What is the main side effect concern for patients taking MAOIs?

The main side effect concern for patients taking monoamine oxidase inhibitors (MAOIs) is hypertensive crisis. MAOIs can lead to dangerous increases in blood pressure when patients consume tyramine-rich foods (such as aged cheeses, cured meats, and fermented products) or certain medications. This is due to the inhibition of the monoamine oxidase enzyme, which normally breaks down tyramine. When tyramine levels rise significantly, it can cause a rapid release of norepinephrine, leading to a hypertensive crisis characterized by severe headaches, elevated blood pressure, and potentially life-threatening complications such as stroke.

While other side effects such as dry mouth, weight gain, and urinary retention can occur with the use of various medications, they are not the primary concern with MAOIs. The risk of hypertensive crisis necessitates careful dietary restrictions and management while on these medications, highlighting its significance as the main side effect concern.