II. Precautions

  1. See MAO Inhibitors
  2. Follow low tyramine diet and avoid Sympathomimetics, Serotonergic Medications
  3. MAO Inhibitors are not first-line agents for Mood Disorders

III. Indications

  1. Refractory Major Depression

IV. Background

  1. Isocarboxazid (Marplan) is no longer manufactured in U.S.

V. Mechanism

  1. See MAO Inhibitor
  2. Isocarboxazid is a hydrazine MAO Inhibitor which irreversibly blocks MAO nonselectively (MAO-A and MAO-B are both affected)

VI. Dosing

  1. Start 10 mg orally twice daily
  2. May increase the daily dose by 10 mg every 2 to 4 days to 40 mg in the first 1-2 weeks (in divided doses)
  3. Maximum: 60 mg per day (in divided doses)

VII. Adverse Effects

VIII. Drug Interactions

  1. See MAO Inhibitors
  2. Hepatic metabolism

IX. Safety

  1. Unknown safety in pregnancy and Lactation

XI. References

  1. (2023) Med Lett Drugs Ther 62(1592): 25-32
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 36-7
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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