Monoamine Oxidase Inhibitors (MAOIs) in psychiatric practice:: how to use them safely and effectively
Monoamine Oxidase Inhibitors (MAOIs) in psychiatric practice:: how to use them safely and effectively
Monoamine oxidase inhibitors (MAOIs) were among the first licensed pharmacological treatments for patients with depression, but over time have fallen out of mainstream clinical use. This has led to a loss of clinician training opportunities and reduced availability of MAOIs for prescribing. This article provides a concise and practical overview of how to use MAOIs safely and effectively in psychiatric practice. We consider the history of MAOIs, why they are not used more frequently, their mechanisms of action, availability, indications and efficacy, general tolerability, withdrawal symptoms, and safety considerations (including hypertensive reactions and serotonin syndrome). Practical advice is given in terms of dietary restrictions, interactions with other medications (both prescribed and non-prescribed), and how prescribers can stop and switch MAOIs, both within the drug class and outside of it. We also provide advice on choice of MAOI and treatment sequencing. Lastly we consider emerging directions and potential additional indications.
703–716
Baldwin, David
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Chamberlain, Samuel
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Baldwin, David
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Chamberlain, Samuel
8a0e09e6-f51f-4039-9287-88debe8d8b6f
Baldwin, David and Chamberlain, Samuel
(2021)
Monoamine Oxidase Inhibitors (MAOIs) in psychiatric practice:: how to use them safely and effectively.
CNS drugs, 36 (1), .
(doi:10.1007/s40263-021-00832-x).
Abstract
Monoamine oxidase inhibitors (MAOIs) were among the first licensed pharmacological treatments for patients with depression, but over time have fallen out of mainstream clinical use. This has led to a loss of clinician training opportunities and reduced availability of MAOIs for prescribing. This article provides a concise and practical overview of how to use MAOIs safely and effectively in psychiatric practice. We consider the history of MAOIs, why they are not used more frequently, their mechanisms of action, availability, indications and efficacy, general tolerability, withdrawal symptoms, and safety considerations (including hypertensive reactions and serotonin syndrome). Practical advice is given in terms of dietary restrictions, interactions with other medications (both prescribed and non-prescribed), and how prescribers can stop and switch MAOIs, both within the drug class and outside of it. We also provide advice on choice of MAOI and treatment sequencing. Lastly we consider emerging directions and potential additional indications.
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Accepted/In Press date: 27 May 2021
e-pub ahead of print date: 9 July 2021
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Local EPrints ID: 449630
URI: http://eprints.soton.ac.uk/id/eprint/449630
ISSN: 1172-7047
PURE UUID: a202560f-78bb-4ded-8108-fe413a56fbc2
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Date deposited: 09 Jun 2021 16:31
Last modified: 15 Nov 2022 05:01
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Author:
Samuel Chamberlain
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