MAOI Drugs for Depression: How Do They Work?
MAOIs or monoamine oxidase inhibitors are drugs used to treat several conditions, such as anxiety and depression. MAOI drugs are some of the earliest antidepressants created. Still, they are not always the best option despite successfully addressing different symptoms. In most cases, they are replaced by other drugs because of possible drug interactions and a propensity for more side effects than alternative treatments.
Even so, MAOIs may be beneficial if other antidepressants haven’t been effective and are frequently administered. Check out this article to learn more about what MAOIs are and how they treat depression.
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What Are MAO Inhibitors?
As mentioned above, MAOIs have similar efficacy to other antidepressant medications. But due to the high chances of severe interactions with numerous food-derived amines and pharmacological interactions, they are no longer the first-line treatment for depression.
MAOIs are effective in treating atypical depression, treatment-resistant depression, panic disorder, social phobia, and Parkinson’s disease. A subgroup of MAOIs known as reversible inhibitors of monoamine oxidase-A (RIMAs) selectively and permanently inhibit the MAO-A enzyme. RIMAs are clinically used to treat dysthymia and depression. They are less dangerous in single-drug overdose than MAOIs as they have better reversibility.
How Do MAOI Drugs Work for Depression?
Depression may be accompanied by changes in the levels of neurotransmitters (chemical messengers) that brain cells use to communicate. These include serotonin, dopamine, norepinephrine, glutamate, and brain-derived neurotrophic factor. By changing the activity of these neurotransmitters, antidepressants like MAOIs can treat depression.
The neurotransmitters’ norepinephrine, serotonin, and dopamine levels are lowered in the brain by an enzyme called monoamine oxidase. MAOIs stop this from happening; as a result, more of these brain chemicals are available to bring changes in circuits and cells that have been impacted by depression.
The levels of serotonin, norepinephrine, and dopamine rise due to MAOIs blocking this enzyme. A person with depression may see a reduction in their symptoms as a result of the effects brought by this medication. Usually, MAOIs require several weeks to start acting, just like other kinds of antidepressants.
List of MAOI for Depression
The following list of MAOI drugs is approved by the FDA for the treatment of depression.
- Isocarboxazid (Marplan)
- Tranylcypromine (Parnate)
- Selegiline (Emsam)
- Phenelzine (Nardil)
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Side Effects of MAOI Medications
MAOIs are regarded as safe when used at the suggested dosage. However, they have been linked to several side effects, including overdosing, which might be lethal. Less severe side effects are the following:
- Dry mouth
- Weight gain
- Water retention (Edema)
- High or low blood pressure
- Muscle cramps
- Sexual dysfunction
MAOIs Drug and Food Interactions
MAOIs are usually not the first treatment of choice because they can cause serious reactions if you take them with certain other drugs or foods. Before using an MAOI, make sure to inform your doctor of all the drugs and nutritional supplements you are taking.
Drug interactions. MAOIs and other antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), should not be combined. Сombining these two medications can result in possibly lethal serotonin syndrome. Serotonin syndrome is a condition that may occur when two or more medicines alter brain serotonin levels. Also, if combined with MAOIs, some over-the-counter supplements, like St. John’s Wort, might cause serotonin syndrome.
Food interactions. Tyramine-rich meals and drinks must be avoided while taking MAOIs to avoid possibly fatal high blood pressure increases. A substance called tyramine is present in many foods: aged cheeses, salami, grapefruit, red wine, etc. The MAO enzyme controls the blood pressure-lowering effects of this substance. Tyramine can accumulate to dangerously high levels and cause high blood pressure when the MAO enzyme is suppressed.
Precautions and Monitoring
Consider the following precautions before starting MAOI therapy:
- Medical conditions. Tell your doctor if you have diabetes, cardiovascular diseases, hypertension, hyperthyroidism, or any other medical condition.
- Pregnancy. It is advisable to explore the advantages and disadvantages of MAOI medication beforehand if you are a nursing mother or pregnant.
- Discontinuation syndrome. When reducing or quitting MAOI medication, some patients complain of withdrawal-like symptoms. These symptoms are thought to represent the brain’s attempt to balance serotonin and norepinephrine levels following a rapid change. Consult your doctor before stopping or quitting medication.
- Risk of suicide. In 2004, the US Food and Drug Administration released a statement. Requiring all antidepressant drug manufacturers to put a warning on their medicines regarding a potential rise in suicidal thoughts and actions in young people up to the age of 24, especially during the initial treatment.
Before You Leave
Although newer antidepressants with fewer side effects and no tight dietary restrictions have replaced MAOIs, MAOI drugs are still a viable option for some patients.
Only a licensed physician can prescribe the best medicine for your symptoms. To get a professional assessment of your depression symptoms, speak with mental health professionals at Mango Clinic.