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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Ontology: Isocarboxazid (C0022154)

Definition (NCI) A hydralazine and monoamine oxidase (MAO) inhibitor with antidepressant activity. Isocarboxazid blocks the breakdown (oxidative deamination) of biogenic amines by inhibiting MAO, thereby increasing the concentrations of norepinephrine and 5-hydroxytrytamine (5-HT) at central aminergic receptors. These neurotransmitters are involved in sustaining mood and emotions. The down-regulation of central beta-adrenergic and serotonergic receptors by chronic inhibition of MAO may also contribute to the antidepressant effects seen by isocarboxazid. (NCI05)
Definition (MSH) An MAO inhibitor that is effective in the treatment of major depression, dysthymic disorder, and atypical depression. It also is useful in the treatment of panic disorder and the phobic disorders. (From AMA, Drug Evaluations Annual, 1994, p311)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D007520
SnomedCT 29877002, 387161000
LNC LP18146-8, MTHU003467
English Isocarboxazid, 3-Isoxazolecarboxylic acid, 5-methyl-, 2-(phenylmethyl)hydrazide, 3-Isoxazolecarboxylic Acid, 5-methyl-, 2-(phenylmethyl)hydrazide, Ro 5-0831, isocarboxazid (medication), isocarboxazid, Isocarboxazid [Chemical/Ingredient], ISOCARBOXAZID, MAOI - Isocarboxazid, Isocarboxazid (product), Isocarboxazid (substance)
Swedish Isokarboxazid
Czech isokarboxazid
Finnish Isokarboksatsidi
Russian IZOKARBOKSAZID, ИЗОКАРБОКСАЗИД
Spanish isocarboxazida (producto), isocarboxacida, isocarboxacida (producto), isocarboxacida (sustancia), isocarboxazida (sustancia), isocarboxazida, Isocarboxazida
Polish Izokarboksazyd
French Isocarboxazide
German Isocarboxazid
Italian Isocarbossazide
Portuguese Isocarboxazida