Monoamine oxidase inhibitors. potent antidepressants with important precautions

Monoamine oxidase inhibitors (MAOIs) are part of one of the first generations of drugs developed for the treatment of depression.

They work by blocking the activity of a brain enzyme that normally breaks down key neurotransmitters involved in mood regulation, such as dopamine, serotonin, and norepinephrine.

By preventing this breakdown, the levels of these compounds increase, promoting better communication between neurons and, consequently, improved emotional well-being.

Mechanism and clinical applications

This type of antidepressant has been particularly useful in cases where other treatments have failed to produce positive results. This is because its mechanism broadly affects neurochemical balance, which can benefit people with resistant depression. However, this same breadth of action carries risks, limiting its widespread use.

MAOIs are available in various formulations, some of which are administered orally and others through transdermal systems. Despite their effectiveness in certain patients, they are not routinely prescribed due to the precautions required for their use.

Side effects and warnings

These medications can cause a number of adverse effects. The most common include digestive disturbances, drowsiness or, conversely, insomnia, fatigue, headaches, dizziness, and skin irritation (in the case of patches). More complex symptoms may also occur, such as decreased libido, hypertension, urinary problems, or tingling sensations.

A particular characteristic of MAOIs is that they require dietary restrictions. Combining them with foods rich in certain amines (such as tyramine) can trigger hypertensive crises, so patients should avoid products such as cold cuts, certain aged cheeses, fermented beverages, and processed foods. It is also essential to avoid combining them with other medications without medical supervision, as serious reactions may occur.

Indications and clinical use

Given their risk profile, MAOIs are reser