International MAOI expert group: Editorial and recommendations

by | Last updated Oct 17, 2021 | Published on Jul 5, 2019 | Anti-Depressants, MAOIs, Recent Commentaries

I am proud to announce that the position statement and recommendations produced by my International MAOI expert groups has been published as an editorial in CNS Spectrums.

The title is ‘Revitalizing monoamine oxidase inhibitors: A call for action’


Its impact and influence will be determined to a significant extent by sharing it with others to ensure it becomes widely known.  The icons at the top of the page will assist you to do that (Twitter, twerp, twaddle, and all that stuff).  By spreading the word, you will help others find quality information more quickly and easily — and that is life-saving for some people.

This publication is from the ‘International expert groups on MAOIs’ that I convened at the beginning of last year.  A number of members have contributed in various ways to this statement, the final form was shaped, steered, and finalised by the listed authors, integrating many opinions, ideas, and comments from participants.

It may be noted that the signatories of this document constitute some 80 eminent researchers and practitioners from all over Europe and America, not only psychiatrists, but also those from other relevant disciplines including toxicology, emergency medicine, anaesthetics, and a number of pure researchers from biochemistry and pharmacology.

We hope that people from various clinical disciplines, for instance pharmacy and general primary care medicine, will be enabled to appreciate that much of the information they are exposed to concerning these drugs (even in supposedly authoritative texts) is both wrong and out-of-date (recommendation No. 2), and that it is quite incorrect to indicate to patients that these drugs are difficult, dangerous, and dated.  For some patients, they are undoubtedly life-saving.

One hopes that the number of eminent signatories who have given their imprimatur to this statement will imbue it with sufficient gravitas for it to be taken notice of by those in a position to influence the implementation of its recommendations. These are:

1. That bodies such as; professional organisations, health-care teaching institutions, and regulatory agencies act to facilitate the availability in their countries of all four MAOI medications (i.e., tranylcypromine, phenelzine, isocarboxazid, and STS).


2. That pharmacy databases, drug-drug interaction software, electronic health records, and patient educational materials require urgent updating to incorporate correct state-of-the-art information on drug interactions and on dietary advice.


3. That specialty training in psychiatry should incorporate knowledge of, and experience in, the clinical use of all MAOIs.


4. That practice guideline developers incorporate information about MAOIs from older literature, clinical expertise, and patient perspectives to provide a more complete view of the important role of MAOIs in clinical practice.


5. That there be improvement of continuing education about MAOIs and performance initiatives to audit MAOI prescribing, provide feedback to prescribers, and assure use of best practices with MAOIs.


 The full text of this editorial is available at CNS Spectrums website

Article doi:10.1017/S1092852919001196




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