Eleva Tablets - Consumer Medicines Information leaflets of prescription and over-the-counter medicines. MAOI (monoamine oxidase inhibitor) Antidepressants. Monamine oxidase inhibitors were the first medications marketed as antidepressants. They were developed in the 1. They have been largely supplanted by other antidepressants that have fewer side effects, but there are still some situations where a MAOI is indicated. They are used to treat: Atypical depression, especially where there is extreme sensitivity to the environment or to rejection. Anergic bipolar depression (low energy)Depression that has not responded to other antidepressants. MAOIs are also used to treat panic disorder and other conditions. How MAOIs work. Depression is thought to be related to an imbalance of brain chemicals, especially serotonin, dopamine and norepinephrine. These chemicals carry messages between nerve cells. They are released into the space between two nerve cells, and they bind with specific sites on the cell membrane of the receiving cell. Any chemicals that don't bind with the receiving cell are broken down and returned to the first cell by an enzyme called monamine oxidase. MAOIs inhibit monamine oxidase and keep it from breaking down the chemicals. That allows them to accumulate and helps restore the chemical balance. Contraindications. Monamine oxidase inhibitors should not be taken if: You have recently taken another antidepressant (within the past 2- 5 weeks, depending on the medication). You cannot follow a strict special diet. You have severe heart disease or have recently had a heart attack or stroke. You have a seizure disorder. You have asthma or bronchitis. You have high blood pressure. Side Effects. Most people have side effects when they are taking MAOIs. The side effects are usually mild and temporary, but they can be serious enough to warrant stopping the medication. The usual side effects of MAOIs are: Dry mouth. Lightheadedness. Low blood pressure, especially when first standing up. Reduced tolerance for alcohol. Weight gain. Sleep problems. The most serious side effects of MAOIs are related to their potential for interaction with food and other medications. These are discussed in the next section. Interactions. MAOIs interact with a wide range of foods, supplements and medications. Some of them are: Cold and allergy medicines, antihistamines, cough medicines. Over the counter diet medications. Antipsychotic medications. Asthma medications. Tranquilizers and sedatives. Blood pressure medications. Consumer information about the class of antidepressant medications, monoamine oxidase inhibitors (MAOIs) names, side effects, drug interactions, recommended dosages. Monoamine oxidase inhibitors (MAOIs) are one of the oldest classes of antidepressants and are typically used when other antidepressants have not been effective. MAOI Diet Facts. Monoamine Oxidase Inhibitors (MAOIs) are drugs used to treat depression, high blood pressure, and other medical conditions. If you are taking MAOIs. Medications for heart dysrhythmias. Seizure medications. Medications for ADHDCocaine and similar drugs. Pain medications, especially meperdine (Demerol)Dextromethorphan (found in many cough and cold medications- can cause fatal interaction)Tryptophan. Other antidepressants. Tyramine- containing foods- see Appendix 1 for a list of tyramine containing foods. Hypertensive crisis: Tyramine and MAOIs can produce a hypertensive crisis, where your blood pressure rises rapidly and becomes very high. This can result in a heart attack or stroke, and is a medical emergency. Serotonin syndrome: MAOIs interact with other antidepressants and serotonergic medications because they both alter serotonin levels. A toxic reaction, serotonin syndrome, can occur. This is sometimes described as Neuroleptic Malignant Syndrome or as MAOI reaction. Characteristics include shaking and shivers, anxiety, tremors and sweating and can progress to very high fevers, seizures, cardiovascular collapse and death. Withdrawal. As with other antidepressants, MAOIs must be withdrawn gradually. Learn about Vyvanse (Lisdexamfetamine Dimesylate) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related medications. Many patients with anxiety disorders experience physical symptoms related to anxiety and subsequently. Monoamine oxidase inhibitors (MAOIs) are chemicals that inhibit the activity of the monoamine oxidase enzyme family. They have a long history of use as medications. Analyses of the comparative effectiveness, side effects and toxicity of psychotropic drugs with emphases on serotonin syndrome and monoamine oxidase inhibitors. Abruptly stopping them can cause withdrawal symptoms that can be extremely uncomfortable. Appendix 1: Tyramine- containing foods. Tyramine is found primarily in aged or fermented foods. The tyramine content rises as the food ages- something that has been in the refrigerator for a week has more tyramine than it did when it was fresh. One way to avoid tyramine is to eat very fresh foods. Cheese and wine have more tyramine than other foods. Here is a list of other tyramine- containing foods. Cheese. Beer or wine, including nonalcoholic varieties. Canned meat. Meat extracts. Canned gravy. Caviar. Hard sausages. Meat tenderizer. Unrefrigerated, fermented, pickled, salted or dried fish. Game meat, especially if aged. Liver. Aged meat. Avocadoes. Bananas. Fava beans. Figs. Sauerkraut. Soybean products (tofu, soy sauce, etc)Bouillon. Meat, yeast and protein extracts. Aspartame (possibly). Monoamine oxidase inhibitor - Wikipedia. For the Easter Island statues, see Moai. Monoamine oxidase inhibitors (MAOIs) are chemicals that inhibit the activity of the monoamine oxidase enzyme family. They have a long history of use as medications prescribed for the treatment of depression. They are particularly effective in treating atypical depression. Inhibition of both MAO- A and MAO- B is used in the treatment of clinical depression and anxiety. MAOIs appear to be particularly indicated for outpatients with dysthymia complicated by panic disorder or hysteroid dysphoria, which involves repeated episodes of depressed mood in response to feeling rejected. There are two isoforms of monoamine oxidase, MAO- A and MAO- B. MAO- A preferentially deaminatesserotonin, melatonin, epinephrine, and norepinephrine. MAO- B preferentially deaminates phenethylamine and certain other trace amines; in contrast, MAO- A preferentially deaminates other trace amines, like tyramine, whereas dopamine is equally deaminated by both types. Reversibility. The enzymes turn over approximately every two weeks. A few newer MAOIs, a notable one being moclobemide, are reversible, meaning that they are able to detach from the enzyme to facilitate usual catabolism of the substrate. The level of inhibition in this way is governed by the concentrations of the substrate and the MAOI. Some MAOIs inhibit both MAO- A and MAO- B equally, other MAOIs have been developed to target one over the other. MAO- A inhibition reduces the breakdown of primarily serotonin, norepinephrine, and dopamine; selective inhibition of MAO- A allows for tyramine to be metabolised via MAO- B. Tyramine is broken down by MAO- A and MAO- B, therefore inhibiting this action may result in its excessive build- up, so diet must be monitored for tyramine intake. MAO- B inhibition reduces the breakdown mainly of dopamine and phenethylamine so there are no dietary restrictions associated with this. MAO- B would also metabolize tyramine, as the only differences between dopamine, phenethylamine, and tyramine are two phenylhydroxyl groups on carbons 3 and 4. The 4- OH would not be a steric hindrance to MAO- B on tyramine. If large amounts of tyramine are consumed, they may suffer hypertensive crisis, which can be fatal. When MAO- A is inhibited, though, NE levels get too high, leading to dangerous increases in blood pressure. Of note, no dietary modifications are needed when taking a reversible inhibitor of MAO- A (i. MAO- B inhibitors (e. John's wort, tryptophan). It is vital that a doctor supervise such combinations to avoid adverse reactions. For this reason, many users carry an MAOI- card, which lets emergency medical personnel know what drugs to avoid. Certain combinations can cause lethal reactions, common examples including SSRIs, tricyclics, MDMA, meperidine. However, the dependence- producing potential of MAOIs or antidepressants in general is not as significant as benzodiazepines. Withdrawal symptoms can be managed by a gradual reduction in dosage over a period of weeks, months or years to minimize or prevent withdrawal symptoms. If one also tapers dosage gradually, the result is that for weeks a depressed patient will have to bear the depression without chemical help during the drug- free interval. This may be preferable to risking the effects of an interaction between the two drugs, but it is often not easy for the patient. There is no universally taught or accepted practice regarding dentistry and use of MAOIs such as phenelzine and it is, therefore, vital to inform all clinicians especially dentists of the potential effect of MAOIs and local anesthesia. In preparation for dental work, withdrawal from phenelzine is specifically advised, however since this takes two weeks it is not always a desirable or practical option. Dentists using local anesthesia are advised to use a non- epinephrine anesthetic such as mepivacaine at a level of 3%. Specific attention should be paid to blood pressure during the procedure and the level of the anesthetic should be regularly and appropriately topped up since non- epinephrine anestetics take longer to come into effect and wear off faster. Patients taking phenelzine are advised to notify their psychiatrist prior to any dental treatment. Certain other supplements: Hypericum perforatum (. Subsequent in vitro work led to the discovery that it inhibited MAO and eventually to the monoamine theory of depression. MAOIs became widely used as antidepressants in the early 1. The discovery of the 2 isoenzymes of MAO has led to the development of selective MAOIs that may have a more favorable side- effect profile. As a result, the use by medical practitioners of these older MAOIs declined. When scientists discovered that there are two different MAO enzymes (MAO- A and MAO- B), they developed selective compounds for MAO- B, (for example, selegiline, which is used for Parkinson's disease), to reduce the side- effects and serious interactions. Further improvement occurred with the development of compounds (moclobemide and toloxatone) that not only are selective but cause reversible MAO- A inhibition and a reduction in dietary and drug interactions. Psychiatric Times. Retrieved 2. 3 November 2. CNS Spectrums. 1. Journal of Food Composition and Analysis. S5. 8–S6. 5. R.; Hollander, E.; Schneier, F.; Campeas, R.; Welkowitz, L.; Hatterer, J.; Fallon, B. Acta Psychiatrica Scandinavica. S3. 60): 2. 9–3. 4. PMID 2. 24. 80. 64. The Journal of Clinical Psychiatry. PMID 3. 54. 29. 85. Archives of General Psychiatry. PMID 1. 55. 84. 63. E.; Mundim, F. D.; Alves, A. B.; Liebowitz, M. R.; Amrein, R. A controlled study with moclobemide and phenelzine. The British Journal of Psychiatry. PMID 1. 39. 33. 04. Archives of General Psychiatry. PMID 9. 86. 25. 58. Arch Gen Psychiatry. PMC 1. 47. 58. 05 . PMID 1. 02. 32. 29. A preliminary report. Archives of General Psychiatry. PMID 6. 37. 56. 21. Arch Gen Psychiatry. PMID 6. 38. 85. 24. Matthew; Quitkin, Frederic M.; Stewart, Jonathan W.; Ocepek- Welikson, Katja; Mc. Grath, Patrick J.; Tricamo, Elaine (1. International Journal of Eating Disorders. PMID 8. 12. 43. 22. Journal of Psychiatric Research. PMID 3. 90. 03. 62. Arch Gen Psychiatry. PMID 3. 28. 24. 82. The British Journal of Psychiatry. Arch Gen Psychiatry. PMID 8. 48. 93. 26. Psychopharmacology Bulletin. PMC 3. 57. 02. 73 . PMID 1. 96. 29. 02. Journal of Neural Transmission. Supplementum. PMID 3. S.; Logan, J; Azzaro, A. J.; Fielding, R. M.; Zhu, W; Poshusta, A. K.; Burch, D; Brand, B; Free, J; Asgharnejad, M; Wang, G. J.; Telang, F; Hubbard, B; Jayne, M; King, P; Carter, P; Carter, S; Xu, Y; Shea, C; Muench, L; Alexoff, D; Shumay, E; Schueller, M; Warner, D; Apelskog- Torres, K (2. Neuropsychopharmacology. PMC 2. 83. 32. 71 . PMID 1. 98. 90. 26. Massaro (2. 00. 2). Handbook of Neurotoxicology. ISBN 9. 78. 08. 96. Polski Merkuriusz Lekarski (in Polish). PMID 9. 43. 22. 89. E.; Binda, C; Mattevi, A (2. Archives of Biochemistry and Biophysics. PMC 1. 99. 38. 09 . PMID 1. 75. 73. 03. Food and Drug Administration. Retrieved 2. 00. 9- 1. The Good Drug Guide. Retrieved 2. 00. 7- 1. At dosages above around 2 mg per day, rasagiline loses its selectivity for MAO type B and also inhibits MAO type A. An MAO- B selective regimen does not cause significant tyramine potentiation, the dreaded 'cheese effect' common to users of older unselective and irreversible MAOIs who eat tyramine- rich foods. This will be taken with and without food. Thus, low- dosage rasagiline demands no special dietary restrictions. Drugs and Drug Policy : The Control of Consciousness Alteration. Thousand Oaks, Calif.: Sage, 2. Case Studies: Stahl's Essential Psychopharmacology. Clinical Neuropharmacology. Suppl 2): S1–7. PMID 8. New England Journal of Medicine. PMID 1. 57. 84. 66. Ritter, P. K. Moore, year 2. PMID 1. 61. 77. 02. PMID 1. 45. 92. 67. V.; Talhout, R.; Vleeming, W.; Opperhuizen, A. Life Sciences. 7. PMID 1. 68. 84. 73. Anthenelli, R. The International Journal of Neuropsychopharmacology. PMID 1. 13. 43. 62. S.; Volkow, N. D.; Wang, G. J.; Pappas, N.; Logan, J.; Shea, C.; Alexoff, D.; Mac. Gregor, R. R.; Schlyer, D. J.; Zezulkova, I.; Wolf, A. Proceedings of the National Academy of Sciences of the United States of America. Bibcode: 1. 99. 6PNAS.. F. PMID 8. 94. 30. S.; Volkow, N. D.; Wang, G- J.; Pappas, N.; Logan, J.; Mac. Gregor, R. 3. 79 (6. Bibcode: 1. 99. 6Natur. F. ISSN 0. 02. 8- 0. PMID 8. 60. 22. 20. Neuropsychopharmacol. PMID 1. 23. 69. 27. Journal of Consulting and Clinical Psychology. PMC 2. 64. 85. 13 . PMID 1. 85. 40. 74. Drug. Lib. com. Retrieved 2. May 2. 01. 3. Psychosomatics. PMID 1. 20. 75. 04. Indian J Psychiatry. PMID 2. 39. 34. 74. An update on drug interactions. PMID 8. 71. 36. 90. J Psychiatry Neurosci. PMC 1. 18. 85. 42 . PMID 7. 90. 52. 88. Br J Hosp Med. 4. PMID 8. 49. 06. 90. Clinical Infectious Diseases. ISSN 1. 05. 8- 4. PMID 1. 66. 52. 31. H.; Wegener, G; Petzer, J. PMID 2. 21. 97. 61.
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