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Monoamine Oxidase Inhibitors

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Critical Care Toxicology

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Abstract

Monoamine oxidase (MAO) inhibitors were serendipitously discovered in the 1950s when tuberculosis patients in Swiss sanitariums treated with isoniazid were noted to experience mood-elevating effects. Iproniazid, another antitubercular hydrazine derivative, was discovered to inhibit monoamine oxidase and had even greater psychostimulatory effects than isoniazid [1]. This led to its use as an antidepressant and paved the way for the development of the first effective agents in the treatment of major depression, the nonselective irreversible MAO inhibitors. MAO inhibitors have been in clinical use since the 1960s although their use has been supplanted by newer antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) that have fewer serious adverse effects and are less hazardous in overdose. Their continued decline in use is confirmed by data from the American Association of Poison Control Centers Toxic Exposure Surveillance System which recorded 3,261 total exposures to MAO inhibitors with 12 fatalities from 2001 to 2013 [2–13]. This is compared to 6,076 total exposures and 58 fatalities for the period from 1989 to 2000 [14–24].

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Authors and Affiliations

  1. Department of Medical Toxicology, Banner - University Medical Center Phoenix, 925 E. McDowell Rd. 2nd Floor, 85006, Phoenix, AZ, USA

    Ayrn D. O’Connor

  2. Department of Emergency Medicine, University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA

    Ayrn D. O’Connor

  3. Emergency Medicine, Wayne State University, Detroit, MI, USA

    Kirk C. Mills

Authors
  1. Ayrn D. O’Connor
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Correspondence to Ayrn D. O’Connor .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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O’Connor, A.D., Mills, K.C. (2016). Monoamine Oxidase Inhibitors. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_28-2

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  1. Latest

    Monoamine Oxidase Inhibitors
    Published:
    27 August 2016

    DOI: https://doi.org/10.1007/978-3-319-20790-2_28-2

  2. Original

    Monoamine Oxidase Inhibitors
    Published:
    01 February 2016

    DOI: https://doi.org/10.1007/978-3-319-20790-2_28-1

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