Clinically Relevant Drug Interactions with Monoamine Oxidase Inhibitors
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Author
Edinoff, A.N.Swinford, C.R.
Odisho, A.S.
Burroughs, C.R.
Stark, C.W.
Raslan, W.A.
Cornett, E.M.
Kaye, A.M.
Kaye, A.D.
Affiliation
College of Medicine-Tucson, University of ArizonaIssue Date
2022Keywords
bleedingdrug interactions
ecstasy
headache
hypertensive crisis
insomnia
Monoamine oxidase inhibitors
sexual dysfunction
weight gain
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Open Medical PublishingCitation
Edinoff, A. N., Swinford, C. R., Odisho, A. S., Burroughs, C. R., Stark, C. W., Raslan, W. A., Cornett, E. M., Kaye, A. M., & Kaye, A. D. (2022). Clinically Relevant Drug Interactions with Monoamine Oxidase Inhibitors. Health Psychology Research, 10(4).Journal
Health Psychology ResearchRights
Copyright © 2022 The Author(s). Open Medical Publishing has chosen to apply the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published under its name.Collection Information
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.Abstract
Monoamine oxidase inhibitors (MAOI) are a class of drugs that were originally developed for the treatment of depression but have since been expanded to be used in management of affective and neurological disorders, as well as stroke and aging-related neurocognitive changes. Ranging from irreversible to reversible and selective to non-selective, these drugs target the monoamine oxidase (MAO) enzyme and prevent the oxidative deamination of various monoamines and catecholamines such as serotonin and dopamine, respectively. Tyramine is a potent releaser of norepinephrine (NE) and is found in high concentrations in foods such as aged cheeses and meats. Under normal conditions, NE is unable to accumulate to toxic levels due to the presence of MAO-A, an enzyme that degrades neurotransmitters, including NE. When MAO-A is inhibited, the capacity to handle tyramine intake from the diet is significantly reduced causing the brain to be vulnerable to overstimulation of postsynaptic adrenergic receptors with as little as 8-10 mg of tyramine ingested and can result in life-threatening blood pressure elevations. In addition to adverse reactions with certain foods, both older and newer MAOIs can negatively interact with both sympathomimetic and serotonergic drugs. In general, patients on a MAOI want to avoid two types of medications: those that can elevate blood pressure via sympathomimetic actions (e.g., phenylephrine and oxymetazoline) and those that can increase serotonin levels via 5-HT reuptake inhibition (e.g., dextromethorphan, chlorpheniramine, and brompheniramine). Illicit drugs that stimulate the central nervous system such as ecstasy (MDMA, 3,4-methylenedioxymethamphetamine) act as serotonin releasers. Patient involvement is also crucial to ensure any interaction within the healthcare setting includes making other providers aware of a MAOI prescription as well as avoiding certain OTC medications that can interact adversely with MAOIs. © 2022, Open Medical Publishing. All rights reserved.Note
Open access journalISSN
2420-8124Version
Final published versionae974a485f413a2113503eed53cd6c53
10.52965/001c.39576
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Except where otherwise noted, this item's license is described as Copyright © 2022 The Author(s). Open Medical Publishing has chosen to apply the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published under its name.