MAOI & Sleeping pills
Monoamine oxidase inhibitors (MAOIs) belong to a category of antidepressants that operate by obstructing the function of the enzyme monoamine oxidase. This enzyme is accountable for metabolizing certain neurotransmitters such as serotonin, norepinephrine, and dopamine. MAOIs are grouped into selective and non-selective categories and are also segregated into a specific subtype of monoamine oxidase (A or B).
MAOIs include a number of substances as well as certain antidepressants, such as Moclobemide, Phenelzine, Tranylcypromine, and Selegiline.
Sleeping pills, also recognized as sedative-hypnotics, constitute a broad group of pharmaceuticals and substances that are employed to aid people in falling and staying asleep.
I assume that this combination is unlikely to be used to achieve recreational effects. Readers are more likely to encounter a situation when they take a drug from one group and for some reason they need to take a drug from another.
Given that we are considering fairly broad groups of substances, it is unlikely to be possible to take into account all possible combinations within the one topic. Nevertheless, I want to go through the main classes of sleeping pills and outline their possible interactions with MAOIs
Benzodiazepine tranquilizers (Diazepam, Temazepam, Triazolam). The combination of benzodiazepines with MAOIs can lead to seizures, a pronounced sedative effect up to the suppression of central nervous system activity. Paradoxical reactions with agitation, aggression and inappropriate behavior may also occur. At the same time, specific cases of reaction are possible. For example, MAOIs reduce the activity of Diazepam. While the effects of Alprazolam and Temazepam will increase.
Non-benzodiazepine sleeping pills such as Zolpidem, Zaleplon, and Eszopiclone, typically result in increased sedative effects and respiratory depression, which may exceed safe levels.
Tricyclic antidepressants (TCAs) like Doxepin and Trimipramine may cause central nervous system excitation and arterial hypertension, and carry the risk of developing acute and hazardous serotonin syndrome. It is advisable to maintain an interval of at least two weeks between the cancellation of the MAOIs and the prescription of TCAs, and at least one week between the cancellation of TCAs and the prescription of MAOIs.
Antihistamines such as Diphenhydramine and Doxylamine may mutually enhance the effect of drugs, resulting in an increased depressive effect on the central nervous system. Diphenhydramine may also increase anticholinergic activity, leading to dryness of the mucous membranes, slowing of digestion and urination processes, and increased abdominal tone with simultaneous muscle weakness. There is also the possibility of developing a severe syndrome with agitation, delirium, aggression, and coma.
Barbiturates like Butabarbital, Secobarbital, and Phenobarbital may mutually enhance the effect of drugs, leading to an increased depressive effect on the central nervous system and potentially dangerous comatose states and respiratory depression. Additionally, there may be an increase in barbiturates in the blood plasma, significantly increasing their toxic effects.
Melatonin Agonists such as Ramelteon have very little interaction data available, and there is no information about acute and severe conditions associated with such a combination. However, based on general logic, it is possible to predict an increase in sedative effects and central nervous system depression.
Orexin receptor antagonists such as Suvorexant, Lemborexant, and Daridorexant, when co-administered with MAOIs, may increase the risk of central nervous system depression and daytime impairment.
Combining MAOIs with sleeping pills may result in increased sedation, causing drowsiness, fatigue, decreased mental alertness, and decreased consciousness. Moreover, it can lead to a decrease in breathing rate, which may pose a significant risk.
Furthermore, this combination may increase the levels of certain neurotransmitters in the body, leading to various side effects, including confusion, agitation, hallucinations, and seizures.
If switching from one substance to another within these groups, it is advisable to wait at least a few weeks. It is strongly recommended to consult with a doctor before taking any of the mentioned drugs.
All things considered, we recommend avoiding this combination under any conditions.
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