Monoamine Oxidase Inhibitors (MAOIs) Lecture Notes

Introduction

• MAOIs are a class of antidepressants.
• Known for numerous drug and food interactions.
• Mnemonic aid: Relate MAOIs with the island of Maui (both are spelled similarly).

Common MAOI Drugs

• Isocarboxazid
  • Symbolized by ice cubes.
• Phenylzine
  • Represented by fennel.
• Tranylcypromine
  • Symbolized by a "waitress in training."

Usage

• Treatment: Primarily used for depression.
• Not first-line treatment due to severe side effects and interactions.

Side Effects and Interactions

Hypertensive Crisis

• Caused by increased arterial pressure.
• Severe high blood pressure (>180/120).
• Can lead to a stroke.
• Monitor: Headaches, neck stiffness, and blood pressure.

Food Interactions

• Avoid foods with tyramine (can trigger hypertensive crisis).
  • Examples: Wine, aged cheeses, processed meats.
  • Other foods: Chocolate, yogurt, pickled/fermented foods.

Serotonin Syndrome

• Caused by an overload of serotonin signaling.
• Symptoms: Agitation, restlessness, tachycardia, hypertension, muscle rigidity.
• Avoid combining MAOIs with other serotonin-altering medications (e.g., SSRIs, TCAs).
• Rule: Do not take MAOIs within 14 days of other serotonin-altering drugs.

Summary

• MAOIs include drugs like isocarboxazide, phenylzine, and tranylcypromine.
• Treat depression but are not first-line due to side effects and interactions.
• Key risks: Hypertensive crisis (avoid tyramine foods) and serotonin syndrome (avoid other serotonin drugs within 14 days).

Conclusion

• Use mnemonic tools to easily recall MAOI facts for tests and clinical practice.