What Is Tyramine and Why to Avoid it on MAOIs

Learn Why You Need to Avoid Tyramine on MAOIs

Depression. Mario Vedder / Stringer / Getty Images

If you're taking an MAOI (monoamine oxidase inhibitor) for depression, you may have been told to be careful about your diet. Specifically, you may need to be careful about tyramine, which is found in certain foods, which can interact with your MAOI medication and make you sick. This article explains what tyramine is, what foods contain it and why tyramine is such a problem.

What Is Tyramine and How Does it Interact with MAOIs?

Tyramine is a naturally-occurring compound found in many foods and beverages. This compound has an effect on blood pressure and is regulated by the enzyme monoamine oxidase. Normally monoamine oxidase in the gastrointestinal tract breaks down most of the tyramine in the food you eat, but MAOI antidepressants block this process, causing tyramine levels to rise.

Because tryamine can fit into the same receptor sites as monoamines such as norepinephrine and dopamine, it can block their reuptake, leaving more of them outside nerve cells where they can exert their effects, including raising blood pressure.

When tyramine reaches dangerously high levels, it can result in resulting in a hypertensive crisis (critically high blood pressure). 

An extreme rise in blood pressure is quite dangerous because it can damage your body's organs. And, if your blood pressure is not reduced quickly, you could experience some of the following effects:

Because of this danger, it is quite important for you to follow your doctor's advice about what foods to avoid while taking an MAOI.

Avoiding Tyramine-Rich Foods

While taking an MAOI, you need to avoid foods and beverages high in tyramine to prevent potentially fatal high blood pressure spikes.

However, some will find the dietary restrictions difficult to follow, especially if these foods happen to be some of your favorites.

The foods that contain tyramine include:

  • Cheese: All cheeses except cottage cheese and yogurt
  • Alcoholic Beverages: Red wine (especially Chianti), sherry, vermouth, cognac, beer, liqueurs
  • Fish: Smoked fish, pickled herring, caviar
  • Meat: All fermented/aged meat, including, corned beef, salami, pepperoni, liver and sausage
  • Fruit: Spoiled or overripe fruits, canned or overripe figs, stewed or whole bananas (including peeled)
  • Yeast Extracts: Vitamin supplements (brewer's yeast)
  • Sauerkraut
  • Bouillon
  • Soy Sauce
  • Beans: Broad bean pods (Italian green beans), fava beans

Cheeses contain the largest amounts of tryamine, especially aged cheeses, so they are the foods most commonly associated with this reaction.

Know the Warning Signs of a Hypertensive Crisis

If you choose to use an MAOI as your antidepressant, in addition to following doctor's orders regarding your food intake, it is important to be aware of the warning signs of a hypertensive crisis, which include:

If these symptoms occur, you should get medical assistance immediately to bring down your blood pressure and prevent further complications.

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Article Sources

  • Brent, Jeffrey and Robert Palmer. "Monoamine Oxidase Inhibitors and Serotonin Syndrome." Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. Eds. Michael W. Shannon et. al. 4th Ed. Philadelphia: Saunders/Elsevier, 2007.