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Monoamine Oxidase Inhibitors (MAOIs) for Social Anxiety Disorder

Examples

Generic Name Brand Name
isocarboxazid Marplan
phenelzine sulfate Nardil
tranylcypromine sulfate Parnate

How It Works

These medicines balance certain brain chemicals (neurotransmitters). When these brain chemicals are in proper balance, the symptoms of anxiety are reduced. Monoamine oxidase inhibitors do this by reducing the amount of monoamine oxidase, the substance that breaks down the neurotransmitters.

Why It Is Used

Monoamine oxidase inhibitors (MAOIs) usually are not the first medicines given for anxiety, because they have serious side effects when combined with certain foods and/or medicines. They are usually given to people who have anxiety and who:

  • Did not get better with other antidepressants.
  • Cannot tolerate the side effects of other antidepressants.
  • Have a family or personal history of successful treatment with MAOIs.
  • Have unusual depression or anxiety symptoms.

When these drugs are not recommended

MAOIs are not recommended for children or teens.

How Well It Works

MAOIs may not be the first medicines given for anxiety, because the side effects can be severe. But MAOIs are the treatment of choice in cases of anxiety or depression with unusual features, such as a heavy feeling in the arms and legs, sensitivity to rejection, and a reactive mood. MAOIs are often used as an alternative treatment for anxiety or depression that has not responded to other medicines.

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, such as some cheeses, broad beans such as fava beans, pickled foods such as sauerkraut, beer, and red wine. Eating these foods can cause severe high blood pressure and other health problems. Talk with your doctor about diet and medicine restrictions 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 social anxiety 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 social anxiety 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)new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry
Current as of June 13, 2013

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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