Antidepressant Agents

Question 1

Monoamine Oxidase Inhibitors (MAOIs)

Answer 1

Uses:
-most effective for atypical depression

• panic disorder
• some phobias

Ex:
-phenelzine (Nardil)

Nursing considerations:
-assessment: pregnancy is contraindicated; suicidal ideation

-monitor:

vitals

liver function

effects: dizziness, excitement, nervousness, confusion, nausea, vomiting, weight gain, orthostatic hypotension, arrhythmias, potential hypertensive crisis, pectoral angina (chest pain)
- Pt teaching:

dietary interactions:

=avoid foods with high tyramine such as aged cheeses; aged or fermented meats, fish or poultry; fava beans; red wines; smoked or pickled fish, meat or poultry; and soy sauce

=tyramine may be absorbed in high concentrations in
the presence of MAOIs, increasing the BP

=tyramine also causes the release of norepinephrine (NE), further contributing to the increase of BP

drug-drug interactions: combination with insulin or oral antidiabetic agents results in additive hypoglycemic effects

Question 2

Effects on children

Answer 2

-Challenging as response is unpredictable, studies
indicate increase in suicidal ideation and behavior

-MAOIs should be avoided in children

Question 3

Effects on older adults

Answer 3

• More susceptible to adverse effects

- Decreased hepatic and renal function – start low, go slow