Interactions have been reported when combining pharmacologic doses 1—6 gm of l -tryptophan with tranylcypromine. Dietary consideration in MAO inhibitor regimens. However, nowadays, young cheeses weeks old are delivered to retail by many producers for economic reasons. Also, as long as your medication doesn’t keep you from sleeping, you can reduce the impact of nausea by taking it at bedtime. When taking an antidepressant, tell your doctor about any other prescription or over-the-counter medications, herbs or other supplements you’re taking. Dietary restriction, tyramine, and the use of monoamine oxidase inhibitors. Anderson, I. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. The improved starter cultures, now widely used, show a lack of, or much diminished, amino acid decarboxylase activity which results in lower concentrations of BAs [40, ].
This trend has also been driven by concern about food and drug interactions and side effects, as well as waning physician experience with these medications. Many psychiatrists, in fact, never prescribe MAOIs. Recent research has liberalized the MAOI diet and identified symptom presentations more likely to respond to these medications. The nonselective monoamine oxidase inhibitors MAOIs currently available in the United States include phenelzine Nardil, isocarboxazid Marplan, and tranylcypromine Parnate. These medications are irreversible inhibitors of the enzyme monoamine oxidase MAO. Reversible inhibitors of MAO have been well studied in the treatment of depression, but are not currently available in the United States. With the continuing increase in the number of available antidepressants, the use of MAOIs relative to other antidepressant medications has declined. When they are prescribed, MAOIs are often given at inadequate doses. The antidepressant effects of MAO inhibition were discovered serendipitously when patients with tuberculosis were treated with iproniazid. Inhibition of MAO A, which most specifically catabolizes serotonin, norepinephrine, and tyramine, is thought to be most directly linked with the antidepressant activity of MAOIs.
This comprehensive monograph surveys original data on the subject of both dietary tyramine and drug interactions relevant to Monoamine Oxidase Inhibitors MAOIs, about which there is much outdated, incorrect, and incomplete information in the medical literature and elsewhere. Many of the drug interactions previously supposed to be serious are either non-existent or non-serious. Very few foods now contain problematically high tyramine levels, that is a result of great changes in international food production methods and hygiene regulations. Cheese is the only food that, in the past, has been associated with documented fatalities resulting from acute tyramine-induced hypertension. The few interactions between MAOIs and other drugs are now well understood and are quite straightforward to avoid and deal with. They are detailed and discussed here by a recognised expert. MAOIs have no clinically relevant pharmaco-kinetic interactions. That is now well defined and is straightforward to avoid by not co-administering any drug with serotonin re-uptake inhibitor SRI potency. Anaesthesia is not difficult or contra-indicated if a patient is taking MAOIs. MAOIs are safe and straightforward to use, quite contrary to current popular opinion.