Sat27November0445PM 9

A prescription for which of these antidepressant drugs carries the strictest dietary restrictions?

(Please select 1 option)

Escitalopram

Citalopram

Tranylcypromine This is the correct answer

Moclobemide Incorrect answer selected

Amitriptyline

Explanation

Tranylcypromine is a monoamine oxidase inhibitor (MAOI) that is non-selective and non-reversible.

There is a very real hazard of hypertensive crisis with potentiation of amines in the diet (for example, tyramine). Monoamine oxidase inhibitors prevent the 'physiological blood-brain barrier' and the liver from deaminating monoamine neurotransmitters to achieve their effect. If the enzyme is inactivated, dietary monoamines such as tyramine can displace noradrenaline from synaptic vesicles to precipitate a hypertensive crisis.

Amitriptyline is a tricyclic antidepressant and is incorrect.

Citalopram and Escitalopram are incorrect as they are selective serotonin reuptake inhibitors (SSRI). Escitalopram is one isomer of citalopram.

Whilst moclobemide is a MAOI, it is selective for MAO type A and also reversible. Fewer dietary restrictions are necessary than with unselective MAOIs such as tranylcypromine.

Answer Statistics

1

2%

2

2%

3

39%

4

48%

5

11%

Times answered: 246