A treatment for depression: Are you aware of Isocarboxazid pills?

Do you sometimes feel very sad, anxious, or just plain bored with life? In medicine, we call this condition ``Depression``. So, doctors prescribe certain medications to help us in times like these. For example, a special medication used to treat a condition called depression is ``Isocarboxazid``. ``Marplan`` is another brand name for this medication.

What kind of medicine is `Isocarboxazid`?

Simply put, `Isocarboxazid` is a medicine that helps reduce your sadness, anxiety and improve your mood. Our brains contain chemical messengers called `Dopamine`, `Norepinephrine` and `Serotonin`. These are the chemicals that help control our feelings of happiness and sadness. `Isocarboxazid` works by increasing the levels of these chemicals in the brain.

This medicine belongs to the group of medicines called `MAOI`. `MAOI` stands for `Monoamine Oxidase Inhibitors`. This enzyme (`Monoamine Oxidase`) breaks down the chemicals mentioned earlier like `Dopamine`, `Norepinephrine`, `Serotonin` in our body. So, because `MAOI` medicine stops the activity of that enzyme, those good chemicals stay in the brain for a longer time. That is what helps reduce depression. But doctors can also prescribe this medicine for other diseases. So if you have any questions, ask your doctor or pharmacist.

Things you need to tell your doctor before starting this medication

Before you start taking `Isocarboxazid`, there are a few things you should definitely tell your doctor. Because this medicine is not suitable for everyone. Therefore, you should tell your doctor about these things very honestly.

• Do you have the eye disease `Glaucoma`?
• Do you get frequent headaches or migraines?
• Do you have heart disease?
• Do you have high blood pressure?
• Have you had an irregular heartbeat before?
• Have you had a previous stroke?
• Are you a regular drinker?
• Do you have kidney disease?
• Do you have liver disease?
• Are there any other mental illnesses?
• Is there a cancerous condition of the adrenal gland called `Pheochromocytoma`?
• Have you recently had a head injury (head trauma)?
• Are there any seizures?
• Have you had suicidal thoughts, plans, or attempted suicide before? Has anyone in your family done so?
• Do you have an allergic reaction to the medicine `Isocarboxazid`, other medicines, foods, dyes, or preservatives?
• Are you pregnant or trying to get pregnant?
• Are you a breastfeeding mother?

If any of these apply to you, it is very important to inform your doctor about it.

How should I use this medicine?

This medicine comes in the form of tablets. It should be taken by mouth with a glass of water. It is best to take it as prescribed by your doctor, at the same time every day. Continue to take this medicine until your doctor tells you to stop.

When the pharmacy gives you this medicine, it also gives you a special instruction leaflet (a `MedGuide`). You should read this `MedGuide` carefully every time you take the medicine and when you change the medicine bottle. It contains very important information about this medicine.

Remember: This medicine is for you only. Do not share your medicine with others, even if they have the same symptoms as you.

If you are giving this medicine to young children, special care should be taken. Therefore, talk to your doctor about it and get advice.

If you think you have accidentally taken too much of this medicine, go to the nearest hospital emergency department immediately, or call a poison control center, without delay.

What to do if you miss a dose of medication?

If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at once. Doing so may increase the dose.

Other things that may interact with this medicine (interactions)

This is something to be very careful about . The drug `Isocarboxazid` can interact very badly with some foods and other medications. This can cause dangerous side effects.

Avoid foods containing `Tyramine`!

It is not a good idea to eat foods high in the chemical tyramine while taking `Isocarboxazid`. If these two are combined, life-threatening conditions such as a sudden severe headache, a high blood pressure (`Hypertensive crisis`), or an irregular heartbeat can occur.

What foods are high in `Tyramine`?

• Aged cheeses
• Processed meats - things like sausages, salami, pepperoni
• Beer and ale (even non-alcoholic beer)
• Wine (especially red wine), sherry
• Hard liquor, Liqueurs
• Avocados
• Bananas (especially well-ripened ones)
• Figs, Raisins
• Soy sauce, Miso soup
• Yeast/protein extracts
• Tofu (Bean curd)
• Fava or broad bean pods
• Any over-ripe fruit

This list is not complete, so ask your doctor, pharmacist, or nutritionist for a complete list of foods that contain tyramine.

Also, it is a good idea to limit beverages containing caffeine (such as tea, coffee, chocolate, and cola) while taking this medication.

Ask your doctor how long you should avoid these foods and drinks after stopping this medication.

Medicines that should never be taken with this medicine

The following medications can cause very serious reactions if taken together with `Isocarboxazid`. Therefore, if you are currently taking these medications, you should tell your doctor.

• Atomoxetine
• `Buspirone`
• `Carbamazepine`
• Some high blood pressure medications: `Guanabenz`, `Guanadrel`, `Guanethidine`, `Reserpine`
• `Cocaine`
• `Cyclobenzaprine`
• Dextromethorphan (contains some cough syrups)
• Weight loss drugs or stimulants: Amphetamines, Ephedra
• `Diphenoxylate`
• `Ephedrine`
• General or local anesthetics (if you are taking these medications before surgery, you should tell your doctor )
• `Ginseng`
• Green tea (overconsumption)
• `Guarana`
• Linezolid (an antibiotic)
• Other types of `MAOI`: `Phenelzine` (phenelzine), `Rasagiline` (rasagiline), `Safinamide` (safinamide), `Selegiline` (selegiline), `Tranylcypromine` (tranylcypromine)
• Medications for migraine headaches
• Medicines for movement disorders such as Parkinson's disease: `Entacapone`, `Levodopa`, `Selegiline`, `Tolcapone`
• Meperidine (painkiller)
• `Methylene blue`
• Medications for other depression, anxiety, or mood problems
• Prescription pain medications
• `Procarbazine`
• `SAM-e`
• `St. John's Wort` (an herbal remedy that some people take for mental well-being)
• `Tramadol` (painkiller)
• `Tryptophan`
• Tyramine (found in foods and may also be found in some supplements)
• `Viloxazine`
• `Yohimbine`

Other medications that may interact with this medicine

The following medications may also interact with `Isocarboxazid`. Therefore, if you are taking these, tell your doctor about them as well.

• Barbiturates (e.g. Phenobarbital)
• Diuretics
• Isoniazid (a medicine for tuberculosis)
• Medicines for symptoms such as colds, allergies, and flu
• Medications for diabetes
• Medicines in the `Phenothiazines` group (e.g. `Chlorpromazine`, `Prochlorperazine`, `Thioridazine`)

This list is not complete. So tell your doctor about all the medicines you take (prescribed, over-the-counter, herbal, vitamin, nutritional supplements). Also tell your doctor if you smoke, drink alcohol, or use other drugs. Some things can interact with this medicine.

Other things to be careful about when taking this medicine

• If your symptoms do not improve or seem to get worse, tell your doctor right away. Keep in touch with your doctor to see how the medicine is working. It may take several weeks for this medicine to take full effect. Therefore, it is important to continue taking the treatment as your doctor tells you.
• Suicidal thoughts or worsening depression: This is very important . While taking this medicine, especially at the beginning of treatment or after changing the dose, watch your mind carefully for new suicidal thoughts or worsening depression. Also, if you have any sudden changes in your mood, such as feeling anxious, restless, irritable, hostile, aggressive, stubborn, very restless, overly agitated and hyperactive, or having trouble sleeping, call your doctor right away. Tell your family and ask them to watch for these changes too.
• You may feel sleepy or dizzy. So, until you know how this medicine affects you, do not drive, operate machinery, or do anything that requires concentration. Do not get up or sit down too quickly, especially if you are elderly. Doing so will reduce the chance of dizziness and falling.
• Alcohol can interfere with the effectiveness of this medicine, so avoid drinking alcohol.
• This medicine may cause dry eyes and blurred vision. If you wear contact lenses, you may experience some discomfort. Lubricating eye drops may help. If this problem persists or is severe, see an eye doctor.
• Dry mouth can be a problem. Chewing sugar-free gum, sucking on sugar-free hard candy, and drinking plenty of water can help. If this problem persists or becomes severe, talk to your doctor.
• Consult your doctor before taking any self-medication for things like coughs, colds, and allergies. Also, do not take any weight loss medication without your doctor's approval. The ingredients in some of these products may increase side effects.
• This medicine may affect blood sugar levels. If you have diabetes, talk to your doctor before changing your diet or the dose of your diabetes medicine.
• If you are going to have any surgery, medical test, or procedure, tell your doctor that you are taking this medicine. This medicine usually needs to be stopped about 10 days before an elective surgery.
• This medication can cause low vitamin B6 levels. So make sure you are getting enough vitamin B6 while taking this medication. Talk to your doctor about the foods and vitamins you are taking.

What are the possible side effects of this medicine?

Like all medications, Isocarboxazid can cause side effects in some people. Some are serious, some are not so serious.

Side effects that you should tell your doctor immediately:

If you experience any of these symptoms, tell your doctor without delay :

• Allergic reactions : Skin rash, itching, red spots on the skin, swelling of the face, lips, tongue or throat.
• Serotonin Syndrome Symptoms : Irritability, confusion, fast or irregular heartbeat, muscle stiffness or twitching, excessive sweating, high fever, seizures, chills, vomiting, diarrhea. These can be symptoms of a dangerous condition called Serotonin Syndrome, because this medicine increases the level of serotonin in the brain.
• Symptoms of liver injury : Pain in the upper right abdomen, loss of appetite, nausea, light-colored stools, dark yellow or brown urine, yellowing of the skin or eyes, unusual weakness or fatigue.
• Low blood pressure : Dizziness, fainting, blurred vision.
• Seizures .
• Severe increase in blood pressure : Sudden onset of severe headache, nausea, vomiting, neck stiffness, rapid or irregular heartbeat (this may be a sign of a `Tyramine` reaction).
• Thoughts of suicide or harming yourself, worsening mood, and increased depression .

Side effects that are usually not very dangerous, but should be reported to the doctor if they persist:

These side effects are usually not serious, but if they persist or bother you, tell your doctor:

• Constipation
• Dizziness
• Dry mouth
• Headache
• Nausea
• Tremors

If you notice any unusual or new symptoms while taking this medicine that are not listed, tell your doctor. You can also report side effects to the FDA at 1-800-FDA-1088.

How do you store this medicine?

• Keep this medicine out of the reach of children and pets .
• Store at room temperature (between 15 and 30 degrees Celsius / 59 and 86 degrees Fahrenheit). Keep the medicine bottle/packet tightly closed .
• Do not use expired medications. Throw them away.

How to dispose of unused or expired medicine:

• There are medication take-back programs. You can find out about them at your pharmacy or the police.
• If that's not possible, check the medicine label or the leaflet inside to see if it should be thrown in the trash or flushed down the toilet. If you're not sure, ask your doctor.
• If it is safe to throw in the trash, take the medicine out of the container. Mix it with something else, such as cat litter, soil, or coffee grounds. Put the mixture in a bag or container, seal it well, and throw it in the trash.

Finally, things to remember

`Isocarboxazid` is a very important drug for treating depression. However, because it belongs to the `MAOI` class, it can cause serious interactions with food (especially foods containing `Tyramine`) and other medications.

While you are taking this medicine, be very careful about changes in your mood, especially thoughts of suicide. If you have any problems, tell your doctor right away. Take the right dose, at the right time, exactly as your doctor tells you. Only then can you get the most out of this medicine and improve your mental health.

This article is only a summary. If you have any further questions about this medicine, please talk to your doctor, pharmacist, or other healthcare provider.

` Isocarboxazid, MAOI, depression, mental health, dopamine, serotonin, tyramine, side effects, drug interactions