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Monoamine Oxidase Inhibitors in Depressive Disorders

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NeuroPsychopharmacotherapy

Abstract

Monoamine oxidase inhibitors (MAOIs) first came into use as antidepressants in the 1950s and 1960s but were soon replaced as first-line drugs by tricyclic antidepressants and then later by drugs like selective serotonin reuptake inhibitors (SSRIs). However, there is a strong feeling among many prominent health professionals that the MAOIs are effective antidepressants (and anxiolytics in some cases) that are underutilized because of concerns about potential adverse effects, including food-drug and drug-drug interactions, even though these are often avoidable and/or manageable. In this review, we discuss various aspects of MAOIs including pharmacology, clinical applications, pharmacokinetics/metabolism, adverse effects, food-drug and drug-drug interactions and combinations with other drugs for pharmacotherapy. Several of the MAOIs are multifaceted, and their actions in addition to inhibition of MAO are discussed briefly, as are the concerns about the underutilization, current availability and inadequate education about these drugs in academic settings.

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Acknowledgements

The authors are grateful to CIHR (GBB, AH, DM) and the Offices of the Provost and the Vice President (Research) (GBB), the Faculty of Medicine & Dentistry and the Department of Psychiatry, University of Alberta (GBB, DM, AH) for funding. The technical and secretarial support of Ms. Tricia Kent is gratefully acknowledged.

Conflicts of Interest

Dr. Meyer has patents to detect MAO in brain and blood in mood and commonly associated disorders and is developing natural health products to counter temporary elevation in MAO-A in the early postpartum. Dr. Baker is an advisor for NeuraWell Therapeutics about MAOIs, but that company has had no input into the preparation of this manuscript. The other authors have no conflicts to declare.

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Meyer, J.H., Matveychuk, D., Holt, A., Santhirakumar, A., Baker, G.B. (2021). Monoamine Oxidase Inhibitors in Depressive Disorders. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_98-1

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