MAOI – Side Effects, Diet & Interactions

MAOIs were the first type of antidepressant developed, and became widely used in the 1950s.

A monoamine oxidase inhibitor, or MAOI, is a type of antidepressant drug.

In addition to treating depression, MAOIs are sometimes used to treat such conditions as:

• Bipolar disorder
• Panic disorder
• Social anxiety disorder
• Post-traumatic stress disorder (PTSD)
• Eating disorders, including anorexia or bulimia
• Other psychiatric disorders
• Parkinson’s disease

MAOIs balance the level of certain chemicals in the brain by inhibiting the enzyme known as monoamine oxidase.

The following medicines are examples of MAOIs:

• Isocarboxazid (Marplan)
• Phenelzine (Nardil)
• Selegiline (Emsam)
• Tranylcypromine (Parnate)

MAOIs were the first type of antidepressant developed, and became widely used in the 1950s.

Today, a doctor typically prescribes an MAOI only when other antidepressants fail, because newer drugs are often more effective and have fewer side effects.

MAOI Side Effects

There is a risk of serious side effects, especially when MAOIs are combined with certain food or drugs.

Some side effects of MAOIs include:

• Dry mouth
• Nausea
• Diarrhea or constipation
• Drowsiness
• Headache
• Insomnia or other sleep disturbance
• Agitation
• Skin reactions
• Dizziness
• Low blood pressure
• Involuntary muscle jerks or muscle aches
• Reduced sexual desire or decreased sexual ability
• Weight gain
• Difficulty urinating
• Tingling sensation of the skin

MAOIs — like all antidepressants — also carry a black-box warning about the potential for suicidal thoughts and behaviors.

In short-term studies, antidepressants increased the risk of suicidal tendencies in some children and young adults with depression or psychiatric disorders.

MAOIs and Drug Interactions

MAOIs can cause serious reactions if you take them with certain other drugs.

Be sure to tell your doctor and pharmacist all the medications you’re taking before you take an MAOI.

This includes prescriptions and over-the-counter medications, vitamins and other dietary supplements (nutritional shakes, protein powders, etc.), herbal remedies, and illegal or recreational drugs.

MAOI Diet

Certain foods and drinks can cause dangerous reactions if they’re taken with an MAOI.

Your physician will probably tell you to avoid foods that contain high levels of tyramine, dopamine, and tryptophan.

Some restricted foods may include:

• Aged cheeses
• Yogurt
• Cured meats and certain other meat products
• Fermented sausages such as pepperoni, salami, and bologna
• Beef or chicken liver
• Anchovies
• Caviar
• Herring
• Shrimp paste
• Draft beer and red wine
• Certain liqueurs
• Fermented soy products, such as soy sauce, miso, or tofu
• Sauerkraut
• Certain fruits, such as bananas, raspberries, dried fruits, or overripe fruits
• Fava beans
• Chocolates
• Caffeinated beverages, such as coffee, tea, or cola

Talk to your doctor about all dietary restrictions before taking an MAOI, and make sure you understand which foods and drinks to avoid.

MAOIs and Pregnancy

Since there is so little known about the effects of MAOIs on a developing baby, doctors generally avoid prescribing them during pregnancy or breastfeeding.

Also, MAOIs may interact with other medications that you may need during labor and delivery.

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High Tyramine Foods May Trigger Dangerous Side Effects

Monoamine Oxidase Inhibitors (MAOIs), like most other antidepressants, work by targeting and, to some degree, preventing changes in brain chemistry that result in a depressed mood. Although MAOIs have, for the most part, been replaced by newer generations of antidepressant medications, they are still in use because they are particularly effective for treating some major and treatment-resistant forms of depression.

In fact, because they are so effective, some mental health experts are calling for wider consideration of MAOIs for difficult-to-treat depressive conditions, and for more training of new physicians on how to use them. MAOIs currently approved for treating depression include oral phenelzine (brand name Nardil), tranylcypromine (Parnate), and isocaroxazid (Marplan), and the transdermal patch form of selegiline (EMSAM).¹˒²

“When researchers looked at how MAOIs were being used in the 1980s, they were commonly being prescribed for people with bipolar disorder,” recalls psychiatrist Matthew Edlund, MD, MOH, director of the Center for Circadian Medicine in Sarasota, Florida. “They worked particularly well for older adults.”

But back in the 1950s, when MAOI medications were first introduced and prescribed to treat depression, patients began having problems with high blood pressure and migraine headaches, especially after eating specific types of foods. Medical experts took note, and researchers determined that a dangerous and potentially fatal interaction was occurring when these patients ate foods rich in tyramine, an amino acid (protein) found in the diet and also naturally produced in the body. ³ Foods rich in tyramine include aged, cured, pickled, smoked and fermented foods, tap or unpasteurized beer, red wine, dried fruit, and fresh citrus.

How MAOIs Work

While they are in your body, MAOI medications inhibit, or block, the action of an enzyme known as monoamine oxidase. One of the usual jobs this enzyme performs is to remove certain neurotransmitters (chemical messengers such as serotonin, norepinephrine and dopamine) from your brain, in order to maintain a normal flow. MAOIs prevent this removal, allowing these “feel good” chemicals to flood those areas of your brain that are involved in depression and help elevate your mood.

At the same time, however, MAOIs also prevent this enzyme from doing another one of its usual jobs, which is to metabolize, or break down, tyramine to a form that is easily eliminated from your body. This normal process of elimination also prevents tyramine from building up to unsafe levels in your body, whether it occurs naturally or comes from your diet.

So while you are taking MAOIs for depression, Dr. Edlund explains, your body is already working harder to process naturally occurring tyramine. Any tyramine that comes from your diet is “extra,” and can easily accumulate in your body and overload the system. That’s what causes side effects such as headaches and elevated blood pressure, as well as gastrointestinal upset, rapid heartbeat, shortness in breath, and neurological problems like confusion, anxiety, and vision changes that accompany sudden surges in blood pressure. When blood pressure shoots up high enough, there is the possibility of a hypertensive crisis, which can be deadly.

Avoiding Dangerous Side Effects

The way to prevent these side effects is to avoid eating foods that are high in tyramine throughout the period of time you are taking MAOIs and for several weeks after you stop the medication, to allow all traces of the drug to to be eliminated from your body. Foods and to eliminate from your diet include the following specific types, as well as any combination foods (such as soups, stews, casseroles, stir-fries, and baked goods) that may include these as ingredients, as well as certain other types of drugs and supplements:²˒ ⁴˒ ⁵˒ ⁶

Aged, fermented, pickled and air-dried meats, poultry and fish. To include salami, dried sausages such as mortadella, jerky, aged chicken livers, smoked salmon (lox), caviar, and pickled herring, as well as any animal foods that have spoiled or have been improperly stored. (Tyramine levels increase in foods when they are held at room temperature.) Also avoid gravies and sauces made with meat extracts, soy products, or cheese.

• Aged (mature) cheeses, including Cheddar, Stilton, Swiss, camembert, blue, and gorgonzola varieties.

• Fava beans, broad beans (and their pods), snow peas, and most soybean products (with the exception of soy beverages).

• Dried fruit such as raisins, apricots, and prunes. Oranges, grapefruit, lemons, limes, and pineapple contain small amounts of tyramine and should be limited to no more than 1/2 cup per day. Other fruits are fine but avoid any that are overripe.

• Fermented and pickled foods such as sauerkraut, kimchi, miso, pickles, pickled vegetables, Asian fish sauce, soy sauce, fermented bean curd (tofu). and concentrated yeast extract products such as Marmite and Vegemite.

• Beer on tap and unpasteurized or home-brewed beers. (Canned and bottled beers have been pasteurized, which prevents further fermentation and production of tyramine.) Vermouth and Korean beers are also known to be high in tyramine.

• Protein supplements and supplemental products, especially those promoted for weight loss and body-building. Check the ingredient list for any form of tyramine, including L-tyramine, N-Methyl-L-Tyramine HCL and N-Methyltyramine HCL.

Additionally, speak to your health care provider or pharmacist before you take any prescription or over-the-counter products for weight reduction, allergies, sinus, cold, cough or flu, or mood (including herbal products such as ginseng or St. John’s Wort.) Make sure your prescriber is aware of all medications and supplements you take for any reason.

“Be especially careful with cough and cold medications, decongestants, antihistimes, and any other products that contain epinephrine, pseudoephedrine or phenylpropanolamine (banned in the U. S and many other, but not all, countries),” Dr Edlund warns. “When combined with MAOIs, these substances can cause the same problems with hypertension as tyramine, leading to increased heart rate and stroke.”

1. Menkes D, Bosanac P, Castle. MAOIs—does the evidence warrant their resurrection? Australasian Psychiatry. February 25, 2016; 24(4): 371-373 Accessed March 15, 2019
2. Culpepper L. Reducing the burden of difficult-to-treat major depressive disorder: revisiting monoamine oxidase inhibitor therapy. Primary Care Companion CNS Disorders. October 31, 2013; 15(5) Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3907330/ Accessed March 15, 2019
3. Ramachandraih CT, Subramanyam N, Bar, KJ, Baker G, Yeragani VK. Antidepressants: from MAOIs to SSRIs and more. Indian Journal of Psychiatry. April-June 2011; 53(2): 180-182. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136031/ Accessed March 15, 2019
4. Kathrynne Holden, MS, RD. Meal Ideas and Menus: Avoiding High-tyramine Foods Made Easy. Vanderbilt University Medical Center. Available at: https://www.mc.vanderbilt.edu/documents/neurology/files/Tyramine%20Menu%20Book%2006227101.pdf Accessed March 15, 2019
5. Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/maois/faq-20058035 Accessed March 15, 2019
6. Important Drug and Food Information. National Institutes of Health Clinical Center. Drug-Nutrient Task Force. Available at: https://www.cc.nih.gov/ccc/patient_education/drug_nutrient/maoi1.pdf Accessed March 15, 2019

Notes: This article was originally published March 15, 2019 and most recently updated January 8, 2021.

Top 10 most harmful foods to avoid

Markets, supermarkets, food stalls and convenience stores offer a wide range of products that can be used to make delicious meals or just eat. Some of them are good for the body, others are plus or minus harmless (thanks for that too), but some should be avoided. Not only are they harmful to your health, well-being and figure, but they also have a cumulative effect – if you eat them regularly, the harm from them will accumulate, and this in turn leads to inflammation, weight gain and chronic diseases.

The general rule is that any processing makes foods less healthy, so whole foods should be preferred. Fruit instead of jams and desserts, sourdough instead of yeast, brown sugar instead of refined sugar, and so on. But here is a list of the 10 most harmful foods that should be eaten as little as possible, and ideally completely excluded from the diet: the harm that they bring to the body has been proven by multiple studies. Recommendations for replacing harmful with useful are attached.

Refined oil

Refined oil is vegetable oil (from sunflower, corn, rapeseed, olives, etc.), purified from impurities. Through this purification, the oil is odorless and can be brought to a higher temperature, making it more suitable for frying. But the harm to the body (and the environment) from such oil is much higher than it seems at first glance: during cleaning, it is treated with chemical reagents, and toxins enter the body along with the oil. It seems that everyone already knows that unrefined oil should be used for salad dressings, marinades and other dishes without heat treatment – but in other cases, refined oil should also be discarded.

Substitute for: butter, creamy ghee or unrefined vegetable oil: yes, it can also be fried.

Recipe: Tabouleh salad

Semi-sweet wine

In a simplified form, grape juice is turned into wine by yeast, which converts the sugars it contains into alcohol. In the production of dry wines, this process goes to the end, and only small amounts of residual sugars remain in the wine. For the production of semi-sweet wines, it must be stopped artificially – for example, by sharp cooling of unfermented wine, as a result of which the yeast dies. But that’s in theory. In practice, most semi-sweet wines are nothing more than a “cocktail” of low-quality wine materials and sweet syrup that masks their taste. Since semi-sweet wines are practically not consumed anywhere except the former USSR, the rest of the world is not aware of this disgrace.

Replacement for: dry wine.

Recipe: Rossini Cocktail

Low Fat Dairy Products

The existence of yogurt and other zero-fat dairy products is an echo of the American food corporations’ long-standing struggle. The studies sponsored by the winners convincingly proved that all the harm to health is from fat, after which America was swept by a wave of low-fat foods that everyone happily rushed to buy. The problem is that such products contain a huge amount of sugar. After the obesity epidemic came to the States following the fashion for skim milk, these studies were refuted – it turned out that there is nothing wrong with fat as such, but sugar, on the contrary, is extremely harmful. But the demand for 0% fat remained, and so did the supply.

What to replace: with normal dairy products.

Recipe: How to make yogurt at home

Fruit juices

Fruit is great. They are tasty, they contain many vitamins, and most importantly, fiber, which works like a brush, cleansing your intestines and improving digestion and overall well-being. In addition, fruits have another plus: you can’t eat a lot of them. Unlike juices. In fact, juice, even freshly squeezed, is a sugar concentrate, where there is practically no benefit that fruits have. Like the harm of fats, the benefits of juices have been refuted many times, but …

Substitute for: whole fruits in season.

Recipe: Baked apples

Sausages

Sausage sandwich is a folk delicacy praised by the cat Matroskin. But even GOST sausages, beloved by individual citizens, are a harmful product and should be avoided. Unfortunately, this information is nowhere more official: back in 2015, WHO published a report according to which processed meat products, that is, sausages, sausages, bacon and others like it, are carcinogenic, and their use leads to rectal cancer.

Substitute for: homemade cured or baked meat.

Recipe: Pork Beef

Refined Cereals

In its normal form, a grain is a complex structure that consists of an embryo, membranes that protect it, and endosperm, which stores the nutrients due to which it will grow. When cleaning the shell and the germ is removed, leaving only the endosperm. This prolongs the shelf life of the grain, but deprives it of fiber, iron, B vitamins and many other useful substances. Refined cereals – as well as flour from them – bring only fast carbohydrates to the body, from which the waist grows like yeast. Of course, this in itself is not fatal, but in any case, it is worth giving preference to whole grains and flour.

Substitute for: whole grains and whole grain flour.

Recipe: How to Cook Quinoa

Margarine

Margarine was originally introduced as an affordable alternative to butter, but further research proved it to be an evil to stay away from. The composition of margarine includes processed types of cheap vegetable oil, which contain trans fats, which means that everyone who monitors their health should forget about margarine in baked goods and sandwiches.

Substitute for: butter.

Recipe: Homemade Butter Dough

Sodas

Everything seems to have been clear with sodas for a long time, but the volumes they are still sold suggest that not everyone understands. So, soda is bad. First, it’s sugar – literally cups of sugar in one bottle of lemonade. Secondly, the “chemistry” so beloved by the people, that is, dyes, flavors and everything else that is added to lemonade and that poisons your body with toxins. Thirdly, carbonated drinks themselves, even without taking into account their contents, are harmful to the teeth and the body as a whole.

Substitute for: water or fermented drinks.

Recipe: Beet kvass

Desserts and sweet pastries

Coming to this point, you already understand what is wrong with store-bought sweets: sugar, margarine, refined butter, refined flour, and so on. Alas, you won’t find even purchased pastry, butter or puff, on butter instead of margarine, what can we say about desserts and pastries with a long shelf life? If you’re craving something sweet that you can’t, trust a good pastry chef who uses only quality, whole ingredients and eat them as little as possible anyway.

What to replace: with berries and fruits.

Recipe: Carrot Cake

Sauces & Salad Dressings

Ready-made sauces are the apotheosis of processed food: most of them contain half of everything we have listed above, plus half of the periodic table. Although some sauces, such as soy, are made from natural products, it’s still worth reading the composition: in pursuit of a low price and a long shelf life, manufacturers use tricks that your body will hardly like.

Substitute for: with the same sauces and dressings, but made at home.

Recipe: Homemade salad dressings

Author: Alexey Onegin

Who is this?..

Doctors’ top ten most dangerous foods to avoid • INMYROOM FOOD

You are what you are
eat. Today, this proverb takes on more and more meaning, because in an era
oversaturation of the food market to find a quality product without additives
and preservatives are a rarity. So read the labels carefully and
researching products before buying is almost a civic duty for anyone who
takes care of his health.

Specialists
warn: food unawareness is fraught with consequences for which you can
pay with your well-being not for a year or two. In today’s review
Here is a selection of products and ingredients that doctors recommend
remove from your diet.

1. Ice cream

It may
shock you, but according to doctors, ice cream is the worst food for
person. Look at the composition with a sober look: full of chemicals,
hormones, altered milk protein, saturated fat and refined sugar.
If without an icy dessert and white light is not nice, master cooking at home
banana and coconut milk ice cream.

2. Products with trans fats

According to
research, hydrogenated trans fats, which are now part of
every second product, increase the risk of strokes and heart attacks and negatively
affect the functioning of the digestive system. And their metabolites are difficult to excrete from
organism, which greatly increases the risk of obesity. The best advice is to avoid
such products by the party.

3. Carbonated drinks and store juices

Due to extremely
high sugar content and strong acidity of such drinks, each glass
soda and cheap juice strikes at tooth enamel, digestive organs and
even the skeleton – calcium is washed out. Suffering and weight – nutritionists sometimes call
such drinks are “liquid sweets” and are advised to give preference to homemade
freshly squeezed juices and smoothies.

4. Products with artificial colors

rainbow colors
jelly and rings for breakfast – it can be fun, but not at all safe.
A number of dyes are classified as toxic and allergenic, although from their production,
As usual, they didn’t. Tartrazine Yellow, Brilliant Blue, and Red #40 are dyes made from charcoal
resins, can cause skin rashes and can cause hyperactivity in
children.

5. Products with bleached flour

refined
or bleached flour repeatedly loses in favor of whole grains. The thing is
the fact that in the process of processing such flour loses the shell and the germ of the grain, in
which concentrated valuable vitamins of groups B, E,
minerals and amino acids. Bleached flour products have a high glycemic index,
provoking jumps in blood sugar, leading to overeating.

6. Sliced ​​meat

According to
experts, this popular snack is yet another worst of evils. High
the content of fat, sodium and nitrates used as preservatives – about
a high quality product is out of the question. meat sandwich lovers
vacuum packaging should be careful: doctors warn of an increase
chances of developing stomach cancer.

7. Products with glucose-fructose syrup

This ingredient
was invented to cut production costs, and about health
he doesn’t care about customers. It is glucose-fructose syrup
credited with being the biggest contributor to the obesity epidemic. If possible,
Avoid foods that list this artificial sweetener in
the list of the first 3 ingredients of the composition.

8. Fruits and vegetables

Of course not
this point should be taken too literally – we are talking about inorganic
agricultural products grown with the use of pesticides and other
dangerous chemicals.