Volume 41 · Number 3
MARCH 2011
The Monoamine Oxidase Inhibitors: Relics Reconsidered
Psychiatr Ann. 2011 March;41(3):176-183
By Virginia O'Brien, MD
Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressants. Their mood-enhancing properties were discovered in the early 1950s when iproniazid, an antitubercular agent, was noted to improve patients’ moods. The MAOIs can be categorized as hydrazine or nonhydrazine, reversible versus nonreversible, and MAO-A or MAO-B selective. The mechanism of action of MAOIs involves the inhibition of the monoamine oxidase enzyme, thereby preventing the breakdown of serotonin, norepinephrine, and dopamine (and in the intestine, tyramine), leading to their increased concentrations in the central nervous system. The MAO-A enzyme is present in the brain, gut, and liver, and MAO-B is found in the brain and platelets. Inhibition of MAO-A is required for antidepressant effects.
ABOUT THE AUTHOR
Virginia O’Brien, MD, is a Clinical Associate Professor, Duke University Medical Center, Departments of Psychiatry and Internal Medicine.
Address correspondence to: Virginia O’Brien, MD, 3516 Elba St., Civitan Bldg Box 3516, Durham, NC 27710; fax: 919-681-7504; or e-mail: [email protected].
Dr. O’Brien has disclosed no relevant financial relationships.
EDUCATIONAL OBJECTIVES
- Differentiate among the traditional monoamine oxidase inhibitors (MAOIs), reversible MAOIs (RIMAs), and selegeline transdermal system (STDS).
- Describe common and severe side effects of MAOIs, including hypertensive crisis.
- Discuss the efficacy of MAOIs in comparison to other antidepressants.
This CME activity is primarily targeted to patient-caring physicians specializing in psychiatry. Physicians can receive AMA PRA Category 1 Credits™ by reading the CME articles in Psychiatric Annals and successfully completing the quiz at the end of the articles. Complete instructions are given subsequently. Educational objectives are found at the beginning of each CME article.
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UNLABELED AND INVESTIGATIONAL USAGE
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INSTRUCTIONS
- Review the stated learning objectives of the CME articles and determine if these objectives match your individual learning needs. You must read each of the CME articles in this issue carefully in order to take the quiz. Do not neglect the tables and other illustrative materials as they have been selected to enhance your knowledge and understanding.
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- The quiz questions have been designed to provide a useful link between the CME articles in the issue and your everyday practice. Read each question and choose the correct answer by checking the box next to your desired answer.
- After you answer all questions, your quiz is graded. A score of at least 80% is required to pass
- If you passed the quiz, you will receive by mail a CME certificate of within 4 to 6 weeks. If you failed the quiz, you may retake the quiz at another time by returning to the CME articles and then registering again for the quiz.
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