Monoamine oxidase inhibitors (MAOIs) for depression

Examples

Generic Name	Brand Name
isocarboxazid	Marplan
phenelzine sulfate	Nardil
tranylcypromine sulfate	Parnate

How It Works

These medications balance certain brain chemicals called neurotransmitters by reducing the amount of monoamine oxidase, the substance that breaks down the neurotransmitters. When these brain chemicals are in proper balance, the symptoms of depression are relieved.

Why It Is Used

Monoamine oxidase inhibitors (MAOIs) are usually given to people with depression who:

• Did not get better with other antidepressants.
• Cannot tolerate the side effects of other antidepressants.
• Have a family or personal history of successful treatment with MAOIs.
• Have unusual depression symptoms.

MAOIs usually are not the first medications given for depression because they have serious side effects when combined with certain foods and/or medications.

MAOIs are not recommended for children or teens.

How Well It Works

Current research suggests that monoamine oxidase inhibitors may be as effective as other antidepressants (such as tricyclics) in treating severe depression but may be more effective than other antidepressants in those who have depression with uncommon symptoms such as sleeping and eating too much and being overly sensitive to rejection.¹

Side Effects

Side effects of monoamine oxidase inhibitors include:

• Difficulty getting to sleep.
• Dizziness, lightheadedness, and fainting.
• Dry mouth.
• Blurred vision.
• Appetite changes.
• High blood pressure.
• Changes in heart rate and rhythm.
• Muscle twitching and feelings of restlessness.
• Loss of sexual desire or ability.
• Weight gain.
• Negative interactions with other medications and some foods.

FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when the doses are changed.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

You must avoid eating certain foods, such as some cheeses, broad beans like fava beans, pickled foods like sauerkraut, beer, and red wine, while taking MAOIs. Eating these foods can cause severe high blood pressure.

You must avoid some nonprescription medications, particularly certain cold remedies and diet pills.

You must wait at least 14 days after you stop taking MAOIs before taking another antidepressant.

MAOIs can cause death if they are combined with certain foods or taken with certain other medications.

Talk with your health professional about diet and medication restrictions you need to follow if you are planning to take an MAOI.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Author:	Jeannette Curtis Ralph Poore	Last Updated: March 21, 2007
Medical Review:	Martin Gabica, MD - Family Medicine Lisa S. Weinstock, MD - Psychiatry
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