Monoamine Oxidase Inhibitor (MAOI) Mnemonics: Easy Ways to Remember

What is MAOI-Is?

Monoamine oxidase inhibitors (MAO-Is) are a class of medications that prevent the breakdown of neurotransmitters such as serotonin, norepinephrine (NE), and dopamine, increasing their availability in the brain.

What are MAO Inhibitors used for?

MAO Inhibitors are primarily prescribed for atypical depression but are also used to manage conditions like anxiety and panic disorders, bulimia, personality disorders, and Parkinson's disease (in which Selegiline is often prescribed).

What is the mnemonic for MAOI drugs?

To remember the common MAO-I drugs, use the mnemonic "TIPS" which stands for Tranylcypromine, Isocarboxazid, Phenelzine, Selegiline

Tranylcypromine

Mnemonic: T-Rex Prowler

Key Points:

• Tranylcypromine is a powerful nonselective MAO-I commonly used to treat major depressive disorder, especially when other antidepressants haven’t been effective.
• Its mechanism works by inhibiting the breakdown of serotonin, norepinephrine, and dopamine, increasing their availability in the brain to help stabilize mood.
• While primarily prescribed for atypical depression, it can also be effective for some anxiety disorders, though this is less common.

Isocarboxazid

Mnemonic: Iceberg Chaser

Key Points:

• Isocarboxazid is another nonselective MAO-I used to treat major depression, anxiety, and panic disorders.
• It functions by inhibiting the breakdown of neurotransmitters, specifically serotonin, norepinephrine, and dopamine, which help regulate mood.
• While effective for treating depression, Isocarboxazid is particularly beneficial for patients whose depression is complicated by anxiety or panic.

Phenelzine

Mneomnic: Phoenix Zen

Key Points:

• Phenelzine is a nonselective MAO-I primarily prescribed for major depressive disorder, especially in patients who have not responded to first- or second-line antidepressants.
• It works by inhibiting the breakdown of serotonin, norepinephrine, and dopamine in the brain, which helps elevate mood and alleviate depressive symptoms.
• Besides depression, Phenelzine has also been found effective in treating anxiety and panic disorders, although it is less commonly prescribed for these conditions.

Selegiline

Mneomnic: Sailor Lion

Key Points:

• Selegiline is primarily used in the treatment of Parkinson's disease, where it acts as an adjunct to L-Dopa therapy to enhance its effects and reduce motor complications.
• At low doses, Selegiline selectively inhibits MAO-B, which is responsible for breaking down dopamine, increasing dopamine availability and improving motor function in Parkinson’s patients.
• When taken at higher doses, however, Selegiline loses its selectivity for MAO-B and becomes nonselective
  

What foods should you avoid when taking MAOI drugs?

MAOI drugs should never be combined with tyramine-rich foods (like wine, aged cheese, and cured meats) due to the risk of hypertensive crisis, a sudden and dangerous increase in blood pressure caused by the release of excess neurotransmitters.

To remember foods high in tyramine that must be avoided with MAOIs, think of "FATSY BREAD":

• Fermented foods (soy sauce, miso, tofu)
• Aged cheeses (cheddar, blue, brie)
• Tenderizers (meat prepared with tenderizers)
• Sausages and cured meats (pepperoni, salami)
• Yeast extracts (Marmite, Vegemite)
• Beverages (kombucha, kefir)
• Ripe fruits (overripe bananas, raisins, avocados)
• Extracts (fish sauce, Worcestershire)
• Alcoholic liqueurs (sherry, liqueurs)
• Dried fruits (raisins, apricots)

Which drugs increase the risk of serotonin syndrome when taken with an MAOI?

Additionally, MAO-Is must not be combined with medications such as SSRIs, SNRIs, meperidine, dextromethorphan, or St. John's Wort, as this can trigger serotonin syndrome—a life-threatening condition characterized by symptoms such as hypertension, tachycardia, excessive sweating (diaphoresis), hyperactive bowel sounds, mental status changes, muscle jerks (myoclonus), and hyperthermia.

To remember MAOI drug interactions, use the mnemonic “SCARE”:

• S – SSRIs (risk of serotonin syndrome)
• C – CNS stimulants (hypertensive crisis)
• A – Antidepressants (TCAs and SNRIs)
• R – Reserpine (severe blood pressure effects)
• E – Ephedrine and pseudoephedrine (risk of hypertensive crisis)

Check out our other articles to learn tricyclic antidepressants drug mnemonics and atypical antidepressants mnemonics.