Antidepressants (cont.)

Combining MAOIs with drugs that increase serotonin may cause:

Combining MAOIs with norepinephrine or drugs that constrict blood vessels (epinephrine, amphetamines, pseudoephedrine, ephedrine, phenylpropanolamine, and phenylephrine) may increase blood pressure to dangerous levels.

The antibiotic linezolid (Zyvox) and intravenous methylene blue should not be combined with MAOIs because they also inhibits monoamine oxidase.

MAOIs should be discontinued at least two weeks before administration of drugs that interact with MAOIs. Drugs that interact with MAOIs should be discontinued at least 1-2 weeks before administration of MAOIs. Because the effect of fluoxetine lasts for several weeks after discontinuation, MAOIs should not be initiated for at least five weeks after stopping fluoxetine.

MAOIs are associated with headache and insomnia which may decrease with continued use. Headaches may require treatment with nonsteroidal antiinflammatory drugs (for example, ibuprofen), and insomnia may require treatment with benzodiazepines [for example, diazepam (Valium) or other drugs for insomnia.

Because MAOIs stimulate the nervous system, they may be beneficial for depressed patients who over-sleep or are fatigued.

Hypertension may occur during therapy with MAOIs. Therefore, blood pressure should be monitored periodically during MAOI treatment. Hypertensive crisis may occur when MAOIs are combined with tyramine containing foods or drugs that constrict blood vessels.

Symptoms of hypertensive crises include:

Medically Reviewed by a Doctor on 5/31/2013


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