Three older antidepressants — Parnate, Nardil and Marplan — are among the most effective options for depression that has resisted other treatments. Their regulatory status and practical availability vary sharply between countries. This international view covers the United Kingdom, Australia, Canada, the United States and the Netherlands, with France, Belgium and Switzerland retained for comparison.
An MAOI (monoamine oxidase inhibitor) is a medicine that blocks an enzyme in the brain — monoamine oxidase — which breaks down certain chemical messengers involved in mood (serotonin, noradrenaline and dopamine). Blocking it makes these messengers more available, which can help improve mood. The three medicines below are the “classic” MAOIs: the oldest, the strongest and the most demanding to use.
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Authorised or routinely marketed Supervised special access Not marketed · supervised import may be possible
Country-status sources
Checked on 30 August 2026. A regulatory listing or current prescribing document does not guarantee immediate pharmacy stock, insurance coverage or reimbursement; a pharmacist should confirm these separately.
Marketing authorisation — Official permission to sell a medicine in a country. Without it, the medicine is not routinely on the shelf.
Compassionate access (AAC) — In France, an exceptional framework for certain medicines without marketing authorisation for the indication concerned. It does not automatically apply to every unmarketed medicine: the prescriber and hospital pharmacy must check which ANSM pathway is open.
Importation — Obtaining a medicine available in another country (for example Germany or the United Kingdom) through an authorised pharmaceutical channel. Patients should not organise this themselves: the conditions and reimbursement vary by country.
Articles 71a–71d (Switzerland) — Provisions of the Swiss Health Insurance Ordinance (OAMal) that may allow reimbursement for a medicine not registered in Switzerland or imported from abroad. It is not automatic: the insurer decides case by case, after advice from its medical officer, and only for a serious illness with no authorised alternative.
DIN (Canada) — A Drug Identification Number assigned by Health Canada to a product authorised for sale. It is the Canadian equivalent of a European marketing authorisation and applies federally: a medicine with a marketed DIN has the same federal status in every province, including Quebec.
RAMQ (Quebec) — The Régie de l’assurance maladie du Québec manages the public drug insurance plan. Authorisation for sale is federal (the same throughout Canada); reimbursement is determined through the provincial list.
ARTG (Australia) — The Australian Register of Therapeutic Goods. An active medicine entry indicates regulatory inclusion, but not necessarily that every pharmacy has stock.
Special Access Scheme (Australia) — A clinician-led TGA pathway that may allow an individual patient to receive an unapproved therapeutic good. It is not a routine retail route.
Treatment-resistant depression — Depression that has not responded sufficiently to several adequately delivered antidepressant treatments.
This website provides general information and cannot replace advice from a physician or pharmacist. Do not make any treatment decision without a healthcare professional. MAOIs involve real precautions — dietary and, above all, drug-interaction precautions — which are detailed on the relevant pages.