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Monoamine Oxidase Inhibitor (MAOI) Withdrawal

Purpose: To evaluate a patient following the discontinuation of a monoamine oxidase inhibitor (MAOI).

Description

Discontinuation of a monoamine oxidase inhibitor (MAOI) can result in a number of clinical findings, especially if the discontinuation is done abruptly. Discontinuation of an MAOI should be done with caution with careful monitoring of the patient afterwards, even if the discontinuation is done gradually.


 

MAO inhibitors include:

(1) phenelzine (Nardil)

(2) tranylcypromine (Parnate)

(3) selegine (Eldepryl)

 

The clinical changes seen after discontinuation may range from mild to severe.

 

Findings that may occur after discontinuation of an MAOI:

(1) worsening of depression

(2) psychosis

(3) anxiety or agitation

(4) cognitive impairment or delirium

(5) insomnia or drowsiness

(6) seizures

(7) nausea

(8) sweating

(9) palpations

(10) vivid nightmares

(11) tremor

(12) urinary retention

(13) change in blood pressure

(14) generalized discomfort

 

According to Dilsaver the condition resembles changes seen with discontinuation of psychostimulants after long-term use. This may occur because the MAOI exerts an amphetamine-like effect presynaptically.

 


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Specialty

Objective

ICD-10