MAO inhibitors block the breakdown of neurotransmitters in the brain. Thus, they increase the concentration of dopamine, serotonin and norepinephrine. As a result, they have a positive effect on psychomotor activity, concentration, mood and sleep quality. However, these are, unfortunately, drugs that should be used with caution, always in accordance with the doctor's instructions, due to the large number of interactions and side effects. In what diseases are MAO inhibitors administered?

MAO inhibitorsare drugs used in the pharmacological treatment of depression and social phobia that often accompanies it. The second application of MAO inhibitors is in the treatment of Parkinson's disease. Preparations from this group extend the action of levodopa in the body, which is the basic treatment for Parkinson's disease.

The MAO enzyme can break down this drug. This is due to the similarity of levodopa to natural neurotransmitters. By blocking the enzyme MAO inhibitors stop the breakdown of the drug, increasing its concentration in the brain. MAOIs can also be used as standalone medications for this condition.

Parkinson's disease is associated with a decline in dopamine levels in the central nervous system. MAO inhibitors block the breakdown of this substance, thus increasing its concentration and improving brain functions.

Are MAO inhibitors found in nature?

Plants containing MAO inhibitors have been used all over the world for hundreds of years. These herbs were used by shamans and healers to induce a trance and induce hallucinations. Usually, a combination of a narcotic substance with MAO inhibitors was used, which blocked its decomposition, extending the duration of its action.

The most famous combination of this type is ayahuasca, which is a drink made from a creeper that induces visions, used by shamans in South America. It is traditionally used to heal and relieve depression. The use of herbs containing MAO inhibitors can be dangerous to he alth and life. Information about their traditional use should be treated as a curiosity, and not as a scientifically confirmed method of therapy.

What is pharmacological treatment of depression?

There are two scientifically proven treatments for depression: psychotherapy and drug therapy. In mild depression, working with a psychologist often turns out to be the best way to achieve your goalwhat is mental he alth. With severe symptoms of the disease, it is necessary to take medications.

Pharmacotherapy is also recommended for patients who have a negative attitude towards psychotherapy, resulting from prejudices or negative experiences related to this method. It is advisable to consult a specialist individually to consider various treatment options before starting it.

All antidepressants work in an area of ​​the brain. Most of them affect the level of serotonin, often called the "happiness hormone". However, they do not supply this substance from the outside. Drugs only make it better used. MAO inhibitors and other antidepressants are not addictive. They raise the mood, concentration and creativity to the correct level. They work only in patients who have pathologically decreased them. A he althy person will not improve their mood by taking antidepressants.

Many myths have arisen around antidepressants. Often patients are afraid that by taking these substances they will stop "being themselves". Before starting therapy, it is worth realizing that antidepressants do not change the personality, only the mood. Our sadness is not part of our innate character, but it can be a symptom of a disease that plagues us.

How do MAO inhibitors work?

The mechanism of MAOIs is based on inhibition, i.e. blocking a substance that is responsible for breaking down neurotransmitters. This results in an increase in the concentration of molecules such as serotonin, dopamine and noradrenaline in the brain. The levels of these substances are lowered in people suffering from depression. After the use of MAO inhibitors, psychomotor activity, mood, sleep quality and concentration improve.

The most commonly used drugs in this group in Poland are moclobemide and selegiline. These are modern drugs with high selectivity, which increases their safety of use. Selectivity determines the strength of the therapeutic effect of a drug in proportion to its side effects. The oldest substances from the group of MAO inhibitors have been withdrawn from treatment due to dangerous interactions with other drugs and even food.

The therapeutic effect after starting antidepressant therapy, including MAO inhibitors, is visible only after two weeks. Unfortunately, in some cases it may even be a month. You need to take medications every day to feel better. Using them only in stressful situations does not bring any effects. Therapy usually lasts six to nine months. Some patients need to take medication for the rest of their lives.

MAO inhibitors are discontinuedalways gradually. This process must be monitored by a physician. The longer the drug treatment period, the longer the drug discontinuation period. When deciding to stop taking antidepressants, one should take into account the high probability of withdrawal syndrome.

What should be remembered during treatment with MAO inhibitors?

MAO inhibitors may interact with foods containing tyramine. Tyramine is formed from proteins in foods that are stored or dyed for a long time. Examples of products containing this substance are blue cheese, cold cuts and red wine.

The interaction between tyramine and MAO inhibitors leads to a sudden pressure surge. This phenomenon is called the "cheese effect". This name is related to the death of a patient who, while taking drugs from the described group, ate a cube of yellow cheese, as a result of which he suffered a pressure breakthrough.

Drugs from this group interact with the vast majority of drugs, both legal and illegal. It is inadvisable to consume alcohol during the therapy. MAO inhibitors block the breakdown of many narcotic substances, especially LSD, amphetamines, cocaine and ecstasy.

The persistently high concentration in the body is life-threatening. The result is the appearance of the serotonin syndrome. Its symptoms are:

  • high body temperature
  • high blood pressure
  • diarrhea
  • nausea
  • vomiting
  • tachycardia
  • chills
  • sweating

The consequence of serotonin syndrome can be coma and even death.

Pharmacotherapy of depression should be supported with cognitive-behavioral psychotherapy. This will increase the effectiveness of the treatment process and reduce the likelihood of relapse after drug discontinuation. All kinds of sports and a balanced diet are also recommended. However, it should be remembered that these forms of support will not replace drug therapy in severe depressive episodes.

When using MAO inhibitors, you must follow a strict diet. The products to be excluded are:

  • ripened cheeses
  • sausage
  • champagne
  • wine
  • beer
  • raisins
  • figi
  • avocado
  • soy sauce
  • chocolate

Despite the limitations, care should be taken to provide all the necessary nutrients, because what we eat affects our well-being. You should consult your diet with your doctor.

It must be remembered that sudden discontinuation of MAO inhibitors causes a withdrawal syndrome that is dangerous to he alth.

Surgical procedures with the use of anesthesia are situations that force a break in pharmacotherapy. Drugs should be discontinued under medical supervision two weeks before the planned surgery.

Is it safe to use other drugs with MAO inhibitors?

MAO inhibitors interact with many medications. It is imperative that you inform your doctor that you are taking them before starting therapy with a new drug. Especially be careful of interactions with antidepressants. Such a combination may trigger the aforementioned serotonin syndrome.

Over-the-counter preparations for cold and flu symptoms are a serious problem. They contain substances such as ephedrine, pseudoephedrine, phenylephrine. These drugs interact dangerously with MAO inhibitors.

Medicines and herbal supplements can also be dangerous when combined with antidepressants. Do not use preparations containing St. John's wort and ginseng together with MAO inhibitors.

Other drugs that may also interact:

  • triptans - anti-migraine drugs
  • dextromethorphan - antitussive drug
  • opioids - strong painkillers
  • cimetidine - a drug in the treatment of gastric ulcer
  • non-steroidal anti-inflammatory drugs

Possible side effects during the use of MAO inhibitors

Unfortunately, MAO inhibitors have many side effects. Most of them are exacerbated by drug or food interactions. By strictly following medical recommendations, we can limit the negative impact of drugs on our body.

Taking too much of the drug can cause euphoria, manic states, and the transition from depression to bipolar mania. However, it should be remembered that even a correctly taken medicine causes unwanted reactions of the body. The most common side effects associated with taking MAO inhibitors include:

  • retrosternal pains and palpitations
  • headaches
  • hyperthermia
  • attention disorders and memory disorders
  • visual disturbance
  • psychomotor slowing down and weakness
  • tachycardia
  • vomiting
  • nausea
  • anxiety
  • anxiety
  • chills
  • sweating
About the authorSara Janowska, MA in pharmacyPhD student of interdisciplinary doctoral studies in the field of pharmaceutical and biomedical sciences at the Medical University of Lublin and the Institute of Biotechnology in Białystok. A graduate of pharmaceutical studies at the Medical University of Lublin with a specialization in Plant Medicine.She obtained a master's degree defending a thesis in the field of pharmaceutical botany on the antioxidant properties of extracts obtained from twenty species of mosses. Currently, in his research work, he deals with the synthesis of new anti-cancer substances and the study of their properties on cancer cell lines. For two years she worked as a master of pharmacy in an open pharmacy.

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