|
Monoamine Oxidase Inhibitors
Among the oldest classes of antidepressants, three of the monoamine oxidase inhibitors or MAOIs (isocarboxazid, phenelzine, and tranylcypromine) have been used since the 1950s. In general, all of the MAOIs interfere with an enzyme (MAO) that breaks down neurotransmitters (chemicals that carry messages between nerve cells) in the brain. Higher levels of certain neurotransmitters help to relieve depression. This class is usually reserved for persons who have atypical depression and/or after other types of antidepressants have not controlled depression adequately. MAOIs may also be used to treat other conditions such as panic disorder and social phobias.
Taking one of the MAOIs (available only as oral tablets) requires the individual to be very careful about what he/she includes in his/her diet and other drugs he/she takes by prescription or over the counter (OTC) . Certain foods and drinks (such as alcohol, aged cheeses, or caffeine), many prescription medications, and several non-prescription drugs (such as pseudoephedrine and phenylephrine) can interact with MAOIs to cause a sudden, dangerous rise in blood pressure. Isocarboxazid, phenelzine, and tranylcypromine also have many less serious, but undesirable interactions and side effects (such as weight gain, sedation, or swelling). Their general use has declined, as newer antidepressants with fewer side effects and less risk of interactions have been developed. Recently, however, a new MAOI (transdermal selegiline) was approved. Selegiline targets a specific subtype of MAO and it comes as a patch that is applied to the skin. Both effects reduce the number of interactions and side effects associated with its use.
Treatment with an MAOI typically lasts between 6 months and one year. At the end of treatment, the medication is reduced gradually to prevent withdrawal symptoms. Because the effects of a MAOI can last for several weeks, patients must continue to avoid certain foods and drugs even after they stop taking the MAOI.
Drugs in the class
Isocarboxazid
(
Marplan
)
Phenelzine Tablets
(
Nardil Tablets,
Phenelzine Sulfate Tablets
)
Tranylcypromine
(
Parnate
)
|
