MAOIs (Parnate, Nardil)

This class of drug is also an older type of antidepressant with a number of side effects. However, it is often selected to treat “atypical depression,” which is characterized by excessive sleep, overeating, somatic complaints (many complaints about body parts hurting), and a hypersensitivity to perceived slights from others. When other classes of drugs have failed, these types of drugs are prescribed.

Common side effects: Mild to moderate dry mouth, blurred vision, constipation, urinary hesitancy, insomnia or overstimulation, and orthostatic hypotension (lightheadedness upon standing that may lead to falls).

Usage: While one is taking MAOIs, he or she must follow a special diet. Specifically, he or she must avoid foods that are high in the amino acid tyramine (naturally aged meats and cheeses, microbrewed or home brewed beers, some red wines, and flat beans such as fava beans). Also, if one is taking this type of drug, he or she must avoid over-the-counter cold remedies that contain the decongestant pseudoephedrine. Ingesting these foods or this decongestant may cause a potentially fatal hypertensive crisis. Patients over 40 should have a cardiogram before starting a MAOI.

Issues to Discuss With Your Doctor

1. Patients should spend time talking with their doctors about which type of drug will work best for their particular depressive symptoms.

2. Patients should ask about the side effects that they might experience while they are taking the drug.
3. They should find out what type of monitoring will be necessary to ensure that they are using the drugs safely.
4. They should find out how long they are expected to take the drug.

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