Nearly all mental health conditions are treatable. It can simply take time to find the solution or treatment that works best for your specific challenges. Most can be controlled with therapy, self-help, lifestyle changes, and other strategies, which is why those options are usually the first that people try.
But in some cases you may need extra support. Mental health medications can help those struggling with depression and anxiety regain control, but many also come with side effects that make them less preferable to non-medicinal strategies. That is often the case with an effective and well known depression medication known as Monoamine Oxidase Inhibitors, but more commonly abbreviated to MAOIs.
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What is an MAOI?
Like many mental health medications, MAOIs were discovered by accident. Researchers were looking to develop a treatment for tuberculosis, but found that depressed patients that took an MAOI found some relief in their depression symptoms. It was then researched and found to be effective as a depression treatment.
MAOIs were the first type of depression medication available, and are still used in some form today – although over the past decade a few other popular medications with fewer side effects have replaced them.
Although there is more than one type of MAOI, all of these drugs work by inhibiting what’s known as “monoamine oxidase” – an enzyme in the body that breaks down specific neurotransmitters, including:
- Melatonin, and Several Others
By preventing the effects of this enzyme, the MAOI increases the amount of the above neurotransmitters in the body. Serotonin, dopamine, and other neurotransmitters are the brain chemicals that give you a “good mood” and positive emotions.
In other words, the MAOI lets prevents “Good Mood” brain chemicals from breaking down, which means you have more of them in your body, which means you feel better. The science of this is a bit more complex, but that is the basic approach to how MAOIs work.
Why Don’t More People Take MOAIs?
Depression and anxiety are complex, and so while MAOIs may help some people, others may not see as many benefits. However, by and large, MAO inhibitors are effective at preventing both depression and anxiety.
The problem with MAOIs is with their risks and side effects. MAOIs are still considered to be safe, and if your doctor recommends you take the drug for your anxiety or depression, you may want to consider it. However, there are risks associated with MAOIs that need to be taken into account, including:
High Blood Pressure
The monoamine oxidase enzyme that breaks down several neurotransmitters also breaks down an amino acid known as tyramine. Tyramine is responsible for regulating blood pressure. Too much tyramine can lead to high blood pressure (hypertension). Without the monoamine oxidase to break it down, tyramine can build up in your system.
Because of this, those on MAOIs are told to stop eating foods high in tyramine because it could lead to dangerously high blood pressure that may be fatal. Many foods have tyramine, especially aged foods, so this can be problematic for many people, as it requires many long term dietary changes.
MAOIs are also well known to interact with many prescription and illicit drugs. Any drug, prescription or not prescription, that may increase the amount of amino acids or neurotransmitters in the body may cause an interaction, because there will not be enough monoamine oxidase to break it down. Examples of drugs that cannot be taken when you use MAOIs include Effexor, Welibutrin, many asthma medications, several antihistamines, NyQuil, and hundreds more.
Anyone that is taking an MAOI will need to be very careful about what other medications they take. Even common over the counter medications, herbs, and vitamins may interact with MAOIs, so nothing should be taken without a doctor’s approval.
Examining the Risks and Benefits of MAOIs
It is because of these risks that MAOIs are not advised for everyone. However, MAOIs are still effective for many people that have mental health conditions. The risks simply have to outweigh the rewards, and in some cases other medications and other treatments may be recommended first before MAOIs should be considered. No one should take an MAOI without strict doctor supervision.
MAOIs for Anxiety
MAOIs are best known for their treatment of depression. But studies have shown that MAOIs are also useful for anxiety disorders. Unfortunately, even though MAOIs have been available since the 1950s, not many studies have looked at whether or not MAOIs can benefit anxiety disorders specifically. Often they simply review whether anxiety was reduced when someone also had depression.
Still, some psychiatrists prescribe MAOIs for a variety of anxiety related conditions, including:
- Panic Disorder with Agoraphobia
- Obsessive Compulsive Disorder
- Mixed Anxiety/Depression Symptoms
- Post Traumatic Stress Disorder
They are not typically given to those that have panic disorder without agoraphobia, general anxiety disorder, or social anxiety disorder unless depression is also present or other treatment options have been exhausted.
The recorded effects of MAOIs on anxiety have been largely positive, but because of the side effects it is still generally not recommended. Most doctors and psychiatrists prefer to use MAOIs only on those that have depression because of the sense of urgency for finding an appropriate treatment. With anxiety, most doctors will prefer to try other medications before they recommend MAOIs.
For those that have anxiety, it is still best to try to find strategies to treat your anxiety without the use of medication. If you haven’t yet make sure you take our free 7 minute anxiety test. This test will score your anxiety symptoms, compare your anxiety to others, and provide you with information on how to control it.
Author: Micah Abraham, BSc Psychology, last updated Sep 28, 2017.