General Side Effects

• While the general side effects of MAOIs do not necessarily strike every person, several have been reported by many patients and are considered common. The following symptoms may occur while taking an MAOI: constipation or diarrhea, drowsiness, upset stomach, vertigo, decreased sexual activity, sleeping problems, low blood pressure, weight gain and increase in appetite, tremor or shaking, headache, vision problems, increase in sweat production, a decrease in urination and dry mouth.
  
  

Serotonin Syndrome

• Serotonin syndrome occurs when MAOIs interact with another type of antidepressants called selective serotonin reuptake inhibitors (SSRIs), including Celexa, Prozac, Paxil and Zoloft. Patients are cautioned not to take an MAOI within two weeks of an SSRI to prevent this dangerous condition. Serotonin syndrome requires immediate professional attention; its symptoms include restlessness, hallucinations, confusion, extreme anger or irritability, changes in blood pressure, nausea and vomiting, fever, seizures and coma.
  
  

Suicidal Ideations

• Suicidal ideations can occur with any type of antidepressant, along with worsening depression during the first two months of initial treatment in people age 18 to 24. However, these suicidal impulses can also occur in patients age 65 and older. The patient should monitor her status and report any negative or suicidal thoughts to her doctor or therapist. It is possible that the MAOI must be discontinued in favor of another drug if symptoms rapidly become more serious.
  
  

Food Reactions

• Patients taking MAOIs must follow stringent food restrictions. If a restricted food is eaten, it will increase blood pressure to a dangerously high condition and may result in a stroke. Certain pickled foods, cheeses, chocolate, meats and alcoholic beverages must not be ingested during treatment with an MAOI. The only MAOI that allows patients to eat without serious dietary restrictions is Emsam, and then only when taken in low doses.
  
  

OTC and Prescription Restrictions

• MAOIs must not be used in conjunction with certain over-the-counter medicines such as asthma inhalers, weight-loss supplements, decongestants, and herbal medicines like St. John's wort. In addition, prescription pain medications---including Ultram and Demerol---should not be taken with MAOIs.
  
  

Conclusion

• Treatment with MAOIs needs to be monitored continually, and patients must be honest and open with doctors and therapists about how their treatment is progressing. MAOIs may help many people, but for some the restrictions and interactions cannot be overlooked and they should work with their physician to find a better alternative.