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MONOAMINE OXIDASE INHIBITORS

What are they?

Monoamine oxidase inhibitors (MAOIs) are a group of medicines that are used in the treatment of depression and anxiety. Since other antidepressants, such as the tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs), have become available, MAOIs have been prescribed much less.

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Their effects

MAOIs do not work as well as TCAs or SSRIs in people with moderate or severe depression. However, they are effective in treating atypical depression (depression with features which are opposite to the usual symptoms of depression, such as increased sleep, increased appetite, and increased weight). They can also lift mood in some depressed people whose mood has not responded to other antidepressants.

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Their side-effects

MAOIs interact with certain foods, drinks, and other medicines.

Withdrawal symptoms may occur if MAOIs are stopped suddenly. Instead, the dose should be reduced gradually over about 4 weeks.

Common side effects include: dry mouth, insomnia, increased heart rate, and drowsiness.

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Important notes

  • MAOIs should not be taken with alcohol, or cough, cold, flu or hayfever medicine.

  • MAOIs can interact with other medicines, such as tricyclic antidepressants. Care must be taken when taking more than one medicine. If in doubt, discuss this with your doctor.

  • Foods containing tyramine should be avoided when taking MAOIs. Some of these include: broad bean pods, cheese, chianti wine, game, home brewed beer, paté, pickled herring, and yeast extracts (such as Oxo, Marmite, Bovril, Twiglets). Click here for additional information on dietary restrictions.

  • If stopping MAOIs, do not start taking another antidepressant for 2 weeks.

  • If starting MAOIs, do not start until at least five weeks after stopping fluoxetine; two weeks after stopping other MAOIs, paroxetine or sertraline; and 1 week after stopping all other tricyclics, SSRIs or related antidepressants.

  • People taking MAOIs should carry a warning card with them. Click here to view a printable warning card.

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