MAOIs on the NCLEX
MAOIs: tyramine crisis, drug interactions, washout periods, rare use.
Monoamine oxidase inhibitors are rarely first-line in 2026 but show up on the NCLEX because of dangerous interactions.
Common drugs
Phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl, Parkinson's; transdermal Emsam for depression).
Tyramine crisis
Tyramine-containing foods + MAOI = hypertensive crisis (severe HTN, headache, sweating, possible stroke). Avoid aged cheeses, cured meats, wine, beer, soy sauce, fermented foods.
Drug interactions
Serotonin syndrome with SSRIs, SNRIs, TCAs, tramadol, meperidine, dextromethorphan, St. John's wort. 2-week washout in both directions (5 weeks for fluoxetine).
Indications
Treatment-resistant depression. Atypical depression. Parkinson's (selegiline).
Frequently asked
Why MAOIs rarely used?
Dietary restrictions and drug interactions. Risk-benefit doesn't favor them over SSRIs for most patients.
Selegiline transdermal, same restrictions?
Low-dose patches (6 mg) skip dietary restrictions. Higher doses still require them.
Quick check
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