MAO or monoamine oxidase – is a ferment found in the gastrointestinal tract. MAO help to break up all the substances that our organisms get with food.
MAO inhibitors are being effectively used for treating depression. But it usually happens when other drugs and meds have proved to be ineffective.
Monoamine oxidase breaks up many substances derived from tryptamine. Dimethyltryptamine is the most dangerous one. It can trigger prolonged hallucinations. In ancient times, Indians were using special mixtures of plants that contained dimethyltryptamine together with those that contained MAO inhibitors. This mixture was called “yage”.
The modern world is familiar with only one potent non-synthetic monoamine oxidase inhibitor – Peganum harmala seeds. This plant contains such alkaloids as harmaline and harmine. These alkaloids can trigger hallucinations accompanied with vomiting and convulsions. And one big dosage of alkaloids is enough to cause this condition.
MAOI drugs in medicine
Nowadays there are lots of factors that can cause depression. And sometimes it is not only difficult to treat it with natural remedies, but also using the most common drugs for depression. In this case, MAOIs come to play.
Synthetic inhibitors are the ones that are usually used in treating depression. It is because synthetic inhibitors work longer than vegetative ones. For example, the harmaline and harmine effect lasts for three days after the last dosage, while synthetic inhibitor can last for two weeks.
MAOIs work by restricting the activity of monoamine oxidase, thus stopping monoamine neurotransmitters from the breakdown and increasing their availability. There are two isoforms of monoamine oxidase: MAO-A and MAO-B.
MAO-A deaminates (removes the amine group from a molecule) serotonin, melatonin, epinephrine, and norepinephrine.
MAO-B deaminates phenethylamine and some other trace amines; in contrast, MAO-A preferentially deaminates other trace amines, like tyramine, whereas dopamine is equally deaminated by both types.
Non-selective irreversible MAOIs are prescribed for treating chronic alcoholism and depressions (neurotic, involutional and cyclothymic).
Non-selective reversible MAOIs are prescribed for treating depressions of various genesis, depressive syndrome, melancholic syndrome and athenoadynamic disorders.
Selective irreversible MAOIs are prescribed for treating Parkinson’s disease.
MAOI drugs lists
The non-selective irreversible MAOI list includes:
- Phenelzine (Nardil)
- Isocarboxazid (Marplan)
- Tranylcypromine (Parnate)
The selective irreversible MAOI list includes Selegiline (Emsam, Eldepryl, Zelapar).
The selective reversible MAOI list includes:
- Beta-carboline derivatives
Learn about another group of antidepressants: Tricyclic antidepressants
To avoid all unnecessary risks, it is advised to be on a diet when taking MAOI and for two more weeks after the treatment.
It is because MAOIs don’t allow monoamine oxidase (an enzyme) to be released. This enzyme is designed to reduce excess tyramine in the body. Blocking this enzyme helps relieve depression. But, tyramine can go up quickly if you eat high tyramine foods. This, in its turn, may increase blood pressure and emergency treatment.
Tyramine can generally be found in small amounts of food rich with protein. The more aged the food, the higher tyramine levels. Some foods high in tyramine include:
Foods to avoid
- Meat and liver
- Smoked and pickled fish
- Sausage, bologna, pepperoni, and salami
- Beans pods
- Yeast extract, including beer yeast
- Stale products
Foods to use with caution
(1/2 cup or less than 120 mL)
- Dairy products (only fresh cream, sour cream, cheese, yogurt, or milk)
- Soy sauce
What is more, during the treatment with MAOIs patients mustn’t take any of the following meds:
- Meds for cold – mixtures and pills
- Inhalation medications, including meds for asthma
- Meds for weight loss and appetite suppressants
- Other medications with narcotic effect, including those with caffeine
According to the food processing and storage, every product will have different amounts of tyramine. Eat only fresh foods when you take MAOIs.
You can use the help of Selegiline skin patch. It will ensure that the medication is delivered to your body. The lower the selegiline dose, the fewer restrictions you will have to undergo in eating. Ask your doctor for advice.
In doesn’t matter which MAOI type you take, you must know the list of restricted and allowed products. Dietary restrictions are required for individuals receiving monoamine oxidase inhibitor therapy to prevent a hypertensive crisis and other side effects.
Learn the emergency signs of high blood pressure, which may include:
- Fast heartbeat
- Dilated pupils
- Rarely, bleeding in the brain (hemorrhagic stroke) or death
Be prepared. Ask your doctor what to do if you accidently eat or drink something with too much tyramine so you have a plan in place.
MAOI side effects
MAOIs, despite their efficiency, can be replaced by other antidepressants – safer and with fewer side-effects. But that doesn’t mean that MAOI is a bad medication. Sometimes they help when other treatment fails.
The range of side varies according to the type of MAOI you use to treat depression.
Thus, taking selective reversible MAOI may result into following side effects:
Taking non-selective reversible MAOI may result into following side effects:
- Lowered blood pressure
- Dry mouth
Taking selective irreversible MAOI may cause complications for various body systems, among them are:
- Digestive system: loss of appetite, dry mouth, nausea, diarrhea, constipation, and dysphagy.
- Nervous system: undue fatigability, insomnia, dizziness, hallucinations, headache, anxiety, dyskinesia, motor agitation and psychic excitement, mental confusion, and psychoses.
- Cardiovascular system: high blood pressure, orthostatic hypotension, and arrhythmia.
- Sense organs: diplopia and lowered visual acuity.
- Urogenital system: nocturia, urinary retention and painful urges to urinate.
- Allergic reactions: shortness of breath, photosensitization, skin rush, and bronchospasm.
Taking selective irreversible MAOIs can also trigger perspiration, hypoglycemia and loss of hair.
Keep in mind that all of the information explained in this article is additional and simplified, and should be taken into account only with drug prescription. This information is given to provide you with a common knowledge of the drug basics and its possible consequences and risks.
You do need to consult with your doctor and/or pharmacist and to read the instruction sheet before taking any medication.