MAOIs and Depression Treatment Guidelines

Monoamine oxidase inhibitors (MAOIs) have proven efficacy for treating depression, particularly in patients with atypical depression, high levels of anxiety, anergic bipolar depression, and treatment-resistant depression. However, MAOIs are not supported as first-line treatments due to safety and tolerability concerns and the need for dietary restrictions; instead, current guidelines recommend MAOIs as third-, fourth-, or fifth-line treatments. However, a newer, transdermal MAOI formulation limits the need for dietary restrictions and has fewer sexual and metabolic effects than some of the newer antidepressants.