Monoamine Oxidase Inhibitors in Depressive Disorders

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 drugdrug 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 drugdrug interactions and combinations with other drugs for pharmacotherapy. Several of theMAOIs 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.