Perinatal EvidenceCompass
Prepopulated workbenchMED-040

Antidepressants — MAOI

Isocarboxazid

Monoamine oxidase inhibitor antidepressant

Not a categorical safety rating

This record organizes questions; it does not close them.

The clinical fields and position statements are prepopulated from the public-source corpus. They have not completed individual dual extraction, formal appraisal, exact-label reconciliation, or multidisciplinary sign-off. Do not use this page to justify abrupt discontinuation or reflexive switching.

Inventory identity

What this record represents

Canonical generic name
Isocarboxazid
Entity type
single-ingredient drug
Active component(s)
Isocarboxazid
Formulation / route / interval
Oral; formulation varies
Attachment entry
Isocarboxazid
Separate monograph status
No — cross-reference shared molecule monograph
Identity and cross-reference
Not populated in v0.95
Inventory verification confidence
Moderate — molecule-level source; exact product/jurisdiction pending

Decision taxonomy

Five positions kept separate

These are workbench statements for reviewer execution. They are not independently commissioned, patient-specific recommendations.

  1. 01

    Stable continuation

    Workbench statement

    Do not withhold or discontinue solely because of pregnancy or lactation. For this record, assess indication, prior response, relapse severity, dose/formulation, alternatives, exposure timing, and mapped evidence; individual commissioned adjudication remains pending.

  2. 02

    New initiation in pregnancy

    Workbench statement

    For a new start, prefer an effective option with the strongest diagnosis-specific efficacy and reproductive evidence when clinically suitable. This record has not received an individual, independently verified initiation ranking.

  3. 03

    Switch before conception

    Workbench statement

    Before conception, consider a switch only when expected benefit exceeds relapse, withdrawal, failed-switch, and dual-exposure risks. Build and monitor the plan before pregnancy when feasible; no universal switch direction is assigned here.

  4. 04

    Unplanned exposure

    Workbench statement

    After unplanned exposure, confirm product, route, dose, timing, indication, co-exposures, and symptoms; do not advise abrupt cessation. Use the mapped evidence and current label to decide whether any targeted fetal assessment is indicated.

  5. 05

    Delivery, postpartum & lactation

    Workbench statement

    Create separate delivery, postpartum-dose, neonatal-observation, and lactation plans. Do not infer breastfeeding suitability from pregnancy evidence or routinely taper before delivery without drug-specific support.

Linked evidence

4 mapped claim summaries

Mapping can include class-wide, framework, formulation, regulatory, or evidence-gap claims. A linked claim is not necessarily a drug-specific causal estimate.

A-001Provisional public source

ACOG recommends against withholding or discontinuing a psychiatric medication solely because of pregnancy or lactation.

Public-source certainty descriptor
guideline recommendation; not a formal GRADE rating in this module
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
preconception through lactation
Comparator
continuation versus withholding/discontinuation
Effect or numbers carried forward

No reliable quantitative estimate.

Limitations

Requires individualized benefit-risk assessment and does not mean every medicine should continue.

Sources, citation controls, and verification state
PMID
37486661
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending
A-003Provisional public source

In a selected prospective cohort of pregnant patients with recurrent major depression, discontinuation was associated with more relapse than maintenance.

Public-source certainty descriptor
moderate for a high-recurrence population; limited generalizability; not GRADE
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
pregnancy
Comparator
antidepressant discontinuation versus maintenance
Effect or numbers carried forward

Relapse 68% among 65 discontinuers versus 26% among 82 maintainers.

Limitations

Selected cohort enriched for recurrent illness; nonrandomized treatment decision; not applicable to every patient or drug.

Sources, citation controls, and verification state

Linked sources

PMID
16449615
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending
A-019Evidence gap

MAOIs lack robust human pregnancy and lactation cohorts; hypertensive, serotonergic, food, drug, and anesthesia interactions dominate clinical planning.

Public-source certainty descriptor
insufficient reproductive evidence; high interaction certainty; not GRADE
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
pregnancy, delivery, and lactation
Comparator
no adequate comparator cohort
Effect or numbers carried forward

No reliable quantitative estimate.

Limitations

Sparse reporting and strong selection; oral/transdermal selegiline and moclobemide are not interchangeable with irreversible MAOIs.

Sources, citation controls, and verification state

Linked sources

PMID
Not populated in v0.95
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending
A-067Provisional public source

FDA prescription labeling uses narrative Pregnancy and Lactation Labeling Rule sections rather than the former A/B/C/D/X letter categories.

Public-source certainty descriptor
high for US regulatory framework
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
pregnancy and lactation
Comparator
not applicable
Effect or numbers carried forward

No reliable quantitative estimate.

Limitations

Exact labeling and revision date remain product-specific; non-US systems differ.

Sources, citation controls, and verification state

Linked sources

PMID
Not populated in v0.95
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending