Monoamine oxidase inhibitors (MAOIs) and reversible monoamine oxidase inhibitors (RIMAs) are a type of antidepressant drugs given for the treatment of depression. They are good at treating atypical depression, Parkinson's disease, anxiety disorders, social phobia and have also shown to help people to stop smoking tobacco.

As MAOIs drugs can be fatal if someone takes too much, they are usually only ever given when other antidepressant drugs have failed. Some newer drugs such as selegiline and moclobemide have proven to be safer than the older MAOIs and are prescribed by physicians in the first instance.

Uses 
MAOIs and RIMAs are used to provide a second line of treatment for certain psychiatric illnesses, most commonly types of hard to treat depression with not normal symptoms and anxiety disorders (with or without panic attacks). They may also be used for social phobia. MAO-B inhibitors are used to treat Parkinson's disease. Certain MAOIs have been shown to help people to stop smoking tobacco.

How they work 
Monoamine oxidase inhibitors work by stopping the action of an enzyme called monoamine oxidase. This enzyme breaks down a group of brain signalling chemicals called the monoamine neurotransmitters. There are two types of the enzyme, MAO-A and MAO-B. Each type breaks apart different chemicals in the group. MAO-A breaks down melatonin, serotonin, epinephrine and norepinephrine. MAO-B breaks down phenylethylamine and the trace amines. These chemicals (neurotransmitters) are used in the brain for signalling purposes. Dopamine, for example, is a chemical that affects motivation and pleasure. Effectively, they work on balancing the brain's chemistry.

Side effects 
Like all drugs, MAOIs and RIMAs can have effects that are not intended and are not part of the treatment that the drugs provide. In this class of drug, these include a risk of a hypertensive crisis. This can be caused by high levels of tyramine; such as by eating cheese (except cream or cottage cheese, meat extracts such as Bovril, yeast extract, stock cubes, fermented soya bean products, alcohol (especially fortified wine (port, sherry), beer and chainti wine. Also preserved fish, preserved poultry, offal, avocado, banana skins, broad bean pods and pickled or smoked herring must be avoided. Certain medications can also cause a hypertensive crisis with MAOIs and RIMAs, such as; amphetamine, fenfluramine, ephedrine, phenlyephrine, phenylpropanolamine, nasal decongestants, L-dopa, pethidine and tricyclic antidepressants. Use of a RIMA rather than a MAOI can reduce these side-effects, however tyramine rich foods should still be avoided.

List of MAOIs 
 Pharmaceutical Drugs
 Nonselective MAO-A/MAO-B Inhibitors
 Hydrazines
 Benmoxin (Nerusil, Neuralex)
 Hydralazine (Apresoline)
 Iproclozide (Sursum)
 Iproniazid (Marsilid, Iprozid, Ipronid, Rivivol, Propilniazida)
 Isocarboxazid (Marplan)
 Isoniazid (Laniazid, Nydrazid)
 Mebanazine (Actomol)
 Nialamide (Niamid)
 Octamoxin (Ximaol, Nimaol)
 Phenelzine (Nardil, Nardelzine)
 Pheniprazine (Catron)
 Phenoxypropazine (Drazine)
 Pivalylbenzhydrazine (Tersavid)
 Procarbazine (Matulane, Natulan, Indicarb)
 Safrazine (Safra)
 Non-Hydrazines
 Caroxazone (Surodil, Timostenil)
 Echinopsidine (Adepren)
 Furazolidone (Furoxone, Dependal-M)
 Linezolid (Zyvox, Zyvoxam, Zyvoxid)
 Tranylcypromine (Parnate, Jatrosom)
 Selective MAO-A Inhibitors
 Brofaromine (Consonar)
 Metralindole (Inkazan)
 Minaprine (Cantor)
 Moclobemide (Aurorix, Manerix)
 Pirlindole (Pirazidol)
 Toloxatone (Humoryl)
 Selective MAO-B Inhibitors
 Lazabemide (Pakio, Tempium)
 Pargyline (Eutonyl)
 Rasagiline (Azilect)
 Selegiline (Deprenyl, Eldepryl, Emsam)

 Herbal Drugs
 Selective MAO-A Inhibitors
 Resveratrol (found in skin of red grapes)
 Nonselective MAO-A/MAO-B Inhibitors
 Curcumin (found in turmeric)
 Harmala alkaloids (found in tobacco, Syrian rue, passion flower, ayahausca, and Tribulus terrestris)
 Harmine, Harmaline, Tetrahydroharmine, Harmalol, Harman, Norharman, etc.
 Rhodiola Rosea (active constituent(s) unknown)
 Selective MAO-B inhibitors
 Catechin (found in the tea plant, cocoa, and cat's claw)
 Desmethoxyyangonin (found in kava)
 Epicatechin (also found in the tea plant, cocoa, and cat's claw)
 Fo-Ti (active constituent(s) unknown)
 Hydroxytyrosol (found in olive oil)
 Piperine (found in pepper)
 Unknown Selectivity
 Ginkgo Biloba (active constituent(s) unknown)
 Liquorice (active constituent(s) unknown)
 Myristicin (found in nutmeg, parsley, and dill)
 Siberian Ginseng (active constituent(s) unknown)
 St. John's Wort (active constituent(s) unknown)
 Yerba Mate (active constituent(s) unknown)
 Yohimbe (active constituent(s) unknown)

 Research Compounds
 Nonselective MAO-A/MAO-B Inhibitors
 Hydrazines
 Metfendrazine
 Selective MAO-A Inhibitors
 Amiflamine
 Bazinaprine
 Befloxatone
 Befol
 Cimoxatone
 Clorgyline
 Esuprone
 Methylene Blue
 Sercloremine
 Tetrindole
 Tyrima
 Selective MAO-B Inhibitors
 D-Deprenyl
 Ladostigil
 Milacemide
 Mofegiline

Related pages
 Psychiatry
 Mental illness
 Pharmacology
 Prescription drug

Notes

Other website 
 Antidepressant, Monoamine Oxidase (Mao) Inhibitor (Oral Route) - Mayo Clinic

Drugs used in psychiatry