Panic Disorder and MAOIs

Monoamine oxidase inhibitors (MAOIs) are a type of antidepressant that relieve symptoms of panic disorder by preventing the breakdown of serotonin and noradrenaline.

Common names include:

• Isocarboxid (Marplan)
• Phenelzine (Nardil)
• Tranylcypromine (Parnate)

These medications are especially effective for people whose symptoms have not responded to other treatments. Improvement is usually seen in 2-6 weeks after beginning treatment. MAOIs are not addictive.

Read more details about MAOIs.

MAOIs are used mainly when other antidepressants have failed in the treatment of major depression and panic disorder.³ This partly due to the risk of hypertensive reaction (severe and sudden rise in blood pressure, potentially leading to cerebral hemorrhage or death).

MAOIs can trigger high increases in blood pressure when combined with foods containing tyramine². These include soy, cheese, chocolate, overripe fruit, pickles, fermented meat and other processed foods. Some medications including decongestants also contain high levels of tyramine so patients should ask for a complete list of prohibited foods, medicines and substances when taking a MAOI⁵.

Other potential side effects include dry mouth, sexual dysfunction, skin rash, and blurred vision.

MOIs are fatal in overdose. Thus, they are less commonly used in comparison to other pharmacological medications.

MAOIs can cause adverse reactions when combined with many other types of drugs, such as:

• Other types of MAOIs
• Antidepressants
• Sympathomimetics
• Sedatives
• Narcotics
• Anesthetics
• Antihypertensive drugs
• Diuretics
• Antihistamines
• Buspirone
• Dexfenfluramine
• Dextromethorphan

When taking MAOIs, you should not eat food with a high tyramine content, such as:

• Cheese
• Alcohol
• Pickled, marinated, smoked, cured, or fermented foods
• Organ meats
• Nuts and peanut butter
• Fava beans
• Onions
• Avocados
• Canned figs
• Chocolate
• Caffeine
• Foods containing monosodium glutamate (MSG)