Monoamine oxidase inhibitors (MAOIs) for panic disorder

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Monoamine oxidase inhibitors (MAOIs) help balance certain chemicals in the brain (neurotransmitters) to relieve symptoms of anxiety associated with panic disorder.

Monoamine oxidase inhibitors (MAOIs) are usually given to people with panic disorder who:

• Do not get better with other antidepressants.
• Cannot tolerate the side effects of other antidepressants.
• Have a history of successful treatment with MAOIs.

Although MAOIs are as effective as other antidepressants for treating panic disorder, other antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants are generally tried first because they have less serious side effects.

Side effects of monoamine oxidase inhibitors include:

• Difficulty getting to sleep.
• Dizziness, lightheadedness, and fainting.
• Dry mouth.
• Blurred vision.
• Appetite changes.
• Severe high blood pressure.
• Changes in heart rate and rhythm.
• Muscle twitching and feelings of restlessness.
• Loss of sexual desire or ability.
• Weight gain.
• Negative interactions with other medications and some foods.

Serious reactions—or even death—can result when MAOIs are combined with some foods and medications.

MAOIs are not recommended for children, teens, or nursing or pregnant women.

FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when the doses are changed.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

You must avoid eating certain foods, such as some cheeses, broad beans such as fava beans, pickled foods such as sauerkraut, beer, and red wine while taking MAOIs. Eating these foods can cause severe high blood pressure and other health problems. Talk with your health professional about diet and medication restrictions you need to follow if you are planning to take an MAOI.

Common nonprescription medications, particularly certain cold remedies and diet pills, can also be dangerous when taken with an MAOI.

MAOIs can cause death if they are taken in overdose.

You must wait at least 14 days after you stop taking MAOIs before taking another antidepressant.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.