written by: Dr. Kristie Leong
• edited by: Donna Cosmato
• updated: 10/12/2010
Certain foods don't interact well with medications called monoamine oxidase inhibitors that are used to treat depression. Find out what foods to avoid with MAOIs. It could save your life.
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Foods to Avoid with MAOIs
Medications can interact with one another and even with certain foods. This is especially true of people who take a class of medications called monoamine oxidase inhibitors, commonly known as MAO inhibitors. These medications are used to treat depression that doesn’t respond to other antidepressants – especially atypical depression. It’s important to know how to eat when taking this class of medications. What are foods to avoid with MAOIs?
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How Do MAO Inhibitors Work?
To understand what foods to avoid with MAOIs, it’s important to know how these medications work. MAO inhibitors block an enzyme called monoamine oxidase. Since this enzyme is important for breaking down certain neurotransmitters, or brain messengers, MAO inhibitors cause the level of some neurotransmitters to rise - including serotonin, norepinephrine, and epinephrine. All of these neurotransmitters play a role in mood.
Monoamine oxidase also breaks down a chemical called tyramine, which is found in some foods. When a person takes an MAO inhibitor, the tyramine in foods can’t be broken down – and, instead, accumulates. When it does, it causes large elevations in blood pressure, called a hypertensive crisis, and, potentially, can lead to a heart attack or stroke. This is why it’s important to know what foods to avoid with MAO. Eating the wrong foods could be fatal.
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Foods to Avoid with MAO Inhibitors
As noted, it’s important to avoid eating foods that contain tyramine while taking MAO inhibitors since this could lead to a hypertensive crisis. Fermented foods that contain large amounts of tyramine include such foods as aged cheeses, frozen yogurt, sour cream, fermented meats, liver, pickled meat, sauerkraut, yeast extract, fava beans, dried fruits, tofu, overripe fruit, and game meats. These items should be completely avoided when taking MAO inhibitors.
It’s also important to avoid red wine, beer, brandy, ale, liquers, sherry, and cognac; and limit caffeinated beverages and chocolate when taking MAO inhibitors. This isn’t an exhaustive list, so it’s important to talk to your doctor about what foods you can and can’t eat on MAO inhibitors to prevent elevations in blood pressure. Certain medications such as decongestants, pain killers, cough medications, diet pills, and other antidepressants should also not be used with MAO inhibitors. Mixing MAOIs with tyramine-containing foods or certain medications can have life-threatening consequences.
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Foods to Avoid with MAO: The Bottom Line?
It’s important to know what foods to avoid with MAO inhibitors, because tyramine alters brain neurotransmitter levels. These “brain messengers” have powerful effects both physically and mentally. If you eat tyramine-containing foods in significant quantities, it not only causes blood pressure levels to rise, but it can lead to mental changes such as psychosis. Always take MAO inhibitors as prescribed – and know what to eat and what not to eat when you're on them.