Psychiatric Technician Practice Exam

How long should one wait to switch from a monoamine oxidase inhibitor to another antidepressant to avoid serious reactions?

1. One week

2. Two weeks

3. Three days

4. Ten days

The correct answer is: Two weeks

When transitioning from a monoamine oxidase inhibitor (MAOI) to another antidepressant, it is crucial to allow an appropriate washout period to prevent the risk of serious reactions, particularly hypertensive crises. The mechanism behind this is that MAOIs inhibit the enzyme responsible for breaking down monoamines, leading to increased levels of neurotransmitters such as norepinephrine. If another antidepressant is introduced before allowing sufficient time for the MAOI's effects to diminish, there can be dangerous interactions. The recommended waiting period is typically at least two weeks after discontinuing an MAOI before starting a different antidepressant. This duration helps ensure that the MAOI is adequately cleared from the system and reduces the likelihood of adverse reactions due to the cumulative effects of both the MAOI and the new antidepressant acting on the same neurotransmitter pathways. In clinical practice, adhering to this guideline is important for patient safety, particularly given the severity of potential drug interactions when MAOIs are involved.