Medicines belonging to the MonoAmine Oxidase Inhibitor (MAOI) family are antidepressants, used in cases of severe, resistant or atypical depression.
Definition: what is an MAOI drug?
They were developed in the 1960s. These are antidepressants used for treat depressive episodes in adults, moderate to severe. They make it possible to correct the symptoms of the depressive state to return to a normal state. They exist in two forms: selective form, more often prescribed, and the non-selective. “The latter is less prescribed because drugs of this form impose a strict lifestyle. They can interact with certain foods and other medications“says Dr. Patrick Lemoine.
What is the list of MAOI drugs?
“There has been no real MAOI in France since 2015: previously, there were two treatments, Marsilid® and Moclamine®, but the first is out of stock in France, says Dr. Lemoine. Only Moclamine remains® “.
Monoamine oxidase inhibitors MAOIs have the role of block the breakdown of dopamine and serotonin (two neurotransmitters that have the role of regulating mood) by monoamine oxidases (MAO). This helps treat symptoms related to depression.
What are the indications for an MAOI medication?
“In France, they were prescribed second or even third line in the treatment of moderate to severe depressive disordersthis because of their interactions with certain drugs and foods, when other possible treatments have failed (serotonin inhibitors, IRS or IRSNA…)explains our expert. In countries like the USA, they are prescribed in cases of resistant depression and in cases of atypical depression (hypersomnia, bulimia mellitus), in panic disorders, phobic disorders.” It is also possible to prescribe them in cases of Parkinson disease.
What are the side effects of MAOIs?
“They are usually mild and infrequent”, says the psychiatrist. It is :
- Hypertensive crisis possibly although very rarely fatal : it occurs when the treatment is taken at the same time as foods rich in tyramine (chocolate, beer, wine, smoked foods, fermented cheeses, offal, bananas, etc.) or another antidepressant drug IRS, IRSNA… , some anesthetics, etc.
- Severe headaches
- Constipation
- Insomnia or excitement
What are the contraindications to MAOI drugs?
These treatments should not be prescribed in the following cases:
- Hepatic insufficiency
- pheochromocytoma
- delusions and manic states
- history of Cerebrovascular Accident (CVA)
- pregnancy
- feeding with milk
- surgical intervention scheduled (the treatment must be stopped at least 15 days before)
► In combination with other medications. This is the case of certain over-the-counter medicines to treat a cold or cough. It can also interact with sedative treatments. Talk to your pharmacist. But as a precautionary principle, any self-medication is contraindicated in combination with MAOI drugs.
► In combination with certain foods. This is the case of fermented cheeses, poultry livers, yeast extracts, gamy meats, caffeinated drinks or products containing cyclamate (fake sugar) because there is a risk of suddenly raising blood pressure, which can cause heart attack.
Thanks to Dr. Patrick Lemoine, psychiatrist.