Nootropics with MAOI Properties
Several substances marketed or discussed in the context of cognitive enhancement (nootropics) possess MAOI activity, usually as one of several mechanisms of action:
- Bacopa monnieri (Brahmi): An Ayurvedic herb sometimes used to improve memory, it has been shown to have MAOI properties in some studies, alongside antioxidant effects and neurotransmitter modulation.
- Ginkgo biloba: Extracts from this plant, often used for cognitive support, have a mild MAOI effect and can interact with other antidepressants.
- Harmaline: Found in plants like Banisteriopsis caapi, harmaline is a potent, reversible inhibitor of MAO-A.
- Methylene Blue: Has some research support showing enhanced cognition and in my practice mant report enhanced cognition. These are patients on approximately 10-15 mg a day. These low doses likely are probably acting as an MAO-A inhibitor. It is not remotely as powerful as prescription antidepressants in huge numbers using high doses for reasons in a pending Bartonella textbook. After reviewing every major English research article on methylene blue causing serotonin syndrome with antidepressants, most expert psychiatrists feel the suggested dangerous fear came from overdose amounts of Prozac or Paxil that are never used. Or possibly extremely high amounts of methylene blue. Many trying to kill Bartonella that is vastly more common than Lyme disease routinely mix 300 mg of methylene blue and antidepressants. Find more in my future definitive textbook on Bartonella: THE DIAGNOSIS AND TREATMENT OF BARTONELLA.
Safety and Risks
Combining MAOIs, whether prescription medication or nootropic supplements, carries risks:
- Hypertensive Crisis: MAOIs prevent the breakdown of tyramine, an amino acid found in aged cheeses, cured meats, and certain other foods and drinks. The list of foods that pose a risk has become smaller over 37 years. Consuming these limited foods while on MAOIs can possibly lead to a sudden, dangerous spike in blood pressure, which possibly might cause a stroke.
- Serotonin Syndrome: Taking an MAOI with other agents that increase serotonin levels (such as SSRIs, SNRIs, certain over-the-counter cold medications, or even possibly some herbal supplements like St. John’s Wort) can cause a potentially fatal condition called serotonin syndrome, characterized by symptoms like confusion, rapid heart rate, and muscle rigidity. It is unwise to totally dismiss these issues, but also to act like they are common. However, we mention in our exciting DESTROY DEPRESSION: RETURN TO JOY ( 1/30/2026) that the most elite biological psychiatrists do mix MAOIs with other classes of antidepressants when other approaches fail.
- Due to these interactions and side effects, MAOIs should only be prescribed by an expert medical doctor psychiatrist who has used them previously. If you are on these prescription ones they can be profoundly effective, But you must learn about some limited huge tyramine filled foods to avoid, and some medications like Demerol–a pain medication.