MAOIs Antidiabetics

Most antihistamines possess anticholinergic properties that by themselves are of minor intensity but may increase considerably if given together with MAOIs. Interactions of MAOIs with antihypertensives (e.g., reserpine-type drugs) and oral antidiabetic drugs, as well as insulin and L-dopa, have all been encountered. It can be seen why MAO inhibitors are not viewed today as initial therapy except possibly in atypical depression. Certain panic and phobic reactions respond well. An important indication would be in case of therapeutic failures with the tricyclic or other heterocyclic antidepressants. 

The blood glucose-lowering effects of insulin and the oral antidiabetics can be increased by MAOIs. This may improve the control of blood glucose levels in most diabetics, but in a few it may cause undesirable hypoglycaemia. Moclobemide appears not to interact. 

The interaction of the non-selective MAOIs is an established interaction of only moderate clinical importance. It can benefit the control of diabetes in many patients, but some individuals may need a reduction in the dose of their antidiabetic to avoid excessive hypoglycaemia. The effects of concurrent use should be monitored. This interaction would seem possible with any antidiabetic/MAOI combination, but this requires confirmation. 

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