What major side effect can occur with the use of MAOIs?

The use of monoamine oxidase inhibitors (MAOIs) can lead to hypertensive crisis as a significant side effect. MAOIs function by inhibiting the enzyme monoamine oxidase, which is responsible for breaking down neurotransmitters such as norepinephrine, serotonin, and dopamine. When these inhibitors are used, particularly in conjunction with foods high in tyramine (like aged cheeses, cured meats, and some alcoholic beverages), the breakdown of tyramine is hindered. Elevated levels of tyramine can lead to excessive release of norepinephrine, which in turn can cause a dramatic increase in blood pressure, resulting in a hypertensive crisis. This condition is potentially life-threatening and is characterized by symptoms such as severe headache, palpitations, and sweating.

Although the other options listed may be side effects associated with other classes of medications, they are not typical concerns for MAOIs in the same way that hypertensive crisis is. For instance, serotonin syndrome is more commonly associated with selective serotonin reuptake inhibitors (SSRIs) and other serotonergic drugs. Extrapyramidal symptoms are primarily linked to antipsychotics, particularly first-generation antipsychotics, while weight gain is frequently discussed in the context of other antidepressants