What is a side effect closely associated with historical use of MAOIs?

High blood pressure is a significant side effect closely associated with the historical use of Monoamine Oxidase Inhibitors (MAOIs). MAOIs can interact with tyramine, a compound found in certain foods like aged cheeses and cured meats. When tyramine levels rise due to the consumption of these foods in conjunction with MAOIs, it can lead to a hypertensive crisis, characterized by a dangerous increase in blood pressure. This potential for severe hypertensive responses is one of the critical concerns for patients taking MAOIs and is well-documented in the history of their use.

In contrast, weight loss is not typically a direct concern associated with MAOIs, as they do not primarily have appetite-suppressing effects. While there might be anecdotal cases of weight loss, especially related to improved mood and activity levels in some patients, it isn't a standard or recognized side effect. Enhanced wakefulness is also not a hallmark of MAOIs. Some patients might experience fatigue rather than increased wakefulness. Lastly, while there is a risk with alcohol for those taking various psychotropic medications, the specific overdose risk with alcohol is not the defining historical concern of MAOIs. Rather, the critical interaction leading to hypertension sets the precedent and underscores