MONOAMINE OXIDASE INHIBITORS AND ANAESTHESIA

Abstract
There has been a recent renewal of interest in the use of monoamine oxidase inhibitors in psychiatry. The concurrent administration of anaesthetic agents, particularly narcotic analgesics, is often a cause for concern. Although many monoamine oxidase inhibitor–drug interactions have been reported, in practice it is only the interaction with pethidine which has led to fatalities. What is not appreciated is that the monoamine oxidase inhibitor–pethidine interaction has two distinct forms—“excitatory” and “depressive”. It is this lack of appreciation that has led to much confusion when dealing with patients taking monoamine oxidase inhibitors.