monoamine oxidase inhibitors revisited

  title={monoamine oxidase inhibitors revisited},
  author={Douglas G. Wells and Andrew R. Bjorksten},
  journal={Canadian Journal of Anaesthesia},
ConclusionUntil recently, traditional teaching has been to discontinue MAOI therapy two to three weeks before surgery. The literature and texts relating to the concurrent use of MAOI’s with anaesthesia are confusing, outdated and often contradictory. Significant adverse drug reactions can and have occurred in a minority of patients receiving MAOI’s. The true incidence of such reactions is unknown. While there are several recent clinical reports indicating the safety of these agents in… 
Anesthesia and Monoamine Oxidase Inhibitors-Reply
It is now time to reevaluate the traditional sentiment regarding discontinuation of monoamine oxidase inhibitors (MAOIs) 2 to 3 weeks prior to elective surgery because of cardiovascular instability and central nervous system dysfunction during anesthesia.
MAOIs to RIMAs in anaesthesia — a literature review
This review suggests that combination of modern anaesthetic techniques and newer, specific reversible MAOIs should allow safe anaesthesia with maintenance of antidepressant therapy.
Serotonin syndrome due to venlafaxine and maintenance tranylcypromine therapy
The development of the serotonin syndrome is described in a 60 year old female on chronic tranylcypromine treatment following the inadvertent ingestion of a single dose of venlafaxine, leading to an altered mental status that progressed to hyperthermia and coma.
MAO inhibitors and coronary artery surgery: a patient death
  • W. Noble, A. Baker
  • Medicine
    Canadian journal of anaesthesia = Journal canadien d'anesthesie
  • 1992
It is concluded that MAOIs should be discontinued, if possible, before surgery in which catecholamines may be needed, because of the unusual reactions inpatients while taking both meperidine andMAOIs.
Cardiac surgery in a patient taking monoamine oxidase inhibitors: an adverse fentanyl reaction.
There are 12 case reports in the world literature implicating the combination of meperidine and MAOIs as potentially fatal, this being related to an inhibition of 5-hydroxytryptamine (5-HT) uptake by both the opioid and MA01 in the brain leading to increased levels of 4-HT at the synaptic cleft and consequent adverse reactions including hyperpyrexia, hypertension, hypotension, tachycardia, or convulsions.
The Role of Monoamine Oxidase Inhibitors in Current Psychiatric Practice
Clinicians must continue to familiarize themselves with the properties of and indications for prescribing MAOIs and identify symptom presentations more likely to respond to these medications.
Dietary restrictions and drug interactions with monoamine oxidase inhibitors: the state of the art.
  • M. Rapaport
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 2007
MAOIs have been well established as an effective intervention for people with treatment-resistant depression, and transdermal formulations may provide a valuable therapeutic option and eliminate the drug-food interaction.
Kingston General Hospital
The classic MAOI, phenelzine and tranylcypromine, irreversibly inhibit MAO for 2 to 3 weeks until new enzyme is synthesized, and suitability of these patients for ambulatory anesthesia has been controversial.


Anesthesia for cardiac surgery in patients receiving monoamine oxidase inhibitors.
Two patients who underwent cardiac operation in whom this period of withdrawal of MA01 therapy was not feasible are reported, indicating that MA01 may also be useful as therapy for regulation of weight and appetite, posttraumatic stress disorders, and endogenous depression.
Subarachnoid hemorrhage following ephedrine and MAO inhibitor.
The following is a report of a patient taking an MAO inhibitor who developed a subarachnoid hemorrhage immediately following the ingestion of one oral dose of ephedrine.
The first cycle was completed in 1960 when iproniazid was removed from the market because of instances of severe and frequently fatal hepatitis, and several new MAO inhibitors had been introduced; some of these were specifically synthesized in this study.
Monoamine Oxidase Inhibitors: Prescription and Patient Management
With careful patient selection, adequate caution by the physician, and appropriate preparation of the patient, MAOIs are often uniquely effective and have an acceptably low potential for serious toxicity.
Anaesthesia and Monoamine-oxidase Inhibitors
Critics are posed because they may give clues as to how the committee returned a report at such variance with many people's opinions on the Lewisham hospital services for the elderly, and the majority of the committee has direct connexions with theLewisham Hospital Group.
Monoamine Oxidase Inhibitors: Should They Be Discontinued Preoperatively?
It is concluded that discontinuing chronic MAOI therapy prior to anesthesia and surgery is not necessary and blood pressure and heart rate increases after ECT, but returned to baseline levels within 15 min.
Tyramine studies and the safety of MAOI drugs.
A major source of concern in using MAOIs is the risk of hypertensive crises, often called the "cheese effect" and thought to represent a drug-induced enhancement of the tyramine pressor effect.
Monoamine oxidase inhibition in the treatment of migraine.
Depletion of platelet 5HT by the intramuscular administration of Reserpine induces migraine in susceptible individuals, and intravenous 5HT relieves-both spontaneous and reserpine-induced migraine.
The Present Status of Monoamine Oxidase Inhibitors
  • C. Pare
  • Biology, Medicine
    British Journal of Psychiatry
  • 1985
With adequate doses they are effective antidepressants, but dosages have in the past been too low and should not deter doctors from using these drugs, especially in those depressed patients who do not respond to tricyclic-type antidepressants.
Dangers of Monoamine Oxidase Inhibitors
A 54-year-old woman due to have a bilateral myringotomy was found to be unrousable, peripherally dilated, and sweating when premedication was given, but her condition gradually improved and by the following morning had returned to normal.