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  • Monoamine oxidase inhibitors (also referred to as MAOIs or MAO inhibitors) are antidepressant medications that may be used when other classes of antidepressants prove to be ineffective. 

    MAOIs were the first antidepressants to be introduced and are used for multiple mental health conditions, including treatment-resistant depression as well as major depressive disorder.

    In addition to this, MAOIs treat panic disorder and certain social phobias. Despite its effectiveness in the treatment of depression, including resistant depression and depressive symptoms, MAOIs can cause a number of serious side effects.

    Some of the MAOI medications include:

    • isocarboxazid (Marplan)
    • selegiline patch (Emsam)
    • phenelzine (Nardil)
    • tranylcypromine sulfate (Parnate)
    • moclobemide (Avrorix)

    A person taking MAOIs must have strict dietary restrictions put into place due to the many adverse effects which can occur with various foods. MAOIs belong to a class of drugs used as antidepressants, but may be used to help treat Parkinson’s disease as well.

    Side Effects Of MAOIs

    MAOIs work by inhibiting the monoamine oxidase enzymes that break down the numerous types of neurotransmitters in the brain like serotonin, dopamine, norepinephrine, and tyramine.

    In fact, there are two types of monoamine oxidase, MAO A and MAO B. While MAO A focuses on the breakdown of serotonin, MAO B is found in the brain and concentrates on dopamine. Both types of MAOIs cause a number of short-term and long-term side effects.

    Short-Term Side Effects

    According to the National Alliance on Mental Illness (NAMI), MAOIs can cause a number of side effects that may include:

    • blurred vision
    • constipation
    • dry mouth
    • drowsiness
    • nausea
    • restlessness
    • drop in blood pressure when standing
    • difficulty sleeping
    • dizziness

    Long-Term Side Effects

    Some of the more potential long-term side effects of MAOIs may consist of:

    • weight gain
    • sexual dysfunction
    • urinary retention
    • muscle pain
    • headache
    • heart palpitations
    • cognitive dysfunction

    MAOI Toxicity

    Those who overdose on MAOIs may experience a number of health issues such as:

    • hypotension
    • palpitations
    • twitching
    • slowed reflexes
    • flushing
    • agitation

    MAOI Drug Interactions

    Those taking MAOIs have a number of dietary restrictions to abide by, as well as other medications to avoid.

    Common Drug Interactions

    Some of the medications and substances to avoid while taking MAOIs include:

    • selective serotonin reuptake inhibitors (SSRIs)
    • serotonin-norepinephrine reuptake inhibitors (SNRIs)
    • numerous CNS depressants
    • over-the-counter supplements or vitamins
    • St. John’s Wort
    • stimulants
    • tricyclic antidepressants (TCAs)
    • specific medications such as Demerol (meperidine) and Ultram (tramadol)

    In addition to these medications, MAOIs seen in patients with bipolar disorder can result in manic states. Those with bipolar disorder should avoid any of the MAOI medications.

    Serotonin Syndrome

    Antidepressants should not be combined without consulting your healthcare provider. Those who combine SSRIs with MAOIs may develop a serious condition known as serotonin syndrome.

    This life-threatening condition can lead to severe side effects including:

    • high blood pressure
    • tremors or muscle jerks
    • seizures
    • fluctuations in heart rate
    • confusion
    • fever

    Dietary Restrictions

    For those taking MAOIs, numerous foods can interact with the medication, which means you must seek the medical advice of the doctor prescribing you this medication to determine if your dietary needs can be met.

    Some of the foods you must avoid while taking MAOIs include:

    • sauerkraut
    • salami
    • soy sauce
    • aged cheeses
    • alcohol
    • bananas
    • fava beans
    • cured meats
    • draft beer

    Levels of tyramine can be found in aged meats and other products. When combined with MAOIs, this can potentially lead to toxicity according to the Food and Drug Administration (FDA). High levels of tyramine may result in a hypertensive crisis for the person taking the drug.

    If you or a loved one are struggling with substance abuse, please contact us today for information on our inpatient and outpatient treatment options.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Food and Drug Administration - Depression Medicines
    National Alliance on Mental Illness - Depression
    National Alliance on Mental Illness - Types of Medication
    National Alliance on Mental Illness - What to Avoid with Psychiatric Medications
    National Library of Medicine: StatPearls - Monoamine Oxidase Inhibitors (MAOI)

    Medically Reviewed by
    Kimberly Langdon M.D.
    on November 29, 2022
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