Question

There are important instructions for the patient if they plan to change to or from an MAOI and another antidepressant. What are the specifics and what is the underlying reason for those instructions?

Answer 1

When patients are asked to take or withdraw MAOI and another antidepressant, they are provided with some very important instructions. It is because of the fact that these MAOIs and other antidepressant have the tendency to root drug-food interaction or drug-to-drug interactions and even overdoses many a times. If any antidepressants like SSRIs mixes with MAOIs, it can create a serious situation called serotonin syndrome. Symptoms like muscle rigidity, heart rhythms fluctuation, fever seizures, confusion and many problems with kidney, liver or blood pressure can happen. Therefore, it is strongly advised to take a break of at least 2 weeks while switching from one medication to other.

Patients are also advised to eat fresh food and strictly avoid leftover food. This is because when food is left or not being eaten for long, there are more chances of developing tyramine in the food. It can be any kind of meat or fish or even overripe fruits. For a person who is taking these medicines, MAOIs can intercept the breaking of tyramine inside the body and will create a condition of high serum tyramine level. This could result in increasing the blood pressure to a dangerously high level and can even cause death.

Apart from these due to the slow noticeable effects of these doses, patients can also overdose. So, its very important to take just the prescribed amount of drug. Some side effects like dizziness, nausea, insomnia, dry mouth or constipation are also associated with the drug. So, its important for the patients to take care of that. In case of blood pressure fluctuation, seizures, agitation, palpations or fever, the patient must contact the healthcare provider immediately.