Marplan, or Isocarboxazid, is a non-selective, irreversible hydrazine monoamine oxidase inhibitor (MAOI) antidepressant. It treats depression symptoms, phobias, panic, or anxiety disorders.
Due to the possible severe side effects, it is prescribed as a second or third line of treatment after other antidepressants have failed. The medication is complex to use as it also has many contraindications. To know more about this drug, continue reading!
What is Isocarboxazid?
Isocarboxazid’s brand name is Marplan, and as was mentioned above, it is in the monoamine oxidase inhibitor (MAOI) drug class. It is mainly used to treat depression, but a doctor can advise if there are other Isocarboxazid uses apart from depression treatment.
Monoamine oxidase is a natural chemical in the brain that removes monoamines (serotonin, norepinephrine, and dopamine neurotransmitters) from the brain. Low levels of these neurotransmitters are one of the mechanisms associated with the development of depression. Monoamine oxidase also wipes out tyramine, a chemical that regulates blood pressure. The Isocarboxazid’s drug class, MAOIs, inhibits monoamine oxidase — this process increases monoamine neurotransmitters in the brain. MAOI mechanism of action involves restoring brain cells’ communication and hence alleviates depression symptoms.
Since MAOI inhibits monoamine oxidase work, it is vital for a person on medication to pay attention to their blood pressure.
Isocarboxazid Dosage
Marplan is available in the form of 10 mg oral pills that are usually taken two to four times every day. The medication’s maximum prescription dose is 60 mg per day. The dosage depends on the patient’s condition and response to treatment.
The drug is taken with or without food. To avoid the risk of side effects, treatment starts with a low dose that can be increased gradually as the body adjusts to the medication.
When on Marplan treatment, follow the doctor’s guidelines. Take the medication consistently, at the same time daily, and in the prescribed dosage. If the dose is reduced, the patient may not benefit from the treatment, while an increase may cause a fatal Isocarboxazid overdose. So, do not discontinue the medication or change the dose without a doctor’s approval.
Isocarboxazid Interactions
Marplan should not be prescribed concurrently with or right after:
- Other dibenzazepine-related entities and other MAOI inhibitors
The interaction may cause severe convulsions, seizures, circulatory collapse, or coma. At least a week’s break should elapse before a patient is switched to Marplan from another MAOI inhibitor or a dibenzazepine-related entity.
Marplan combination with SSRIs may cause fatal reactions like mental status changes, rapid fluctuations of vital signs, and hyperthermia, among other severe reactions, causing serotonin syndrome.
- Bupropion
Marplan and Bupropion are contraindicated if administered together. At least two weeks should elapse after MAOI therapy before initiating Bupropion Hydrochloride treatment.
- Buspirone
An interaction of Marplan and Buspirone may cause severe side effects such as elevated blood pressure. There should be a ten-day break after the Marplan therapy before using Buspirone.
- Sympathomimetics
Marplan should not be used with medication that contains vasoconstrictors, sympathomimetics, or amphetamines. The interaction of MAOI and tryptophan may cause delirium, agitation, amnesia, and ataxia, among other neurological and behavioral symptoms.
- Meperidine
Meperidine should not be used concurrently with MAOI or within two or three weeks after MAOI treatment. Interaction of the two medications may cause severe side effects like hypertension, convulsion, coma, peripheral vascular collapse, and, in extreme cases, death.
- Dextromethorphan
A combination of MAOI and dextromethorphan may cause psychosis or weird behavior.
- Anesthetic agents
A patient on Marplan treatment should not undergo a discretionary surgery that requires general anesthesia. While on medication, avoid local anesthesia that contains sympathomimetic vasoconstrictors. Discontinue the antidepressant ten days before the elective surgery.
To avoid severe reactions, Isocarboxazid should not be taken with CNS depressants, antihypertensives, excessive caffeine, and foods that require aging (cheese or consumables with a high content level of tyramine).
*It is not a full list of all the possible interactions. Consult your doctor or pharmacist to know more and choose the most appropriate medication.
Isocarboxazid Side Effects
Marplan side effects include:
- Constipation
- Dizziness
- Drowsiness
- Dry mouth
- Headache
- Nausea
- Sleep issues
- Weakness
- Sexual problems
Consult a health practitioner if the side effects persist and are a bother.
Isocarboxazid Warnings
Warnings about Isocarboxazid include:
- Marplan should not be used by minors. It may cause suicidal thoughts and attempts among teens and adolescents. The antidepressant may increase suicidal thoughts or attempts in teens and young adults in the first few months of treatment.
- Marplan should not be used to treat bipolar depression as it intensifies suicide ideations.
- Isocarboxazid should not be prescribed for someone with:
- Cerebrovascular disorders
- Renal impairment
- Brain disorders, blood, blood vessels, or heart conditions
- Liver disease
- Recurrent headaches
- Pheochromocytoma
- Allergy or hypersensitivity to Marplan
Conclusion
Marplan is an effective psychiatric medication. However, it is not the first line of treatment due to its side effects. If the doctor prescribes Isocarboxazid for a mental disorder, it is vital to follow all the instructions as specified. A person should consult a health practitioner the moment they experience severe reactions.
