Monoamine oxidase inhibitors (MAOIs) Show
MAOIs were the first type of antidepressant developed. Learn about the benefits, side effects and risks of these antidepressants. By Mayo Clinic StaffMonoamine oxidase inhibitors (MAOIs) were the first type of antidepressant developed. They're effective, but they've generally been replaced by antidepressants that are safer and cause fewer side effects. Use of MAOIs typically requires diet restrictions and avoiding certain other medications because MAOIs can cause dangerously high blood pressure when taken with certain foods or medications. In spite of side effects, these medications are still a good option for some people. In certain cases, they relieve depression when other treatments have failed. How MAOIs workAntidepressants such as MAOIs ease depression by affecting chemical messengers (neurotransmitters) used to communicate between brain cells. Like most antidepressants, MAOIs work by ultimately effecting changes in the brain chemistry that are operational in depression. An enzyme called monoamine oxidase is involved in removing the neurotransmitters norepinephrine, serotonin and dopamine from the brain. MAOIs prevent this from happening, which makes more of these brain chemicals available to effect changes in both cells and circuits that have been impacted by depression. MAOIs also affect other neurotransmitters in the brain and digestive system, causing side effects. MAOIs are sometimes used to treat conditions other than depression, such as Parkinson's disease. MAOIs approved to treat depressionThe Food and Drug Administration (FDA) has approved these MAOIs to treat depression:
Selegiline is available as a skin (transdermal) patch. Using a patch may cause fewer side effects than MAOIs taken by mouth. If you're using the lowest dose patch, you may not need diet restrictions, but ask your doctor. Side effects of MAOIsBecause of side effects and safety concerns, MAOIs are most often tried when other antidepressants don't work. The most common side effects of MAOIs include:
Other possible side effects include:
Safety concerns with MAOIsConsider these issues and discuss them with your doctor before taking an MAOI:
Suicide risk and antidepressantsMost antidepressants are generally safe, but the FDA requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. MAOIs are generally not prescribed for children, but anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact a doctor or get emergency help. Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood. Stopping treatment with MAOIsTalk to your doctor before you stop taking an MAOI. Stopping treatment with MAOIs has been associated with anxiety, agitation and insomnia, as well as flu-like symptoms such as sweating, chills, nausea, headache and feeling generally unwell (malaise). If you stop an MAOI suddenly, you're more likely to experience a withdrawal-type reaction, sometimes called discontinuation syndrome. Rarely, uncommon withdrawal symptoms such as confusion, detachment from reality (psychosis) and convulsions can occur. You may need to wait two or more weeks between the use of MAOIs and other antidepressants to avoid serotonin syndrome. During those two weeks, you should continue food and beverage restrictions and avoid taking drugs that can cause serious interactions with MAOIs. Work with your doctor to gradually and safely decrease your dose. Finding the right antidepressantEach person reacts differently to a particular antidepressant and may be more likely to have certain side effects. Because of this, one antidepressant may work better for you than another. When choosing an antidepressant, your doctor takes into account your symptoms, any health problems you have, other medications you take and what has worked for you in the past. Inherited traits play a role in how antidepressants affect you. In some cases, where available, results of special blood tests may offer clues about how your body may respond to a particular antidepressant. However, other variables can affect your response to medication. It may take several weeks or longer before an antidepressant is fully effective and for initial side effects to ease up. Your doctor may recommend some dose adjustments or different antidepressants, but with patience, you and your doctor can find a medication that works well for you. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus
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. Which instruction would the nurse include to educate a patient taking sertraline?Take sertraline with or without food, at the same time each day. Sertraline liquid (oral concentrate) must be diluted with a liquid right before you take it. Read and carefully follow all mixing instructions provided with your medicine. Ask your doctor or pharmacist if you need help.
Which instructions would the nurse include in teaching plan for a patient who has been prescribed lithium?Teaching points
Take this drug exactly as prescribed, after meals or with food or milk. Swallow extended- or controlled-release tablets whole; do not chew or crush. Eat a normal diet with normal salt intake; maintain adequate fluid intake (at least 2.5 quarts/day). Arrange for frequent checkups, including blood tests.
Which side effect would the nurse monitor for when administering an SSRI?Possible side effects of SSRIs may include, among others: Nausea, vomiting or diarrhea. Headache. Drowsiness.
Which drug may cause serotonin syndrome if given together with an antidepressant?The drugs and supplements that could potentially cause serotonin syndrome include: Selective serotonin reuptake inhibitors (SSRIs), antidepressants such as citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox), escitalopram (Lexapro), paroxetine (Paxil, Pexeva, Brisdelle) and sertraline (Zoloft)
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Which instructions would the nurse include to educate a patient taking sertraline?
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