Monoamine oxidase inhibitors: reappraisal of dietary considerations

Dangers of adverse effects with MAOIs have been exaggerated, the most serious being hypertensive interactions with cheeses, yeast extracts, certain alcoholic beverages, broad bean pods, certain meats, and foods that are unfresh or overripe. Some adverse reactions involving MAOI-diet interactions were likely due to migraine headache, consumption of unusually large quantities of low-tyramine-containing foods, or other individual variations. Since MAOIs have advantages in pharmacotherapy of certain depressive subtypes and anxiety states, knowledge of the dietary considerations with MAOI treatment is essential to both the clinician and their patients. Patients are easily educated about MAOIs and the necessary dietary restrictions using the steps outlined in this report. Finally, written information concerning the MAOI diet together with Medic-Alert emblems or drug manufacturers' cards warning of MAOI-drug interactions should be provided before MAOI treatment is begun. Although MAOI-drug interactions were not addressed in this article, in general, it is good policy for the patient to contact the clinician whenever another medication (over-the-counter or prescribed by another physician) is at issue so that its safety can be verified.