List of MAOI Antidepressants

Four FDA approved MAOI antidepressant: Phenelzine, Isocarboxazid, Tranylcypromine, and Selegiline.
Four FDA approved MAOI antidepressant: Phenelzine, Isocarboxazid, Tranylcypromine, and Selegiline. (Image: shironosov/iStock/GettyImages)

MAOI refers to a category of antidepressant drugs known as "monoamine oxidase inhibitors" that alleviate depression by stopping (inhibiting) the monoamine oxidase enzyme from metabolizing chemical messengers (neurotransmitters) within the nervous system. This class is the oldest group of antidepressants first manufactured in the 1950s. However, today, it is basically a drug of "last" option when other antidepressants do not work for a patient. This is because MAOIs are known to have many side effects, have severe interaction effects with other drugs, and produce adverse reactions when taken with certain foods.

MAOI Antidepressants

According to the Mayo Clinic, there are presently four MAOI antidepressant drugs that are approved by the Food and Drug Administration. These drugs include the following: Phenelzine (Nardil), Isocarboxazid (Marplan), Tranylcypromine (Parnate), and Selegiline (Emsam). Nardil, Marplan, and Parnate are prescribed specifically to treat depressive disorders. Again, it is emphasized that these antidepressants are not frequently prescribed due to their potential for serious adverse reactions, drug interactions and dietary restrictions.

Emsam

Selegiline, or Emsam, is a unique MAOI because it is the first antidepressant to be delivered by a skin or transdermal patch that delivers the medication over a 24-hour period. Additionally, according to the Mayo Clinic, this medication provides a way to be free of the traditional strict dietary regimen when used in low milligram doses, yet dietary restrictions are needed for higher doses. Emsam is also unique because of its therapeutic effects on individuals with Parkinson’s disease. This drug not only improves motor function ability, but also, acts in a protective way as a immuno-stimulant, which appears to improve cognitive function in those with Parkinson’s.

Safety Precautions

MAOIs interfere with the body’s ability to metabolize a chemical known as tyramine, which at high levels can lead to life-endangering effects, such as a hypertensive crisis or the development of a stroke. Thus, dietary restrictions involve avoiding the intake of substances that are high in tyramine, such as cheese, chocolates, beer and wine, and specific kinds of beef. The potential for severe drug interactions must also be heeded. This medication’s positive outcomes are tempered by its potential for adverse reactions.

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