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How are monoamine oxidase inhibitors used as antidepressants?

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Monoamine oxidase inhibitors (MAOIs) include selegiline (Emsam), isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate). These drugs seem to work a little differently. Monoamine oxidase is a natural enzyme that breaks down serotonin, epinephrine, and dopamine. MAOIs block the effects of this enzyme. As a result, the levels of those neurotransmitters might get a boost. The downside is that MAOIs also prevent the body's ability to break down other medicines metabolized by this enzyme (such as Sudafed, or stimulants) -- raising the risk for high blood pressure -- as well as an amino acid called tyrosine, which is found in certain foods like aged meats and cheeses. MAOIs also shouldn't be combined with other medicines that can raise serotonin (such as certain migraine medicines, or other antidepressants), because that can cause a buildup of excessive serotonin (called "serotonin syndrome"), which could be life threatening.

SOURCES:

News release, FDA.

Ian A. Cook, MD, director of the Depression Research Program, University of California Los Angeles.

Dean F. MacKinnon, MD, associate professor, the Johns Hopkins Hospital, Baltimore.

MedicineNet, "Antidepressants."

Medscape: “FDA Approvals: Symbyax and Edluar.”

National Institute of Mental Health Web site, "Depression."

Reviewed by Smitha Bhandari on June 27, 2019

SOURCES:

News release, FDA.

Ian A. Cook, MD, director of the Depression Research Program, University of California Los Angeles.

Dean F. MacKinnon, MD, associate professor, the Johns Hopkins Hospital, Baltimore.

MedicineNet, "Antidepressants."

Medscape: “FDA Approvals: Symbyax and Edluar.”

National Institute of Mental Health Web site, "Depression."

Reviewed by Smitha Bhandari on June 27, 2019

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