Fortunately, in recent years there have been several plant-based MAO inhibitors that have so far shown low side effects, despite therapeutic doses of MAO inhibition.
Results of this study are consistent with several early, small, prospective double-blind trials suggesting increasing benefit with increasing duration of administration of MAO-B inhibitors.
As with many psychiatric drugs, the discovery of irreversible MAOIs was serendipitous. While being used as an antitubercular agent in the 1950s, iproniazid—a derivative of the hydrazine compound isocarboxazid—was observed to have significant antidepressant properties. Almost at the same time as the discovery of TCAs such as amitriptyline and imipramine (which were also discovered by chance), MAOIs began to be widely used as the first effective antidepressants.
Tyramine (TIE-ruh-meen) is an amino acid that helps regulate blood pressure. It occurs naturally in the body and it's found in certain foods. Medications called monoamine oxidase inhibitors (MAOIs) block an enzyme known as monoamine oxidase, which breaks down excess tyramine in the body. Blocking this enzyme helps relieve depression.
If you take an MAOI and you eat high-tyramine foods, tyramine can quickly reach dangerous levels.
Indeed, most professionals I talk to consider the diet to be the principal danger, when in fact the interaction with other truly contraindicated drugs produce the most dangerous reactions.
MAO inhibitors can be divided in MAOIs that work by blocking either the MAO-A enzyme that is normally associated with serotonergic neurons and the MAO-B enzyme that is associated with dopaminergic neurons. Both have links with the clinical treatment of depression, but they can be subdivided even further into reversible MAOIs and irreversible MAOIs.
In over a decade of legal proceedings that followed, it became apparent that most physicians were unaware of serotonin toxicity and of the potentially fatal interaction of meperidine and monoamine oxidase inhibitors.
What a great question, I've been thinking about this one for a bit and this is what I've come to. I don't use Monoamine Oxidase Inhibitors (MAOI's) to treat depression or anxiety, though from time to time, I think about it.
The drug is rarely used anymore and most people, including young doctors and medical students, don't know much about it. If you've heard the term MAOI, it is probably in conjunction with an ad for a drug such as Prozac (fluoxetine) and the warning "don't take this drug if you are on an MAO inhibitor."
Monoamine Oxidase inhibitors (MAOIs) come in different varieties and there is a little more to remember than just the interaction with cheese. The irreversible non-selective (MAO-A+B) are notorious for causing lethal serotonin toxicity in overdose, these include Phenelzine and Tranylcypromine. The irreversible but selective (MAO-B) Selegiline and the reversible selective (MAO-A) Moclobemide are less toxic.
The major drawback associated with MAOIs is that the interactions that they have with certain foods can be lethal. Due to various lethal dietary interactions, they are considered a “last-line” treatment option for depression. In other words, people typically use MAOIs when they’ve already tried various SSRIs/SNRIs, new atypical antidepressants, and tricyclic antidepressants. Newer research suggests that the dietary interactions associated with MAOIs may not be as severe as initial claims.
When the activity of monoamine oxidase is restricted, the concentration of vital neurotransmitters increases in the central nervous system. Since there is no breakdown of these chemicals, a large quantity remains. Altering this process usually enhances mood and happiness.
Monoamine-oxidase inhibitor (MAOI) antidepressants are a group of medicines that are used to treat depression. They can take up to three weeks to build up their effect to work fully. A normal course of antidepressants lasts at least six months after symptoms ease. You cannot drink alcohol or eat food that contains tyramine (for example, cheese, liver, yoghurt or Marmite®) while you are taking an MAOI. You cannot take some cough and cold medicines while you are taking an MAOI.
Monoamine oxidase inhibitors are responsible for blocking the monoamine oxidase enzyme. The monoamine oxidase enzyme breaks down different types of neurotransmitters from the brain: norepinephrine, serotonin, dopamine, as well as tyramine. MAOIs inhibit the breakdown of these neurotransmitters thus, increasing their levels and allowing them to continue to influence the cells that have been affected by depression.