Question:
MAO inhibitors should not be used with:
MAO inhibitors should not be used with:
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Which opioid also blocks serotonin reuptake?
Updated On: Jun 24, 2026
- Pethidine
- Pentazocine
- Buprenorphine
- Morphine
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The Correct Option is A
Solution and Explanation
Step 1: Monoamine oxidase inhibitors (MAOIs) block the breakdown of serotonin and catecholamines, raising their levels in the brain and at nerve endings.
Step 2: Pethidine (meperidine) is unique among opioids because it inhibits neuronal serotonin reuptake. Combined with an MAOI, serotonin accumulates dangerously.
Step 3: The result is a serious, sometimes fatal reaction with two patterns: an excitatory pattern (serotonin syndrome with hyperthermia, rigidity, agitation, seizures) and a depressive pattern (respiratory depression and coma). This is the classic taught interaction.
Step 4: Morphine and buprenorphine do not block serotonin reuptake, so they are far safer with MAOIs. Pentazocine has weaker serotonergic potential than pethidine and is a lesser concern, which is why the recall key lists A as the best answer over B.
Conclusion: The contraindicated combination is MAOI with pethidine, option A.
Step 2: Pethidine (meperidine) is unique among opioids because it inhibits neuronal serotonin reuptake. Combined with an MAOI, serotonin accumulates dangerously.
Step 3: The result is a serious, sometimes fatal reaction with two patterns: an excitatory pattern (serotonin syndrome with hyperthermia, rigidity, agitation, seizures) and a depressive pattern (respiratory depression and coma). This is the classic taught interaction.
Step 4: Morphine and buprenorphine do not block serotonin reuptake, so they are far safer with MAOIs. Pentazocine has weaker serotonergic potential than pethidine and is a lesser concern, which is why the recall key lists A as the best answer over B.
Conclusion: The contraindicated combination is MAOI with pethidine, option A.
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