Current Place of Monoamine Oxidase Inhibitors in the Treatment of Depression

  title={Current Place of Monoamine Oxidase Inhibitors in the Treatment of Depression},
  author={Kenneth I. Shulman and Nathan Herrmann and Scott E. Walker},
  journal={CNS Drugs},
This paper reviews the discovery and history of the use of irreversible monoamine oxidase (MAO) inhibitors (MAOIs) such as phenelzine, tranylcypromine and isocarboxazid, as well as the second generation selective and reversible MAOIs such as the MAO-A inhibitor, moclobemide and the MAO-B inhibitor, selegiline. Data for review were identified from a literature search of OvidSP Medline and PsycInfo performed in July 2012, using the subject terms and keywords of ‘monoamine oxidase inhibitors… 
Comment on: “Monoamine Oxidase Inhibitors (MAOIs) in Psychiatric Practice: How to Use them Safely and Effectively”
It seems unlikely that melatonin is metabolized by MAO to a considerable extent, but MAO may be considered in endogenous melatonin biosynthesis with respect to insomnia as an adverse effect of MAOIs, or even for depression, as there is a strong association of depression with sleep disorders.
The Monoamine Oxidase Inhibitor Isocarboxazid is a Relevant Treatment Option in Treatment-Resistant Depression: Experience-Based Strategies in Danish Psychiatry
The aim of the present paper is to give a short overview of the clinical efficacy, mechanisms of action and metabolism of MAOIs, and to discuss how the side effects and interactions with these drugs may be avoided.
Monoamine Oxidase Inhibitors (MAOIs) in Psychiatric Practice: How to Use them Safely and Effectively
Practical advice is given in terms of dietary restrictions, interactions with other medications, and how prescribers can stop and switch MAOIs, both within the drug class and outside of it.
Monoamine Oxidase Inhibitors: From Classic to New Clinical Approaches.
This review summarizes the most important aspects regarding the development and clinical use of MAO inhibitors, going through mechanistic and structural details, new indications, and future perspectives.
Combination Therapy with Monoamine Oxidase Inhibitors and Other Antidepressants or Stimulants: Strategies for the Management of Treatment‐Resistant Depression
It is suggested that when used under close supervision and under the care of an experienced clinician in psychiatry, combination therapy may be a consideration for the management of TRD in patients not responding to monotherapy or other combinations of antidepressants.
Inhibitors of MAO-A and MAO-B in Psychiatry and Neurology
The clinical potential of MAO inhibitors together with detailed knowledge of the enzyme's binding site structure should lead to future developments with these drugs.
A brief history of the development of antidepressant drugs: from monoamines to glutamate.
The noncompetitive NMDA receptor antagonist ketamine, which has consistently produced rapid and sustained antidepressant effects in MDD patients in a number of clinical studies, has shown the most promise as a novel glutamatergic-based treatment for MDD.
Monoamine Oxidase Inhibitors—Revisiting a Therapeutic Principle
This review revisits monoamine oxidase inhibitors and their potential in the treatment of human diseases, such as anxiety, depression, mood and personality disorders, and pain and introduces current ideas and developments.
Tranylcypromine in mind (Part I): Review of pharmacology


Monoamine Oxidase Inhibitors: A Modern Guide to an Unrequited Class of Antidepressants
The mechanisms of therapeutic action of MAOIs are discussed, but also the mechanisms explaining their side effects, including hypertensive interactions with dietary tyramine (so-called "cheese reactions") and drug interactions that can lead to hypertensive reactions with some drugs and serotonin toxicities with others.
Clinical pharmacology of MAO inhibitors: safety and future.
Treatment of imipramine-resistant recurrent depression, III: Efficacy of monoamine oxidase inhibitors.
These findings provide strong evidence of the utility of MAOIs in tricyclic-resistant depression, especially in patients with features such as fatigue, volitional inhibition, motoric retardation, hypersomnia, and/or weight gain.
Diet and Monoamine Oxidase Inhibitors: A Re-Examination
It was determined that only four foods clearly warrant absolute prohibition: aged cheese, pickled fish, concentrated yeast extracts and broad bean pods, while there is insufficient evidence to prohibit alcohol completely (even chianti wine) true moderation must apply.
Current prescription patterns and safety profile of irreversible monoamine oxidase inhibitors: a population-based cohort study of older adults.
The low prescription rate of MAOIs is not consistent with the continued recommendation ofMAOIs by expert opinion leaders and consensus guidelines for use in atypical depression and treatment-refractory depression, and heightened awareness of the potential risk of concomitant use of serotonergic agents is necessary.
Monoamine oxidase inhibitors revisited: what you should know.
MAOIs were clearly superior to TCAs, there was little reason to view them as superior to SSRIs, which were substantially safer, and they were often thought of for anxious depression on the basis of an older literature comparing phenelzine with tricyclics such as amitriptyline.
MAOIs in the Contemporary Treatment of Depression
Selective inhibitors of monoamine oxidase type B and the "cheese effect".
Treating depression with atypical features.
  • J. Stewart
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 2007
Treatment for atypical depression remains dependent upon older agents for the greatest efficacy, and Cognitive strategies have shown promise, but demonstrating efficacy in comparison with an MAOI and placebo is limited to a single study.