How do you treat hypertensive MAOI crisis?

Intravenous benzodiazepines are useful for agitation and seizure control. They also may help control the hypertension. Hospital admission is recommended in a patient with a tyramine reaction if symptoms do not resolve within 6 hours of onset or if the episode was an intentional MAOI overdose.

What is done to prevent hypertension in a patient on MAOI antidepressants?

You’ll need to avoid foods containing high levels of tyramine ― an amino acid that regulates blood pressure ― such as aged cheeses, sauerkraut, cured meats, draft beer and fermented soy products (for example, soy sauce, miso and tofu). The interaction of tyramine with MAOIs can cause dangerously high blood pressure.

Can MAOIs and SSRIs be taken together?

It is generally considered dangerous to combine monoamine oxidase inhibitors and SSRIs because MAOIs inhibit serotonin metabolism and can result in circulating serotonin levels that are high enough to produce cardiotoxic and neurotoxic serotonin syndrome.

Can MAOIs cause hypertensive crisis?

If you take an MAOI and you eat high-tyramine foods, tyramine can quickly reach dangerous levels. This can cause a serious spike in blood pressure and require emergency treatment. Avoid consuming foods that are high in tyramine if you take an MAOI.

How do you treat serotonin syndrome?

Depending on your symptoms, you may receive the following treatments:

1. Muscle relaxants.
2. Serotonin-production blocking agents.
3. Oxygen and intravenous (IV) fluids.
4. Drugs that control heart rate and blood pressure.
5. A breathing tube and machine and medication to paralyze your muscles.

How do you reverse an MAOI?

There are no antidotes for MAOI toxicity. Hemodialysis is ineffective in removing the drug from the body. Rapid correction of hyperthermia is vital. Cooling by evaporative heat loss (wetting skin and creating air flow with fans) is an effective treatment.

What medications should be avoided with MAOI?

MAO inhibitors should be avoided with other antidepressants such as paroxetine fluoxetine, amitriptyline, nortriptyline, bupropion; pain medications like methadone, tramadol, and meperidine; dextromethorphan, St. Johns Wort, cyclobenzaprine, and mirtazapine.

Why should MAOIs never be taken with SSRIs?

Confusion, high blood pressure, tremor, hyperactivity, coma, and death may occur when SSRIs are combined with other drugs that increase brain serotonin levels, for example, MAOIs, TCAs, sumatriptan (Imitrex), linezolid (Zyvox), St John’s Wort, tramadol (Ultram), and meperidine (Demerol).

Can you take SSRI and TCA together?

Also, combining tricyclic antidepressants (TCAs) and SSRIs can result in exacerbated tricyclic side effects due to elevated TCA blood levels; these occur because of the effects of SSRIs on the P450 2D6 liver enzyme system which can result in a blockade of the metabolism of TCAs.

What medications are contraindicated with MAOI?

Is Lexapro an MAO inhibitor?

Lexapro is not considered a monoamine oxidase inhibitor (MAOI). MAOIs work by slowing down the breakdown of serotonin and dopamine, another chemical in your brain. This also helps alleviate symptoms of depression. However, MAOIs have a higher risk of side effects and drug interactions than SSRIs such as Lexapro.

Are MAOIs anti-hypertensive drugs or antidepressants?

Back in the 1960s they were more widely used as anti-hypertensive drugs than they were as antidepressants: the following references attest to that (1-10). Many patients on MAOIs will be able to lower, or cease, previously necessary anti-hypertensive drugs.

Why are MAOIs used to treat depression?

SSRIs are generally the first choice for treatment of depression because, beyond just being effective, they have fewer problems with side effects. Because of dietary restrictions and concerns over hypertensive reactions, MAOIs are often used only after other agents have failed.

Is there a difference between MAOI and SSRI?

Although SSRIs function by a similar mode of action, they are different. Certain side effects with one SSRI may not be a problem with another. In general, primary care providers should not prescribe MAOIs unless they have experience with these medications.

Do MAOIs raise blood pressure?

Many doctors still believe that MAOIs raise blood pressure. Back in the 1960s they were more widely used as anti-hypertensive drugs than they were as antidepressants: the following references attest to that (1-10). Many patients on MAOIs will be able to lower, or cease, previously necessary anti-hypertensive drugs.