Monoamine oxidase inhibitors (MAOIs)
Alongside tricyclics, MAOIs were a major class of early antidepressants. Brain scientists in the mid 1960s hypothesised that iproniazid, an anti-tuberculosis drug which accidentally became the first antidepressant, slowed an enzyme (monoamine oxidase) that breaks down the neurotransmitter serotonin. Slowing the enzyme increased the amount of serotonin circulating in the depressed patient’s nervous system, counteracting depression. The hypothesis led to MAOIs, which targeted the same enzyme.
MAOIs were never widespread. They had dangerous side effects such as high blood pressure, and adverse or even life-threatening reactions sometimes resulted from foods MAOI patients ate. These included cheese, liver, certain beans, beer and red wine. In The Silence of the Lambs, fictional psychiatrist and murderer Hannibal Lecter remarked he ate the liver of a former patient ‘with some fava beans and a nice Chianti’. He may have been alluding to three foods considered off limits to MAOI patients.
BibliographyD Healy, The Anti-Depressant Era (Harvard University Press, 1997)
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