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Monoamine Oxidase Inhibitors (MAOIs) for Panic Disorder
Examples
| Generic Name | Brand Name |
|---|---|
| isocarboxazid | Marplan |
| phenelzine | Nardil |
| tranylcypromine | Parnate |
How It Works
Monoamine oxidase inhibitors (MAOIs) help balance certain chemicals in the brain (neurotransmitters) to relieve symptoms of anxiety associated with panic disorder.
Why It Is Used
Monoamine oxidase inhibitors (MAOIs) are usually given to people who have panic disorder and who:
- Do not get better with other antidepressants.
- Cannot tolerate the side effects of other antidepressants.
- Have a history of successful treatment with MAOIs.
How Well It Works
Although MAOIs are as effective as other antidepressants for treating panic disorder, other antidepressant medicines such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants are typically tried first because they have less serious side effects.
Side Effects
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor right away if you have:
- Hives.
- Chest pains.
- Fast or slow heartbeat.
- Severe headache.
- Stiff neck.
- Nausea or vomiting.
Common side effects of this medicine include:
- Dizziness or lightheadedness.
- High blood pressure.
- Appetite changes or weight gain.
- Loss of sexual desire or ability.
- Muscle twitching during sleep.
Serious reactions—or even death—can result when MAOIs are combined with some foods and medicines. While taking MAOIs, you must avoid eating certain foods, including many alcoholic and caffeinated drinks, sour cream and yogurt, bananas, chocolate, and some cheeses such as American, cheddar, and Swiss. Eating these foods can cause severe high blood pressure and other health problems. Talk with your doctor about diet and medicine restrictions that you need to follow if you are planning to take an MAOI.
You must wait at least 14 days after you stop taking MAOIs before taking another antidepressant. Common nonprescription medicines, 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.
The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Taking medicine
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Taking medicines for panic disorder during pregnancy may increase the risk of birth defects. If you are pregnant, breast-feeding, or trying to get pregnant, talk to your doctor. Medicines may need to be continued if your panic disorder is severe. Your doctor can help weigh the risks of treatment against the risk of harm to your pregnancy.
Checkups
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.
Last Revised: September 7, 2012
Author: Healthwise Staff
Medical Review: Anne C. Poinier, MD - Internal Medicine & Lisa S. Weinstock, MD - Psychiatry
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