Monoamine oxidase inhibitors are an extremely potent class of antidepressants that treat depression by preventing the breakdown of serotonin, dopamine, and norepinephrine in the brain, increasing their availability. These medications are not used often because of their potential for drug interactions that can lead to problems with blood pressure as well as the need to avoid foods that contain the amino acid tyramine. Generally, like most antidepressants, MAOIs should be used for bipolardepression only in combination with a mood stabilizer such as lithium or valproate, to minimize the risk of inducing mania.
Antidepressants in this class of drugs that can be used for bipolardepression include:
The bipolar spectrum is a term used to refer to conditions of many people with depression, substance abuse, and a wide range of other psychiatric conditions who also have some symptoms of bipolar disorder. Although they have these similar symptoms, they are not diagnosed with bipolar disorder as it is commonly defined. Some psychiatrists find the concept useful. But since it has not been rigorously studied it hasn't been widely adopted.
Among these, Parnate has been the most extensively studied specifically in bipolardepression, leading in one randomized trial to improvement in over 80% of subjects. Like other classes of antidepressants, the MAOIs take several weeks to begin working. Your doctor may also prescribe a sedative to help relieve anxiety, agitation, or sleep problems while the antidepressant begins to work. You will also need to monitor what foods you eat to avoid side effects.
MAOI Side Effects
Eating certain smoked, fermented, or pickled foods, drinking certain beverages, or taking certain medications can cause severe, sudden high blood pressure in combination with MAOIs. People taking these antidepressants must follow a special diet.
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National Institute of Mental Health: "Step-BD Womens Studies."
Massachusetts General Hospital Bipolar Clinic & Research Program.
MedicineNet: "Bipolar Disorder (Mania)."
WebMD Medical Reference: "Effects of Untreated Depression."
American Psychiatric Association: "Practice Guideline for the Treatment of Patients With Bipolar Disorder."