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 bipolar depression only in combination with a mood stabilizer such as lithium or valproate, to minimize the risk of inducing mania.
Mixed episodes in bipolar disorder are a form of mental illness. In most forms of bipolar disorder, moods alternate between elevated and depressed over time. A person with mixed episodes experiences both mood "poles" -- mania and depression -- simultaneously or in rapid sequence. Technically, mixed episodes are described only in people with bipolar I disorder (not bipolar II disorder), although this distinction is expected to change as the psychiatric diagnostic classification system is currently...
Among these, Parnate has been the most extensively studied specifically in bipolar depression, 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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