Objective: This article provides an up-to-date review of major drug interactions and an overview of food
interactions with monoamine oxidase inhibitors (MAOI) including both antidepressants and other drugs used in general
Data Sources: English language literature identified by PubMed search of terms including monoamine oxidase,
phenelzine, tranylcypromine, isocarboxazide, selegiline, rasagiline, linezolid, methylene blue, serotonin syndrome,
hypertensive crisis. Articles were selected primarily from the last 10 years of published journals with a selection of
classical older articles. Exclusion criteria were not applied because of the interest in including case reports of drug
Data Extraction: type, frequency, and severity of drug interactions.
Results: Classical irreversible non-selective monoamine oxidase inhibitors (MAOI) (phenelzine, tranylcypromine, and
isocarboxazid) have been minimally utilized due to fear of dietary and drug interactions. Moclobemide and transdermal
selegiline offer greatly improved safety and comparable psychiatric efficacy, while non-psychiatric MAOIs such as
linezolid, methylene blue, oral selegiline and rasagiline have similar potential drug interactions. The most hazardous
MAOI drug interactions involve SSRI and SNRI antidepressants, meperidine, tramadol, dextromethorphan and
sympathomimetics while the food interactions involve high tyramine aged fermented foods.
Conclusions: Awareness of hazardous MAOI drug interactions is essential both in using these drugs for treatment of
depression and in general medical consultation.