Expert Consultations: Real-World Answers

Use of MAOIs in clinical practice – Interview

Published on July 1, 2025 Certification expiration date: July 1, 2028

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Helen Tellegen

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Highlights

Modern foods rarely cause dangerous tyramine reactions; monitor blood pressure. Overtreatment of hypertensive episodes poses greater risk than elevation itself.
Phenelzine may have unique efficacy for social anxiety. Tranylcypromine is weight-neutral and has fewer sexual side effects.
The primary serotonin toxicity risk involves combining an MAOI with a serotonin reuptake inhibitor. Non-SRI agents like mirtazapine can be safely co-administered.

Mechanism of Action: MAOIs vs. Other Antidepressants

Helen Tellegen, PMHNP: Could you explain the mechanism of action of MAOIs and what makes them unique to other antidepressants?

Ken Gillman, MD : The fundamental difference between MAOIs and most other antidepressants lies in their mechanism of action. While tricyclics and subsequent generations of antidepressants act via reuptake inhibition, MAOIs inhibit the enzyme monoamine oxidase.

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Learning Objectives:

After completing this activity, the learner will be able to:

Assess and manage cardiovascular risks associated with MAOI therapy.
Select appropriate MAOI therapy based on patient-specific clinical presentations.
Implement safe prescribing practices to prevent serotonin toxicity.

Original Release Date: July 1, 2025

Expiration Date: July 1, 2027

Expert: Ken Gillman, M.D.

Medical Editors: Helen Tellegen, Flavio Guzmán, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credits.
Download your certificate.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.75 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Ken Gillman, M.D.