Monoamine oxidase inhibitors, or MAOIs, were the first kinds of antidepressants available, back in the 1950s, according to the Mayo Clinic. Monoamine oxidase breaks down the neurotransmitters norepinephrine, serotonin and dopamine in the brain, and MAOI drugs interfere with this process, allowing larger amounts of these neurotransmitters to stay in the brain, boosting mood (mayoclinic.com). Drugs that are classified as MAOIs include phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan) and selegiline (Emsam).
General Side Effects
MAOIs typically cause more side effects than other classes of antidepressants, and are generally prescribed for individuals in whom other depression medications were not effective. Side effects of these drugs include constipation, nausea, low blood pressure, decreased urination, sweating, muscle twitching, blurred vision, trembling and weakness.
Food Interactions
Another reason MAOIs are not typically first-line treatment for depression is the fact there are dietary restrictions while on these medications. Some foods have large amounts of the chemical tyramine, and when this chemical interacts with MAOIs, it can cause high blood pressure that can cause a stroke. Foods that have high levels of tyramine include beer, wine, certain cheeses, some meats, pickled foods and chocolates, according to the Mayo Clinic. Your doctor can go over the full list of foods you may need to restrict while taking MAOIs.
Serotonin Syndrome
When MAOIs interact with another class of antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin syndrome can occur. Serotonin syndrome occurs when a large amount of serotonin is in the brain, and it can cause hallucinations, confusion, seizures, nausea and vomiting, fever and coma. If you have been taking SSRIs and switch to MAOIs, you should allow at least 2 weeks between the two kinds of medications.
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