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Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressant medications. In the 1950's, iproniazid, an agent used to treat tuberculosis, was discovered to be an inhibitor of MAO and was inadvertently found to produce an improvement in mood.1 They are most effective in treating atypical and melancholic types of depression. Due to the medications dangerous interactions with certain foods and health conditions, they are often used as a last method of treatment.
MAOIs are used mainly when other antidepressants have failed in the treatment of major depression and panic disorder.3 This partly due to the risk of hypertensive reaction (severe and sudden rise in blood pressure, potentially leading to cerebral hemorrhage or death).
MAOIs can trigger high increases in blood pressure when combined with foods containing tyramine². These include soy, cheese, chocolate, overripe fruit, pickles, fermented meat and other processed foods. Some medications including decongestants also contain high levels of tyramine so patients should ask for a complete list of prohibited foods, medicines and substances when taking a MAOI5.
Other potential side effects include dry mouth, sexual dysfunction, skin rash, and blurred vision.
MOIs are fatal in overdose....