Monoamine oxidase inhibitor

MAOImonoamine oxidase inhibitorsMAOIsMAO inhibitorMAO inhibitorsinhibitorreversible inhibitor of monoamine oxidase ARIMAreversible inhibitor of MAO-AMAO-A inhibitor
Monoamine oxidase inhibitors (MAOIs) are a class of drugs that inhibit the activity of one or both monoamine oxidase enzymes: monoamine oxidase A (MAO-A) and monoamine oxidase B (MAO-B).wikipedia
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Monoamine oxidase

MAOamine oxidase (flavin-containing)EC 1.4.3.4
Monoamine oxidase inhibitors (MAOIs) are a class of drugs that inhibit the activity of one or both monoamine oxidase enzymes: monoamine oxidase A (MAO-A) and monoamine oxidase B (MAO-B).
Because of the latter, they are involved in a number of psychiatric and neurological diseases, some of which can be treated with monoamine oxidase inhibitors (MAOIs) which block the action of MAOs.

Social anxiety disorder

social phobiaAnthropophobiasociophobia
They are best known as powerful anti-depressants, as well as effective therapeutic agents for panic disorder and social phobia. MAOIs have been found to be effective in the treatment of panic disorder with agoraphobia, social phobia, atypical depression or mixed anxiety disorder and depression, bulimia, and post-traumatic stress disorder, as well as borderline personality disorder.
Prescribed medications include several classes of antidepressants: selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs).

Atypical depression

Depression
They are particularly effective in treatment-resistant depression and atypical depression.
The reason for its name is twofold: (1) it was identified with its "unique" symptoms subsequent to the identification of melancholic depression and (2) its responses to the two different classes of antidepressants that were available at the time were different from melancholic depression (i.e., MAOIs had clinically significant benefits for atypical depression, while tricyclics did not).

Moclobemide

Aurorix
Newer MAOIs such as selegiline (typically used in the treatment of Parkinson's disease) and the reversible MAOI moclobemide provide a safer alternative and are now sometimes used as first-line therapy.
Moclobemide (sold as Amira, Aurorix, Clobemix, Depnil and Manerix ) is a reversible inhibitor of monoamine oxidase A (RIMA) drug primarily used to treat depression and social anxiety.

Selegiline

deprenylEmsam D -deprenyl
Newer MAOIs such as selegiline (typically used in the treatment of Parkinson's disease) and the reversible MAOI moclobemide provide a safer alternative and are now sometimes used as first-line therapy.
Selegiline acts as a monoamine oxidase inhibitor, and increases levels of monoamine neurotransmitters in the brain.

Tyramine

Foods containing tyraminep''-TyramineCheese effect
People taking MAOIs generally need to change their diets to limit or avoid foods and beverages containing tyramine.
A hypertensive crisis can result, however, from ingestion of tyramine-rich foods in conjunction with the use of monoamine oxidase inhibitors (MAOIs).

Medication

pharmaceuticalpharmaceuticalspharmaceutical drug
RIMAs are used clinically in the treatment of depression and dysthymia.
Drugs affecting the central nervous system include: Psychedelics, hypnotics, anaesthetics, antipsychotics, eugeroics, antidepressants (including tricyclic antidepressants, monoamine oxidase inhibitors, lithium salts, and selective serotonin reuptake inhibitors (SSRIs)), antiemetics, Anticonvulsants/antiepileptics, anxiolytics, barbiturates, movement disorder (e.g., Parkinson's disease) drugs, stimulants (including amphetamines), benzodiazepines, cyclopyrrolones, dopamine antagonists, antihistamines, cholinergics, anticholinergics, emetics, cannabinoids, and 5-HT (serotonin) antagonists.

Tricyclic antidepressant

tricyclic antidepressantsTCAsTCA
Despite this, many psychiatrists still reserve monoamine oxidase inhibitors as a last line of treatment, used only when other classes of antidepressant drugs (for example selective serotonin reuptake inhibitors and tricyclic antidepressants) have failed.
They are not considered addictive and are somewhat preferable to the monoamine oxidase inhibitors (MAOIs).

Serotonin syndrome

hyperserotonemiaserotonin toxicitycentral toxic serotonin reaction
Tryptophan supplements should not be consumed with MAOIs as the potentially fatal serotonin syndrome may result. While safer than general MAOIs, RIMAs still possess significant and potentially serious drug interactions with many common drugs; in particular, they can cause serotonin syndrome or hypertensive crisis when combined with almost any antidepressant or stimulant, common migraine medications, certain herbs, or even most cold medicines (including decongestants, antihistamines, and cough syrup).
This may include selective serotonin reuptake inhibitor (SSRI), serotonin norepinephrine reuptake inhibitor (SNRI), monoamine oxidase inhibitor (MAOI), tricyclic antidepressants (TCAs), amphetamines, pethidine (meperidine), tramadol, dextromethorphan, buspirone, L-tryptophan, 5-HTP, St. John's wort, triptans, ecstasy (MDMA), metoclopramide, ondansetron, or cocaine.

Panic disorder

panicpanic disorderspanic disorde
They are best known as powerful anti-depressants, as well as effective therapeutic agents for panic disorder and social phobia. MAOIs have been found to be effective in the treatment of panic disorder with agoraphobia, social phobia, atypical depression or mixed anxiety disorder and depression, bulimia, and post-traumatic stress disorder, as well as borderline personality disorder.
Nicotine and other psychoactive compounds with antidepressant properties in tobacco smoke which act as monoamine oxidase inhibitors in the brain can alter mood and have a calming effect, depending on dose.

Treatment-resistant depression

treatment-resistantrefractory depressiondepression
They are particularly effective in treatment-resistant depression and atypical depression.
People who are nonresponsive after taking an SSRI may respond to a tricyclic antidepressant, bupropion or an MAOI.

Tramadol

UltramUltracetUltram ER
Certain combinations can cause lethal reactions, common examples including SSRIs, tricyclics, MDMA, meperidine, tramadol, and dextromethorphan.
Tramadol may interact with certain antidepressants and anxiolytics (particularly selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors, monoamine oxidase inhibitors, and tricyclic antidepressants) other opioid analgesics (pethidine, tapentadol, oxycodone, and fentanyl), dextromethorphan, certain migraine medications (triptans, ergots), certain antibiotics (namely, linezolid and isoniazid), certain herbs (e.g. St. John's wort, passiflora, etc.), stimulants (including amphetamines, phenethylamine, and phentermine), lithium, and methylene blue, as well as numerous other therapeutic agents.

N,N-Dimethyltryptamine

DMTdimethyltryptamineN'',''N''-Dimethyltryptamine
Effects can last 3 hours or more when orally ingested along with an MAOI, such as the ayahuasca brew of many native Amazonian tribes.

Ayahuasca

yageyagéDaime
B. caapi contains several alkaloids that act as monoamine oxidase inhibitors (MAOIs).

Parkinson's disease

ParkinsonParkinson’s diseaseParkinson disease
They are also used in the treatment of Parkinson's disease and several other disorders.
The main families of drugs useful for treating motor symptoms are levodopa (always combined with a dopa decarboxylase inhibitor and sometimes also with a COMT inhibitor), dopamine agonists and MAO-B inhibitors.

Decongestant

nasal decongestantdecongestantsde-congestant
While safer than general MAOIs, RIMAs still possess significant and potentially serious drug interactions with many common drugs; in particular, they can cause serotonin syndrome or hypertensive crisis when combined with almost any antidepressant or stimulant, common migraine medications, certain herbs, or even most cold medicines (including decongestants, antihistamines, and cough syrup).
These drugs should be used cautiously in hypertensives and in those receiving monoamine oxidase inhibitors (MAOIs), as they can cause hypertensive crisis.

Antidepressant discontinuation syndrome

withdrawal syndromediscontinuation syndromeSSRI discontinuation syndrome
Antidepressants including MAOIs have some dependence-producing effects, the most notable one being a withdrawal syndrome, which may be severe especially if MAOIs are discontinued abruptly or too rapidly.
A discontinuation syndrome can occur after stopping any antidepressant including selective serotonin re-uptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs).

Dysthymia

chronic depressiondysthymic disorderdysthymic
RIMAs are used clinically in the treatment of depression and dysthymia.
The first line of pharmacotherapy is usually SSRIs due to their purported more tolerable nature and reduced side effects compared to the irreversible monoamine oxidase inhibitors or tricyclic antidepressants.

Antidepressant

antidepressantsanti-depressantanti-depressants
While safer than general MAOIs, RIMAs still possess significant and potentially serious drug interactions with many common drugs; in particular, they can cause serotonin syndrome or hypertensive crisis when combined with almost any antidepressant or stimulant, common migraine medications, certain herbs, or even most cold medicines (including decongestants, antihistamines, and cough syrup). Antidepressants including MAOIs have some dependence-producing effects, the most notable one being a withdrawal syndrome, which may be severe especially if MAOIs are discontinued abruptly or too rapidly.
MAOIs tend to have pronounced (sometimes fatal) interactions with a wide variety of medications and over-the-counter drugs.

Selective serotonin reuptake inhibitor

SSRIselective serotonin reuptake inhibitorsSSRIs
Despite this, many psychiatrists still reserve monoamine oxidase inhibitors as a last line of treatment, used only when other classes of antidepressant drugs (for example selective serotonin reuptake inhibitors and tricyclic antidepressants) have failed. Certain combinations can cause lethal reactions, common examples including SSRIs, tricyclics, MDMA, meperidine, tramadol, and dextromethorphan.

Agoraphobia

agoraphobicagoraphobea fear of crowds
MAOIs have been found to be effective in the treatment of panic disorder with agoraphobia, social phobia, atypical depression or mixed anxiety disorder and depression, bulimia, and post-traumatic stress disorder, as well as borderline personality disorder.
Benzodiazepines, monoamine oxidase inhibitor, and tricyclic antidepressants are also sometimes prescribed for treatment of agoraphobia.

Dextromethorphan

DXMVicks Formula 44Creo-Terpin
Certain combinations can cause lethal reactions, common examples including SSRIs, tricyclics, MDMA, meperidine, tramadol, and dextromethorphan.
Dextromethorphan should not be taken with monoamine oxidase inhibitors (MAOIs) due to the potential for serotonin syndrome, which is a potentially life-threatening condition that can occur rapidly, due to a buildup of an excessive amount of serotonin in the body.

Methamphetamine

crystal methmethcrystal methamphetamine
The FDA states that individuals who have experienced hypersensitivity reactions to other stimulants in the past or are currently taking monoamine oxidase inhibitors should not take methamphetamine.

Pethidine

meperidineDemerolPethidine/meperidine
Certain combinations can cause lethal reactions, common examples including SSRIs, tricyclics, MDMA, meperidine, tramadol, and dextromethorphan.
Serotonin syndrome has occurred in patients receiving concurrent antidepressant therapy with selective serotonin reuptake inhibitors (SSRIs) or monoamine oxidase inhibitors, or other medication types (see Interactions below).