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Monoamine-oxidase inhibitors (MAOIs)

Monoamine-oxidase inhibitors (MAOIs) Preparations Comments
For specialist initiation only. There is potential for major food and drug interactions with MAOIs. Alcohol should also be avoided. See BNF for further details on interactions, side-effects and withdrawal. Patients should be provided with appropriate written information.
Isocarboxazid† 10mg tablets Most hepatotoxic.
Phenelzine sulphate 15mg tablets Preferred MAOI – probably the most safest.
Hepatoxic but less than isocarboxazid.
Tranylcypromine sulphate† 10mg tablets Has a greater stimulant action than other MAOIs and is more likely to cause a hypertensive crisis. Less hepatotoxic than phenelzine.
Reversible MAOI
Moclobemide 150mg and 300mg tablets Reduced risk of major food and drug interactions, however patients should still be advised to avoid large quantities of tyramine rich foods and sympathomimetic drugs. See BNF for details on initiating treatment after another antidepressant has been stopped.

† - denotes a less preferred choice of medicine.

 

Continue to Tricyclic anti-depressant drugs

Continue to Selective serotonin re-uptake inhibitors (SSRI's)

Continue to Other antidepressant drugs

 

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