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Alcohol & MAOI
Alcohol, also known as ethanol, is a psychoactive substance. Alcohol primarily affects the brain's neurotransmitter systems. It interacts with ligand-gated ion channels, especially the pentameric neurotransmitter receptors, which include:
- Nicotinic Acetylcholine Receptors (nAChRs): These receptors are involved in various cognitive functions and the reward system.
- GABAA Receptors (GABAA Rs): Alcohol enhances the inhibitory effects of GABA, the primary inhibitory neurotransmitter in the brain. This leads to sedation, anxiolysis, and muscle relaxation.
- Glycine Receptors (GlyRs): These receptors mediate inhibitory neurotransmission in the spinal cord and brainstem.
Along with alcohol can stimulate the release of endorphins, which are the body's natural painkillers. This contributes to the euphoric feelings some people experience when drinking.
Monoamine Oxidase Inhibitors (MAOIs) are a class of antidepressant drugs that have been used for several decades to treat depression.
Monoamine oxidase (MAO) is an enzyme responsible for breaking down neurotransmitters such as catecholamines (e.g., dopamine, norepinephrine) and other monoamines like serotonin and tryptamine. MAOIs work by inhibiting the activity of the MAO enzyme. When MAO is inhibited, the degradation of these neurotransmitters decreases.
As a result of the reduced degradation, there's an increase in the concentration of these neurotransmitters in the synaptic cleft (the space between neurons). This increase can help alleviate symptoms of depression.
Examples of MAOIs:
- Iproniazid: One of the first MAOIs discovered, it was initially an antitubercular drug but was found to have euphoric effects, leading to its use as an antidepressant.
- Moclobemide: A selective and reversible MAOI-A, it's one of the safer and more effective MAOIs used in treating depressive disorders.
- Befloxatone: Another selective and reversible MAOI-A.
- Toloxatone: Used in the treatment of depression.
- Brofaromine: An antidepressant with MAOI properties.
While MAOIs can be effective in treating depression, they come with certain dietary and drug interaction restrictions. For instance, foods rich in tyramine (e.g., aged cheeses, cured meats) can interact with MAOIs and lead to a hypertensive crisis, a sudden and dangerous increase in blood pressure. Additionally, MAOIs can interact with other medications, leading to potential side effects
The interaction between alcohol and MAOIs is a significant concern. MAOIs work by inhibiting the activity of monoamine oxidase. Alcohol, on the other hand, affects various neurotransmitter systems, including enhancing the effects of the inhibitory neurotransmitter GABA and reducing the activity of the excitatory neurotransmitter glutamate. When combined with MAOIs, there's a potential for an imbalance in neurotransmitter levels, leading to adverse effects.
MAOIs can interact with various substances, including certain foods and drinks, to cause a sudden and dangerous increase in blood pressure known as a hypertensive crisis. While alcohol alone isn't a common cause, when combined with MAOIs, there's a potential risk, because tyramine found in many alcoholic beverages.
Both alcohol and MAOIs have depressant effects on the central nervous system (CNS). When taken together, they can have a synergistic effect, leading to enhanced CNS depression. This can manifest as increased drowsiness, sedation, and respiratory depression.
Alcohol is a depressant and can exacerbate the symptoms of depression. When combined with MAOIs, there's a potential for a worsening of depressive symptoms and an increase in suicidal thoughts and behaviors.
In addition, there are risks of increased stress and toxicity to enzymes and liver structure.
All things considered, we recommend avoiding this combination under any conditions.
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