Monoamine Oxidase Inhibitors (MAOIs)

Introduction

• MAOIs are a class of antidepressants.
• Known for significant drug and food interactions.
• Use mnemonic 'Maui' to remember MAOIs.

Common MAOI Drugs

1. Isocarboxazid
   • Mnemonic: Ice cubes (Ice cube for isocarboxazid).
2. Phenelzine
   • Mnemonic: Fennel (Fennel for phenelzine).
3. Tranylcypromine
   • Mnemonic: Waitress in training (Training for tranylcypromine).

Uses

• Treats depression.
• MAOIs are not first-line treatments due to numerous side effects and interactions.

Side Effects and Interactions

Hypertensive Crisis

• Cause: High blood pressure
  • Symbol: Inflating beach ball (increased pressure).
• Symptoms: Headaches, neck stiffness, blood pressure > 180/120.
• Triggers: Foods with tyramine (wine, cheese, processed meats, chocolate, yogurt, fermented foods).

Serotonin Syndrome

• Cause: Overload of serotonin signaling
  • Symbol: Happy face take-out bag (serotonin = feel-good hormone).
• Symptoms: Agitation, restlessness, tachycardia, hypertension, muscle rigidity.
• Prevention: Avoid taking MAOIs with other serotonin-altering medications (SSRIs, TCAs).
  • 14-day washout period before switching between MAOIs and other serotonin drugs.

Summary

• MAOIs: Isocarboxazid, Phenelzine, Tranylcypromine.
• Treat depression, but not first-line due to side effects and interactions.
• Watch for hypertensive crisis (avoid tyramine foods) and serotonin syndrome (avoid serotonin drugs).
• Use visual mnemonics to aid memory and recall.