), sometimes to
the point of breaking blood vessels in the brain and causing a stroke,
or even death. Foods likely to cause this hypertensive reaction are:
Aged cheese in any form
Yogurt
Yeast, Meat Extracts i.e. Bovril
Pickled herring
Liver
Alcohol in more than social (i.e. moderate) amounts (Limit yourself to one glass of beer, wine, or spirits)
Broad bean pods (limas, fava, Chinese, English, etc)
Canned figs
Food that is not fresh (or prepared from frozen or newly opened canned food). Take special care to avoid pickled, fermented, smoked or aged meat, fish, poultry, game, or varitey meats (organ meats and offal)
Caffeine in large amounts
Chocolate in large amounts
Any food that has given unpleasant symptoms previously.
Yogurt
Yeast, Meat Extracts i.e. Bovril
Pickled herring
Liver
Alcohol in more than social (i.e. moderate) amounts (Limit yourself to one glass of beer, wine, or spirits)
Broad bean pods (limas, fava, Chinese, English, etc)
Canned figs
Food that is not fresh (or prepared from frozen or newly opened canned food). Take special care to avoid pickled, fermented, smoked or aged meat, fish, poultry, game, or varitey meats (organ meats and offal)
Caffeine in large amounts
Chocolate in large amounts
Any food that has given unpleasant symptoms previously.
Your doctor should provide you with a similar list. Although most medications are compatible with MAOI’s, those
that are not can be quite dangerous. Some medications in
combination with MAOI’s may cause hypertensive or other severe
reactions. Consequently, patients taking MAOI’s should not
take any medicines, drugs, over the counter preparations (including
cough and cold preparations) or any other medication of any sort
whatsoever without consulting their doctor. Make sure every doctor you see aware that you are taking an MAOI. Ordinary aspirin and acetaminophen (such as Tylenol) are all right if they are not part of a combination preparation for colds.