Antidepressants (MAOIs)
- Highly effective but interaction-heavy
- Best-known role: resistant/atypical MDD
- Tranylcypromine/phenelzine most familiar
- Irreversible MAO blockade persists after stop
- Tyramine → hypertensive crisis risk
- Potent SRIs/releasers → fatal ST risk
- Treatment requires deliberate washouts
Class at a glance
- Highly effective but interaction-heavy
Pharmacology
- Tranylcypromine/phenelzine most familiar
- Irreversible MAO blockade persists after stop
Clinical role
- Best-known role: resistant/atypical MDD
- Treatment requires deliberate washouts
Safety / monitoring
- Tyramine → hypertensive crisis risk
- Potent SRIs/releasers → fatal ST risk
Pearls
- Also orthostasis, insomnia, sexual dysfunction, weight gain
- Often avoided in pregnancy: hypertensive crisis risk
Self-check
- What dietary exposure creates hypertensive-crisis risk with MAOIs?
Tyramine. - Does irreversible MAO blockade end when treatment stops?
No; it persists after stopping.
Drugs in this class (4)
Antidepressants (MAOIs) prescription history
Animated chart of estimated U.S. prescriptions per year, Antidepressants (1957–2026). MAOI highlighted from 1957.
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