Action: monoamine oxidase inhibitor (MAOI)
This class of drugs includes the earliest anti-depressants, but many are still in use today. Sharing a common biochemical action they are notorious for dangerous interactions with chemicals found in certain foods as well as with a variety of prescription and non-prescription drugs.
Also: reversible inhibitor of monoamine oxidase A (RIMA), serotonin syndrome
Specific drugs: isocarboxazid, moclobemide, phenelzine, selegiline, tranylcypromine
Stephen Stahl's Clinical Pearls* (Consult your physician before making any change in your treatment.)
- Phenylcyclopropylamine (Parnate) has stimulant, amphetamine-like properties:
- Insomnia managed with trazodone.
- Orthostatic hypotension dose related.
- With great skill, can be combined in heroic cases with TCAs but never with SSRIs.
- Even MAO B inhibition by deprenyl is dangerous to combine with an SSRI.
- Reversible MAOIs specific for A (moclobemide) can be better tolerated, fewer dietary problems, but sometimes less effective.
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- Kennedy, Sidney H., M.D. (Editor) Clinical Advances in Monoamine Oxidase Inhibitor Therapies (Progress in Psychiatry, No 43)(8474) Hardcover 1994 -"An internationally renowned group of experts present new findings on the relationships among monoamine oxidase, its inhibition, and psychiatric disorders, as well as a detailed explanation of selectivity and reversibility of enzyme inhibition."
*Reprinted with permission from: Stahl, Stephen M Psychopharmacology of Antidepressants Paperback 1997 Martin Dunitz, Ltd & Blackwell Science You cannot fully appreciate this book until you have seen the extraordinary illustrations of every aspect of this area of psychopharmacology and neurochemistry. Loaded with practical clinical "pearls."