TV commercials, OTC medication labels, and even supplements almost universally say that they cannot be taken in combination with an MAOI. Even basic cold medications, decongestants, advil, and tylenol have this warning.
I’m sure there’s justification for everything, but it seems bizarre to me that something with such high interactivity would be taken by anyone. Would being on an MAOI prevent someone from receiving life saving medication in an emergency?
What is it about this class of medication that makes it need to be taken so exclusively? I’ve never heard of anything else remotely like it.
In: Biology
MAOI stands for Monoamine Oxidase Inhibitor, and Monoamine Oxidase breaks down many chemicals in your body. When you inhibit it, it is very easy for these substances to reach toxic levels. In particular, the most dangerous ones can cause your blood pressure to spike to lethal levels when combined with certain foods or medications.
It seems strange to take such a dangerous medication because it is, MAOIs are one of the last medications we turn to for anti-depressive effects these days specifically because they are so dangerous. Unfortunately everyone needs a different combination or type of med to combat depression effectively and for some people, an MAOI is the only thing that works. It’s better to be at risk of a hypertensive crisis than dead by suicide.
Disclaimer, I am not an expert just had a course on pharmakinetic stuff aged ago.
There are a lot of « monoamine » groups in a huge amount of drugs. Its a very simple pattern, basically just a single nitrogen atom.
A certain set of chemicals in your blood which is also responsible for regulating your heart beat happens to react rather readily with monoamines. Your body can deal with a few monoamines here and there thanks to the MAO it produces.
I guess what I’m trying to say is tons of things have monoamine groups in them, especially drugs, and monoamine containing things are bad for your heart, and you are preventing your body from being able to break those potentially dangerous monoamines.
This is opposed to something like an opioid inhibitor or a cannabinoid receptor or whatever; these things are more than just a single atom, and more like an entire molecular shape, and so very specific.
That’s because the original MAOi permanently destroyed the Mao enzyme.
Unlike most other drugs where if there‘s enough of a different compound that different compound would still be able to access that enzyme.
There‘s modern reversible MAOi like moclobemide which have zero of the risk of interaction. Because they don’t permanently chemically react with the enzyme.
So moment too much tyramine is in your system it‘ll still attach to the mao enzyme and will metabolised.
The permanent deactivation of any MAO circulating by old school irreversible MAOi is what made them special.
Not them being MAOi alone,
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