Monoamine Oxidase Inhibitors (MAOIs)

Overview

• MAOIs are a class of antidepressants.
• Significant due to many drug and food interactions.
• Not first-line treatments for depression due to side effects.

Mnemonic

• Maui is used as a mnemonic for MAOIs.

Common MAOI Drugs

1. Isocarboxazid
   • Symbolized by ice cubes ("ice cube oxazid").
2. Phenylzine
   • Symbolized by fennel.
3. Tranylcypromine
   • Symbolized by a waitress in training ("training" for tranylcypromine).

Uses

• MAOIs are used to treat depression.
• Not first-line due to severe side effects and interactions.

Side Effects and Interactions

Hypertensive Crisis

• MAOIs can cause extremely high blood pressure (hypertensive crisis).
• Triggered by eating foods high in tyramine (e.g., wine, cheese, processed meats).
  • Symbolized by a charcuterie board of wine, cheese, and meats.
• Symptoms: headaches, neck stiffness.

Serotonin Syndrome

• MAOIs increase serotonin levels which can lead to serotonin syndrome.
• Symptoms include agitation, restlessness, tachycardia, hypertension, and muscle rigidity.
• Avoid taking MAOIs with other serotonin-altering medications such as SSRIs and TCAs.
  • A 2-week gap is required when switching from SSRIs/TCAs to MAOIs or vice versa.

Summary

• MAOIs include isocarboxazid, phenylzine, and tranylcypromine.
• They treat depression but are associated with side effects and interactions.
• Key risks include hypertensive crisis (tyramine-rich foods) and serotonin syndrome.

Visual Mnemonic

• The video uses visuals like Maui, ice cubes, fennel, and a waitress in training to help memorize MAOIs.

Remember: Avoid foods with tyramine and do not combine with other serotonin-altering drugs. Use the mnemonic to recall details on test day.