Monoamine oxidase inhibitors (MAOIs) are a class of antidepressants that are not commonly used nowadays due to their potential for serious side effects and interactions, but they can be effective in cases where other antidepressants are not suitable. Here are the MAOIs available, along with a list of drugs and foods that should be avoided due to potentially dangerous interactions:
MAOI Drugs Available in Australia
- Tranylcypromine
- Brand: Parnate
- Phenelzine
- Brand: Nardil
- Moclobemide
- Brand: Aurorix
- Note: Moclobemide is a reversible inhibitor of monoamine oxidase and has a somewhat different side effect and interaction profile compared to other MAOIs
Drugs to Avoid with MAOIs
- Other Antidepressants
- SSRIs (e.g., Fluoxetine, Sertraline)
- SNRIs (e.g., Venlafaxine, Duloxetine)
- Tricyclics (e.g., Amitriptyline, Nortriptyline)
- Sympathomimetic Agents
- Pseudoephedrine (common in cold medications)
- Phenylephrine
- Ephedrine
- Opioids
- Pethidine
- Tramadol
- Dextromethorphan (common in cough syrups)
- Central Nervous System Depressants
- Sedatives
- Hypnotics
- Anxiolytics
- Stimulants
- Amphetamines
- Cocaine
- Serotonergic Drugs
- Triptans (for migraine)
- St. John’s Wort
- Tyramine-rich Foods (more significant for non-selective MAOIs like Tranylcypromine and Phenelzine)
Foods to Avoid with MAOIs
- Cheese (especially aged cheese)
- Cured Meats (e.g., salami, pepperoni, chorizo)
- Fermented Foods (e.g., soy sauce, sauerkraut, kimchi)
- Pickled Foods
- Overripe Fruits (e.g., bananas, avocados)
- Fava Beans
- Tap Beer and Red Wine
- Chocolate
- Yeast Extracts (e.g., Marmite, Vegemite)
- Some Supplements (e.g., tyrosine, phenylalanine)
Patients on MAOIs should be closely monitored for hypertensive crises, which can occur due to interactions with certain foods and drugs. It’s also important to educate patients thoroughly about dietary restrictions and potential drug interactions. Moclobemide, being a RIMA, has fewer dietary restrictions compared to other MAOIs, but caution is still advised.