Observation and patient disposition after MAOI poisoning

Admit patients with serotonergic toxidrome due to a monoamine oxidase inhibitor (MAOI) ingestion to a critical care unit.

If patients have ingested more than 1 mg/kg of a MAOI, or co-ingested a MAOI with a serotonergic or adrenergic drug, admit them for at least 24 hours of observation.

If patients have ingested less than 1 mg/kg of a MAOI and have not co-ingested a serotonergic or adrenergic drug, discharge them if they remain asymptomatic for at least 12 hours after ingestion.

If a patient has experienced a tyramine reaction, observe them for at least 4 hours after their symptoms have resolved. To prevent the interaction between MAOIs and tyramine-containing foods, advise patients to follow a tyramine-free diet for 2 weeks after symptoms resolve.

Sedative drugs can continue to cause significant cognitive impairment for several days following exposure. Advise patients not to drive or operate machinery for at least 3 days after discharge.