The acceptability of monoamine oxidase inhibitor (MAOI) drugs for the treatment of MDD is limited by the adverse effect profile, which is outlined on the slide.1 The potential for life-threatening interactions with tyramine-containing foods, or with other serotonergic agents, particularly limits the use of MAOIs.1 MDD treatment guidelines recognise these limitations; for instance, the American Psychiatric Association (APA) guidelines recommend that MAOI drugs be used only in patients who have not responded to other treatments, because of the necessity for dietary restrictions with MAOIs and the potential for deleterious drug–drug interactions.4
References:
1.Stahl SM. Stahl’s Essential Psychopharmacology. Neuroscientific Basis and Practical Applications. 5th Edition. © Cambridge University Press, 2021.
2.Van der Eynde V, Kenneth Gillmann P, Blackwell BB. The prescriber’s guide to the MAOI diet-thinking through tyramine troubles. Psychopharmacol Bull 2022; 52 (2): 73–116.
3.Sadock BJ, Sadock VA, Ruiz P (eds). Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. 10th edition. Vol 1–2. © Lippincott Williams & Wilkins, 2017.
4.American Psychiatric Association. Practice Guideline for the Treatment of Patients with Major Depressive Disorder. 3rd Edition. © American Psychiatric Association, 2010. http://psychiatryonline.org/guidelines.aspx. Accessed April 2025.
