Monoamine Oxidase Inhibitors

We have all seen the advertisements for mood-enhancing drugs to battle depression. Antidepressant medications seem almost magical in their promise to improve daily living by improving mood. But do they work for everyone? Are there risks and, if so, how serious are they?

Monoamine oxidase inhibitors (referred to as MAOIs) represent an older class of antidepressants used in the treatment of depression, anxiety and bipolar disorder. The drugs can be dangerous to use since they are known to interact negatively with other medications and even some foods. However, they have been effective in treating forms of depression which appear untouched by other drugs and treatments.

MAOIs seem most effective in the treatment of atypical depressions. These types of depression usually include symptoms like overeating, oversleeping and over-sensitivity to rejection. Because of their potential hazards and their limited range, MAOIs are sometimes avoided. Research does seem to suggest that newer classes of antidepressants (such as selective serotonin reuptake inhibitors and RIMA) are equally effective in treating atypical depression.

How Do MAOIs Work?

Patients curious about the drugs may wonder how they work. MAOI drugs work by regulating particular enzyme activity within the brain. Inside the brain are chemical messengers known as monoamine neurotransmitters. These messengers are responsible for positive mood and have names many people recognize, including serotonin, noradrenaline and dopamine.

Monoamine oxidase is an enzyme inside the brain that breaks down the monoamines. By inhibiting the enzyme from its task, the number of monoamines increases. The presence of more monoamines in the brain produces an improvement in mood.

Dangers of MAOIs

The news is mixed, of course. The positive effects of MOAIs do come with some potential dangers. The medication can cause serious reactions if taken with other antidepressants, recreational drugs and even cough medications. These drugs have also been shown to interact negatively with the amino acid tyranine which is present in some foods and drinks.

In the same way that MAOIs inhibit the breakdown of monoamines, the drug also works against the breakdown of tyranine. However, tyranine can be dangerous if it is not broken down. For this reason, patients taking MAOIs need to avoid certain foods with the amino acid.

Such foods as aged meats and cheeses, soy products, sauerkraut and marmite, along with certain alcoholic beverages, would need to be taken out of the patient’s diet. If eaten while taking MAOIs, dangerous rises in blood pressure may result. The most up-to-date list of restricted foods can be obtained through a person’s physician or mental health professional.

Just as with most drugs, there are side effects which some experience when they take the medication. Common side effects for those taking MAOIs include insomnia, dizziness, fuzzy vision and drowsiness. It should further be noted that the person taking MAOIs may not experience positive results for several weeks.

Patients should also avoid ceasing the medication abruptly. Once mood improvement occurs, patients are encouraged to continue taking the medication for several months in order to avoid relapse. Even then, the patient should discontinue use of the medication slowly to avoid unpleasant symptoms known as discontinuation syndrome.

The person suffering with clinical depression may be looking for any rope that promises to pull them out of their current situation. Not all medications or treatments are right for every patient, however, so it is vital that sufferers speak candidly with their health care provider and become as informed as possible.

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