Phenelzine is an antidepressant that belongs to a class called monoamine oxidase inhibitors, or MAOIs. Tyramine, a substance found mostly in fermented and aged food, is normally broken down by MAO. When people take MAOIs, tyramine can't be broken down and starts to accumulate. Symptoms of excess tyramine include extremely high blood pressure, headaches and confusion. Combining MAOIs with foods that contain tyramine can be potentially fatal. For this reason, people who take MAOIs need to avoid foods that contain high amounts of tyramine and should eat others in limited quantities. Anyone taking MAOIs must get precise dietary instructions from his psychiatrist.
Cheese and Other Dairy Products
Avoid aged cheeses. These include parmesan, roquefort, brie, cheddar and mozzarella. Consume yogurt, sour cream and buttermilk in small amounts -- smaller than the typical portion size. Cottage cheese, cream cheese and ricotta are the only types of cheese that can be eaten without restriction. Patients should be aware that many foods may contain cheese even though it might not be obvious, such as in pies and bread sticks.
Soups
Avoid all packaged, dried soups and soup cubes. Don't eat miso soup, soup containing fava beans, cheese and wine. Since it's difficult to know exactly what soup prepared in a restaurant or soup stand might contain, avoid eating them.
Fruits, Vegetables and Legumes
Avoid all fermented soy products -- including soy sauce, fermented bean curd, miso soup, tamari and tempeh. Don't eat fava beans, which are widely eaten in the Mediterranean and Middle East. Overripe fruit can contain tyramine, so fruit should be consumed with caution and not at all if it is past its prime.
Meat, Fish and Poultry
Avoid eating any caviar and any type of dried and salted fish. Don't eat liver, dried sausage, salami or any dried meat or meat extract. Canned sardines and fresh sausage are examples of meats that can be eaten in a limited amount.
Beverages
Avoid drinking red wine. Avoid most alcoholic drinks, including beer and non-alcoholic beer and wine. You can drink chocolate drinks, coffee, tea and other drinks containing caffeine but only in limited quantities.
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