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7 out of 10 patients report significant relief in their symptoms.

One Plan for Better Mental Health

  • Expert medication management for Mental Health & related issues (e.g., Insomnia)
  • Refill requests started within 24 hours
  • Labs for Mental Health with detailed provider review
  • Ease of scheduling a monthly appointment with your provider should you need one
  • Ability to send a message 24/7 through your patient portal
  • PLUS! Free blood pressure monitor & MAOI bottle opener

You Decide

With the guidance of your provider, you can make an informed decision about which MAOI is best for you.

Expert Providers & Responsive Care Team

Personalize your treatment plan to achieve your goals. Contact the Help Desk directly from your account.

Timely & Flexible Care

Weekend & evening virtual appointments available. Request refills quickly & easily from your account.

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Are MAOIs Effective?

Studies have found MAOIs are often more effective than more common treatments including SSRIs and TCAs in treating:

  • Depression & Other Mood Disorders [1-5]1. Thase ME, Frank E, Mallinger AG, Hamer T, Kupfer DJ. Treatment of imipramine-resistant recurrent depression, III: Efficacy of monoamine oxidase inhibitors. J Clin Psychiatry. 1992 Jan;53(1):5-11. PMID: 1737741.
    2. Nolen WA, van de Putte JJ, Dijken WA, Kamp JS, Blansjaar BA, Kramer HJ, Haffmans J. Treatment strategy in depression. II. MAO inhibitors in depression resistant to cyclic antidepressants: two controlled crossover studies with tranylcypromine versus L-5-hydroxytryptophan and nomifensine. Acta Psychiatr Scand. 1988 Dec;78(6):676-83. doi: 10.1111/j.1600-0447.1988.tb06403.x. PMID: 3146891.
    3. Amsterdam JD, Shults J. MAOI efficacy and safety in advanced stage treatment-resistant depression–a retrospective study. J Affect Disord. 2005 Dec;89(1-3):183-8. doi: 10.1016/j.jad.2005.06.011. Epub 2005 Oct 6. PMID: 16213594.
    4. Georgotas A, McCue RE, Hapworth W, Friedman E, Kim OM, Welkowitz J, Chang I, Cooper TB. Comparative efficacy and safety of MAOIs versus TCAs in treating depression in the elderly. Biol Psychiatry. 1986 Oct;21(12):1155-66. doi: 10.1016/0006-3223(86)90222-2. PMID: 3756264.
    5. Kim T, Xu C, Amsterdam JD. Relative effectiveness of tricyclic antidepressant versus monoamine oxidase inhibitor monotherapy for treatment-resistant depression. J Affect Disord. 2019 May 1;250:199-203. doi: 10.1016/j.jad.2019.03.028. Epub 2019 Mar 6. PMID: 30861462.
  • Anxiety Disorders [6-11]6. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Update on the efficacy of pharmacotherapy for social anxiety disorder: a meta-analysis. 2014. Available from: https://www.ncbi.nlm.nih.gov/books/NBK293269/
    7. Tyrer P, Shawcross C. Monoamine oxidase inhibitors in anxiety disorders. J Psychiatr Res. 1988;22 Suppl 1:87-98. doi: 10.1016/0022-3956(88)90070-2. PMID: 3050061.
    8. Nies A. Differential response patterns to MAO inhibitors and tricyclics. J Clin Psychiatry. 1984 Jul;45(7 Pt 2):70-7. PMID: 6376487.
    9. Coplan JD, Tiffon L, Gorman JM. Therapeutic strategies for the patient with treatment-resistant anxiety. J Clin Psychiatry. 1993 May;54 Suppl:69-74. PMID: 8509358.
    10. Williams T, McCaul M, Schwarzer G, Cipriani A, Stein DJ, Ipser J: Pharmacological treatments for social anxiety disorder in adults: a systematic review and network meta- analysis [published online ahead of print, 2020 Feb 10]. Acta Neuropsychiatr 2020; 1-8. doi:10.1017/neu.2020.6
    11. Nardi AE, Lopes FL, Valença AM, Freire RC, Nascimento I, Veras AB, Mezzasalma MA, de-Melo-Neto VL, Soares-Filho GL, King AL, Grivet LO, Rassi A, Versiani M. Double-blind comparison of 30 and 60 mg tranylcypromine daily in patients with panic disorder comorbid with social anxiety disorder. Psychiatry Res. 2010 Feb 28;175(3):260-5. doi: 10.1016/j.psychres.2008.06.025. Epub 2009 Dec 29. PMID: 20036427.
  • Bipolar Disorder[12-13]12. Himmelhoch JM, Thase ME, Mallinger AG, Houck P. Tranylcypromine versus imipramine in anergic bipolar depression. Am J Psychiatry. 1991 Jul;148(7):910-6. doi: 10.1176/ajp.148.7.910. PMID: 2053632.
    13. Mallinger AG, Frank E, Thase ME, et al. Revisiting the effectiveness of standard antidepressants in bipolar disorder: are monoamine oxidase inhibitors superior?. Psychopharmacol Bull. 2009;42(2):64-74.
Large medical societies endorse more widespread use of MAOIs particularly in atypical and treatment-resistant mental health conditions with studies reporting 70% success among challenging cases. [12-19]12. Himmelhoch JM, Thase ME, Mallinger AG, Houck P. Tranylcypromine versus imipramine in anergic bipolar depression. Am J Psychiatry. 1991 Jul;148(7):910-6. doi: 10.1176/ajp.148.7.910. PMID: 2053632. 13. Mallinger AG, Frank E, Thase ME, et al. Revisiting the effectiveness of standard antidepressants in bipolar disorder: are monoamine oxidase inhibitors superior?. Psychopharmacol Bull. 2009;42(2):64-74. 14. Practice guideline for the treatment of patients with major depressive disorder (revision). American Psychiatric Association. Am J Psychiatry. 2000 Apr;157(4 Suppl):1-45. PMID: 10767867. 15. Anderson IM, Nutt DJ, Deakin JF. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 1993 British Association for Psychopharmacology guidelines. British Association for Psychopharmacology. J Psychopharmacol. 2000 Mar;14(1):3-20. doi: 10.1177/026988110001400101. PMID: 10757248. 16. https://www.medpagetoday.com/psychiatry/bipolardisorder/3389 17. Sub Laban T, Saadabadi A. Monoamine Oxidase Inhibitors (MAOI) [Updated 2020 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539848/ 18. Armstrong C. APA Releases Guideline on Treatment of Patients with Major Depressive Disorder. Am Fam Physician. 2011 May 15;83(10):1219-1227. (Based on the most up-to-date guidelines for treating depression released by the APA in 2010.) 19. Bodkin JA, Dunlop BW: Moving on with monoamine oxidase inhibitors. Focus 2021; 19:50–52. doi: 10.1176/appi.focus.20200046
Guidelines from large medical societies support more widespread use of MAOIs given their effectiveness in atypical and treatment-resistant mental health disorders [12-19]12. Himmelhoch JM, Thase ME, Mallinger AG, Houck P. Tranylcypromine versus imipramine in anergic bipolar depression. Am J Psychiatry. 1991 Jul;148(7):910-6. doi: 10.1176/ajp.148.7.910. PMID: 2053632.
13. Mallinger AG, Frank E, Thase ME, et al. Revisiting the effectiveness of standard antidepressants in bipolar disorder: are monoamine oxidase inhibitors superior?. Psychopharmacol Bull. 2009;42(2):64-74.
14. Practice guideline for the treatment of patients with major depressive disorder (revision). American Psychiatric Association. Am J Psychiatry. 2000 Apr;157(4 Suppl):1-45. PMID: 10767867.
15. Anderson IM, Nutt DJ, Deakin JF. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 1993 British Association for Psychopharmacology guidelines. British Association for Psychopharmacology. J Psychopharmacol. 2000 Mar;14(1):3-20. doi: 10.1177/026988110001400101. PMID: 10757248.
16. https://www.medpagetoday.com/psychiatry/bipolardisorder/3389
17. Sub Laban T, Saadabadi A. Monoamine Oxidase Inhibitors (MAOI) [Updated 2020 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539848/
18. Armstrong C. APA Releases Guideline on Treatment of Patients with Major Depressive Disorder. Am Fam Physician. 2011 May 15;83(10):1219-1227. (Based on the most up-to-date guidelines for treating depression released by the APA in 2010.)
19. Bodkin JA, Dunlop BW: Moving on with monoamine oxidase inhibitors. Focus 2021; 19:50–52. doi: 10.1176/appi.focus.20200046 with studies reporting a 70% response rate among difficult cases. [20-21]20. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012342s064lbl.pdf
21. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011909s038lbl.pdf Due to their high rate of effectiveness among MAOIs, when they fail to produce a sufficient therapeutic response, it is often due to prescriber inexperience. [28-32]28. Keller MB, Klerman GL, Lavori PW, et al. Treatment received by depressed patients. JAMA. 1982;248:1848–1855.
29. Amsterdam JD, Chopra M. Monoamine oxidase inhibitors revisited. Psychiatric Annals. 2001;31:361–370.
30. Pare CMB. The present status of monoamine oxidase inhibitors. Br J Psychiatry. 1985;146:576–584.
31. Guze BH, Baxter LR, Rego J. Refractory depression treated with high doses of a monoamine oxidase inhibitor. J Clin Psychiatry. 1987;48:31–32.
32. Amsterdam JD, Hornig-Rohan M. Treatment algorithms in treatment-resistant depression. Psychiatr Clin North Am. 1996;19:371–385.

Which MAOI is Right for Me?

There are four FDA-approved MAO Inhibitors:

  • Parnate (Tranylcypromine)
  • Nardil (Phenelzine)
  • Selegiline (Emsam)
  • Marplan (Isocarboxazid)

Each MAOI is different. At your initial consultation, your provider will guide you in selecting a MAOI.

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Know More About

MAO Inhibitors

Monoamine oxidase (MAO) inhibitors or MAOIs are an effective but often underutilized class of medications that treat a variety of mental health issues including depression, anxiety, and bipolar disorder. MAOIs primarily work by preventing the breaking down of several important chemical messengers including dopamine, serotonin, and norepinephrine.

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