Monoamine Oxidase Inhibitors: A Modern Guide to an Unrequited Class of Antidepressants

@article{Stahl2008MonoamineOI,
  title={Monoamine Oxidase Inhibitors: A Modern Guide to an Unrequited Class of Antidepressants},
  author={Stephen M Stahl and Angela Felker},
  journal={CNS Spectrums},
  year={2008},
  volume={13},
  pages={855 - 871}
}
Monoamine oxidase inhibitors (MAOIs) currently have a "bad rap" and are thus infrequently used in psychopharmacology, even by experienced clinicians. Misinformation about the dietary and drug interactions of MAOIs is widespread, whereas pragmatic tips for utilizing MAOIs to minimize risks and to maximize therapeutic actions are largely lacking in the contemporary literature. While clearly not first-line treatments, MAOIs, in the hands of experienced and well-informed clinicians, can be a… 
Opportunities for reversible inhibitors of monoamine oxidase-A (RIMAs) in the treatment of depression
TLDR
Recent progress in RIMAs toward the treatment of treatment-resistant depression is discussed, with the new class of reversible monoamine oxidase inhibitors (RIMAs) having shown efficacy in depression, with safety and tolerability comparable to SSRIs.
A Concise Guide to Monoamine Oxidase Inhibitors: How to Avoid Drug Interactions: Use These Strategies to Maximize Efficacy and Minimize Adverse Effects When Prescribing an MAOI
TLDR
This 2-part guide to MAOIs is to educate clinicians about this often-overlooked class of medications and covers how to avoid potential drug interactions that could affect patients receiving an MAOI.
Tricyclic Antidepressants and Monoamine Oxidase Inhibitors: Are They Too Old for a New Look?
TLDR
This chapter takes a closer look at the arc of MAOI discovery and clinical use, and how these two classes of drugs compare to each other, and argues that TCAs, and particularly MAOIs, should continue to play an important role in the modern treatment of depression, especially in the treatment-resistant patient.
Current Place of Monoamine Oxidase Inhibitors in the Treatment of Depression
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
The Monoamine Oxidase Inhibitor Isocarboxazid is a Relevant Treatment Option in Treatment-Resistant Depression: Experience-Based Strategies in Danish Psychiatry
TLDR
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.
The use of monoamine oxidase inhibitors in primary care.
TLDR
Although primary care clinicians have developed considerable expertise in managing patients with major depressive disorder, and a range of treatment strategies is currently available, some patients still fail to reach remission and clinicians should still be alert for drug interactions and observe recommended washout periods.
Cerebral MAO Activity Is Not Altered by a Novel Herbal Antidepressant Treatment
TLDR
Treatment with NHT was supported as safe in terms of risk for inducing a hypertensive response and the antidepressant- and anxiolytic-like effects of NHT are mediated via pathways other than MAO-A/B inhibition.
From depression to neurodegeneration and heart failure: re-examining the potential of MAO inhibitors
TLDR
The authors review the relevance of MAO isoforms to disease, and they also outline current research and development efforts in this class of drugs, including newer multipotent compounds.
Critical appraisal of selegiline transdermal system for major depressive disorder
TLDR
This review provides an overview of STS’s clinical pharmacology and summarizes what has been learned across nearly a decade of experience, and concludes that STS remains a unique treatment option.
Drugs related to monoamine oxidase activity
  • Z. Fišar
  • Biology, Medicine
    Progress in Neuro-Psychopharmacology and Biological Psychiatry
  • 2016
TLDR
Desirable effects of MAO inhibition include increased availability of monoamine neurotransmitters, decreased oxidative stress, decreased formation of neurotoxins, induction of pro-survival genes and antiapoptotic factors, and improved mitochondrial functions.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 86 REFERENCES
Transdermal Selegiline: The New Generation of Monoamine Oxidase Inhibitors
TLDR
Clinicians should familiarize themselves with the properties and indications for the new generation of MAOIs and it is possible that STS may demonstrate benefit in MDD with atypical features or MDD resistant to other antidepressants.
Combining stimulants with monoamine oxidase inhibitors: a review of uses and one possible additional indication.
  • S. Feinberg
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 2004
TLDR
Another possible indication for this therapeutic regimen is treatment of attention-deficit/hyperactivity disorder in an adult patient whose major depression had uniquely responded to the MAOI tranylcypromine.
Meta-Analysis of the Reversible Inhibitors of Monoamine Oxidase Type A Moclobemide and Brofaromine for the Treatment of Depression
TLDR
A series of meta-analyses of studies of the two most widely researched RIMAs, moclobemide (MOC; Aurorex) and brofaromine (BRO) confirm that both BRO and MOC are as effective as the tricyclic antidepressants, and they are better tolerated.
A clinical overview of monoamine oxidase inhibitors.
  • S. Zisook
  • Psychology, Medicine
    Psychosomatics
  • 1985
TLDR
The major role of MAOIs now appears to be in depressed patients refractory to other pharmacologic treatments, and especially in outpatients with features of both anxiety and depression.
Is the failure of (-)deprenyl, a selective monoamine oxidase B inhibitor, to alleviate depression related to freedom from the cheese effect?
TLDR
There is evidence to suggest that this cheese effect, a facilitated tyramine-induced hypertensive response, is pharmacologically distinct from MAO inhibition proper, and it is conceivable that its central counterpart, an enhanced noradrenaline release due to the access of traces of tyramines to the CNS, is a prerequisite for any therapeutic benifit obtainable with the MAO-inhibitory drugs in general.
Revisiting monoamine oxidase inhibitors.
  • K. Krishnan
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 2007
TLDR
The development of a novel, transdermal MAOI system now offers clinicians an additional option for managing patients with unipolar, bipolar, atypical, and treatment-resistant depression.
CNS stimulant potentiation of monoamine oxidase inhibitors in treatment-refractory depression.
TLDR
With properly motivated and complaint patients and careful clinical monitoring by the prescribing psychiatrist, stimulant potentiation of MAOIs may be a viable option for treatment-resistant depressed patients.
Monoamine oxidase inhibitor dietary restrictions: what are we asking patients to give up?
TLDR
A wide variety of tyramine-containing foods and contraindicated medications were commonly used by psychiatric patients prior to evaluation for possible MAOI pharmacotherapy, but the number and diversity of frequently consumed items do not support recommendations to reduce the breadth of restrictions inMAOI diets.
Transdermal selegiline: targeted effects on monoamine oxidases in the brain
TLDR
Results suggest that transdermal selegiline preferentially inhibits MAO-A in brain relative to the gastrointestinal system, which should be devoid of the potential to cause a hypertensive reaction after the ingestion of tyramine-containing compounds.
Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity.
  • P. Gillman
  • Medicine
    British journal of anaesthesia
  • 2005
TLDR
Knowledge of the properties of these drugs will help to ensure that problems can be avoided in most clinical situations, and treated appropriately (with 5-HT(2A) antagonists for severe cases) if they occur.
...
1
2
3
4
5
...