What do you mean by MAOIs?
MAOIs were introduced in the year 1950 with the intention to treat depression and the full form of MAOIs are Monoamine oxidase inhibitors (MAOIs). These medications are used to treat mental health conditions like depression. People are not using monoamine oxidase inhibitors as there is a number of new medications available in the market working better than these drugs. Today, MAOIs are not in use due to the other antidepressant medications and doctors also referring these drugs to patients only when other antidepressant medications are failed to treat the condition. But these medications can still treat the depression and many people get benefitted from the use of monoamine oxidase inhibitors (MAOIs).
As the other antidepressant medications causing few side effects compared to monoamine oxidase inhibitors (MAOIs), people preferring other depression medications. you have to follow the diet if you are taking monoamine oxidase inhibitors (MAOIs) and also you need to stop taking other medications and these drugs can seriously interact with the other drugs and can cause a lot of problems.
Even though these medications can cause serious side effects, but MAOIs are good at treating depression problems and can ease the symptoms of depression. In some cases, people get relieve from depression only by using MAOIs because these drugs work well when other antidepressant medications are failed to show the improvement in your condition.
This article will help you to understand how MAOIs work, and which foods you need to avoid while taking them, and who they might help.
How do MAOIs work?
MAOIs belong to the category of antidepressant medications and they can treat depression by working on the feel-good chemicals known as neurotransmitters that send brain cells to communicate with each other. Depression can be seen in the people who are having low levels of neurotransmitters such as norepinephrine, dopamine, and serotonin which acts as a feel-good chemical in the brain. If you are feeling sad or depressed, having low levels of these neurotransmitters might be the reason.
Monoamine oxidase inhibitors (MAOIs) work by removing these neurotransmitters or increase the levels of feel-good chemicals like dopamine, serotonin, and norepinephrine. By restricting monoamine oxidase, MAOIs keep more of these feel-good chemicals available to the brain and keeping more serotonin and dopamine levels in the brain will automatically boost your mood.
What are the side effects of Monoamine oxidase inhibitors (MAOIs)?
Dry mouth, prickling or tingling sensation in the skin, nausea, muscle cramps, difficulty starting a urine flow, diarrhea or constipation, weight gain, headache, difficulty in sleeping or insomnia, headache, dizziness or lightheadedness, low blood pressure, skin reaction at the patch site, involuntary muscle jerks, and sexual problems such as erectile dysfunction (unable to maintain an erection during intercourse), or difficulty reaching orgasm are the common side effects of Monoamine oxidase inhibitors (MAOIs).
This is why these medications are not the doctor’s first choice drugs. These medications are associated with more side effects when compared to other antidepressant medications. That is why physicians normally not recommend these drugs to their patients as they tend to cause more side effects.
Understanding monoamine oxidase
Monoamine oxidases are a kind of enzyme that assist neurons to launch everywhere in your body. It is secreted in your liver and eliminates the neurotransmitters after they have performed their respective functions.
Tyramine a chemical compound that assists in controlling the blood pressure is also eliminated by monoamine oxidase, apart from the neurotransmitters. As monoamine oxidase inhibitors hamper monoamine oxide from performing its function, they severely affect the blood pressure along with maintaining the neurotransmitters at maximum levels. One should bear in mind while consuming monoamine oxidase inhibitors to keep a tab on their blood pressure which also involves restricting the intake of some foods.
Drugs which are approved by the FDA:
Isocarboxazid, Phenelzine, Selegiline, and Tranylcypromine are the MAOI drugs that are approved by the food and drug administration (FDA).
There is a skin patch known as selegiline available in the market and using this patch may cause fewer side effects when directly taken by mouth. There is no need of following any diet restriction if you are using the lowest dose patch. But, please bear in mind that you need to talk with your doctor before using this transdermal patch.
Foods to avoid while taking MAOIs
As these drugs raise tyramine levels in the blood, we would advise you to follow a diet that will be designed by your physician.
At the time of MAOIs entered into the market, no one knew that the drug can elevate the tyramine levels in the blood and can cause high blood pressure. Due to this reason, researchers again conducted studies on these drugs. There are many foods that are available in the market contain excess tyramine and we would advise you to avoid these foods while taking monoamine oxidase inhibitors (MAOIs).
Aged chicken liver, aged cheese, yeast extract, beer on tap, miso soup, red wine, sauces containing fish or shrimp, soy sauce, fava beans, raisins, dates, dried fruits, tofu, salami, sauerkraut, and meats that have been fermented or air-dried, such as summer sausage are the examples of tyramine rich foods.
Tyramine levels increase in foods that have not been kept cold enough or foods that they have been stored for a long time.
Stopping treatment with MAOIs
We would advise the people who have intentions to stop using this medication should consult a doctor. Because, sudden stoppage of MAOIs can cause insomnia, anxiety, and agitation, as well as flu-like symptoms like
- Chills
- Nausea
- Sweating
- Headache
- Feeling generally unwell
You may experience discontinuation syndrome if you stop taking MAOI abruptly. Following are the uncommon withdrawal symptoms
- Confusion
- Convulsions
- Detachment from reality (psychosis)
To prevent serotonin syndrome, there should be a time interval of at least two weeks between the use of monoamine oxidase inhibitors (MAOIs) and other antidepressant medications. Throughout those two weeks’ time period you should continue maintaining the limitations of food and drinks which can lead to severe interactions with monoamine oxidase inhibitors (MAOIs).
We would advise you to have a word with your healthcare provider and he will make changes to your dosage or will prescribe you another medication and never stop taking this medication suddenly or without consulting your physician.
MAOIs and suicide risk
Food and drug administration require a warning on antidepressant medications that these medications may cause suicidal thoughts in children and young adults. These suicidal thoughts in people who are taking this drug for the first time or if they made any changes to their dosages.
Generally, doctors never prescribe monoamine oxidase inhibitors (MAOIs) to children, but the people who are taking an antidepressant should be under the control of doctor’s supervision for a few days as these suicidal thoughts are high in the initial days of the treatment.
If you are experiencing suicidal thoughts while taking antidepressants call 911 or consult your physician immediately and get emergency help. Also, please bear in mind that these suicidal thoughts are temporary.
Other precautions
People who are taking monoamine oxidase inhibitors should keep in mind a rare condition called serotonin syndrome along with the blood pressure problems. This problem arises when you have too much serotonin levels available to your body. Following are the symptoms of serotonin syndrome
- Fast heart rate
- Anxiety
- Major changes in blood pressure
- Agitation
- Lack of coordination
- High fever
- Restlessness
- Sweating
- Tremors
- Confusion
It’s not safe to take these antidepressant medications if you are pregnant because MAOIs may harm your child. If you think you are pregnant while you are on medication consult your physician immediately and he will change the dosage of your medication or switch you to other medication. Have a word with your healthcare provider regarding the risks and dangers of taking these antidepressant medications during the pregnancy period.
Don’t take herbal supplements such as St. john’s wort, medical marijuana or other antidepressants like selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and Serotonin-norepinephrine reuptake inhibitors (SNRIs). Discuss with your mental health provider before you would like to use other antidepressants or herbal supplements while you are taking Monoamine oxidase inhibitors (MAOIs).
Conclusion
Monoamine oxidase inhibitors are one of the types of antidepressant medication that can treat depression. Like other antidepressant drugs, they may not suitable for every person who is suffering from depression and it might take one to two weeks to work. Never take MAOIs when you are on other medication as it may interact with other medications and always take your physician’s advice if you want to use monoamine oxidase inhibitors (MAOIs).
References
- https://www.ncbi.nlm.nih.gov/books/NBK539848/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2075358/
- https://www.frontiersin.org/articles/10.3389/fphar.2016.00340/full
Sirisha B