Mao Inhibitors

What Are Mao Inhibitors?

Mao Inhibitors, otherwise known as Monoamine oxidase inhibitors (MAOIs), were developed as initial antidepressants. They proved effective, but as other antidepressants were discovered and produced MAOIs were replaced by drugs that had fewer side effects and were considerably safer.

MAOIs can be cumbersome because one must follow certain dietary restrictions, as there are many food and drug interactions that occur with this antidepressant. One major side effect that is worrisome is high blood pressure, which can occur when MAOIs are taken with certain foods. However, if the antidepressants are taken with care and caution, they are useful medications and work well for some individuals. Sometimes, it is the only medication that works for those who have tried other treatments to no avail.

How Do Mao Inhibitors Work?

MAOIs have been proven useful in treating brain-debilitating conditions such as Parkinson’s disease. Most commonly, however, MAOIs have been used to treat depression. The FDA has approved four MAOIs, which can be used to treat depression: Isocarboxazid, Phenelzine, Selegiline and Tranylcypromine. Some of these antidepressants can be found in patch form, which can cause fewer side effects compared to pills taken orally.

There are certain chemicals that send messages to the brain. Antidepressants like MAOIs change the level of communication between these chemical messengers, otherwise known as neurotransmitters, and the brain. Depression can be relieved by altering the levels of these neurotransmitters sometimes by increasing their level and sometimes by decreasing it.

There is a specific enzyme, monoamine oxidase, which destroys the neurotransmitters norepinephrine, serotonin and dopamine in the brain. The antidepressant MAOIs inhibits these enzymes, allowing these neurotransmitters to be more active and available in the brain. Brain cell communication is improved and the mood of the individual is proposed to become more positive. MAOIs also affect neurotransmitters in the digestive system, which can cause some unpleasant side effects.

Side effects of MAOIs

There are many common side effects caused by MAOIs. It is because of this that MAOIs are often used as a last resort and introduced to patients when other medications are not working efficiently.

Some of the common side effects experienced when using MAOIs can include but are not limited to dry mouth, nausea, drowsiness, headaches, insomnia and lightheadedness. Other possible side effects, which can occur but are less common include sudden muscle spasms, low blood pressure, sleep problems, decrease in sex drive, abnormal weight gain, aching muscles and tingling feeling in the skin.

Considerations of Taking Mao Inhibitors

1. Pregnant and Brest-feeding Women

Many drugs including antidepressants can be harmful to you and your child if you take them when you are pregnant or if you are actively breastfeeding. If you can potentially become pregnant or are planning to become pregnant, consult your doctor before you begin taking antidepressants.

2. Interactions with Foods and Drinks

When taking MAOIs it is important to follow certain dietary restrictions. These antidepressants can have dangerous interactions with specific types of food. Anything that contains tyramine, which is an amino acid responsible for keeping your blood pressure in check, should be avoided. This mainly includes fermented or aged products, such as old cheeses, cured meats, fermented soy products such as tofu or miso, beer and wine. When MAOIs are taken with food high in tyramine, it can cause life-threatening high blood pressure.

3. Interactions with Drugs

MAOIs must also be taken with caution if you are taking any other medications. If you are already using MAOIs, you must avoid other antidepressants, some painkillers, cold and allergy medications, and you should be wary of using some herbal supplements. While you are taking MAOIs, consult your doctor before you take any other type of medication whether it be a prescription or over the counter medication.

4. Serotonin Syndrome

A rare side effect of MAOIs is causing high levels of serotonin. This type of effect usually occurs when you take other medication that also increases the levels of serotonin, such as headache medications, other antidepressants and the herbal treatment, St. John’s wort. Serotonin syndrome signs include anxiety, tremors, restlessness, extreme sweating and a fast heart rate. If you are experiencing any of these symptoms, get medical help right away.

5. Suicide Risk

Antidepressants are most often safe, but it is an FDA requirement that all antidepressants to be labeled with black box warnings. Younger aged individuals such as teenagers and young adults may experience suicidal thoughts when taking antidepressants, particularly when beginning the medication and if the dose changes at all. Anyone who is taking an antidepressant should be monitored for any unusual behavior. If suicidal thoughts or behaviors are exhibited, get emergency help right away.

6. When Stopping Medication

There are certain side effects that can occur if you stop taking MAOIs. Some side effects include flu symptoms, nausea, vomiting and lethargy. If you stop taking your MAOI ‘cold turkey’, you will experience more withdrawal side effects. Some rare withdrawal symptoms include trouble sleeping, psychosis and convulsion. It is best to gradually decrease your dose of MAOI to avoid such side effects. In addition, before you begin another antidepressant, you should wait two or more weeks.

How to Find the Right Antidepressant

Finding the right antidepressant can involve some trial and error. Everyone reacts to medication differently and some people will be more prone to certain side effects.

  • When your doctor prescribes you an antidepressant, he or she will evaluate your entire medical history before they choose the right antidepressant.
  • It is important to look at your symptoms, history of health issues, and other medications that have worked well for you.
  • Your genes also affect what side affects you may experience when taking antidepressants.
  • Your doctor may decide to take specific blood tests to find information about how your body will react to antidepressant medications.

Do not expect results right away. It takes some time for your body to adjust to the antidepressant and it may be several weeks before you feel any changes and the side effects begin to subside. However, once you discover which antidepressant works best for you, you will be able to live a healthier lifestyle with your depression symptoms under control.