MAOIs, or monoamine oxidase inhibitors, are a type of antidepressant that prevent the breakdown of neurotransmitters in the brain, thereby improving brain cell communication and boosting mood. The inhibitor also blocks the breakdown of tyramine, a neurotransmitter precursor and regulator of blood pressure. Eating foods high in tyramine can lead to a build-up in the body and dangerously high blood pressure, or hypertensive crisis. Consult your doctor for more information on this interaction.
Cheeses
Aged cheeses have the highest levels of tyramine. Tyramine content increases as the cheese ages, and it is higher around the rind and fermentation holes. Do not eat aged, outdated and unpasteurized cheeses, including blue, cheddar, feta, Gouda, gorgonzola, mozzarella, Parmesan, Meunster, provolone, Romano, Swiss, Camembert and Stilton cheeses. One ounce, or slice, of these cheeses contains between 28 and 61 mg of tyramine. More than 25 mg of tyramine can lead to hypertensive crisis. Also avoid foods made with cheese, such as cheese casseroles. Pasteurized milk and cottage cheese, cream cheese and ricotta cheese are safe to eat.
Meats and Fish
Avoid eating aged, dried, fermented or pickled meats as the tyramine content increases with age and fermentation. These include processed meats, such as dried, salted and smoked meats and fish, pickled herring, luncheon meats, bacon, bologna, sausage, pepperoni, ham, hot dogs and corned beef. Aged chicken livers contain the most tyramine in this group, with 60 mg per ounce. Most fresh meats and fish are safe to eat.
Fruits and Vegetables
Avoid fermented, overripe, spoiled or moldy fruits and vegetables, including pickles, olives, sauerkraut, overripe bananas, guacamole, broad beans and fava beans. Fresh, canned, frozen and dried fruits and vegetables are safe to eat.
Beverages
Both alcoholic and non-alcoholic beverages contain tyramine. Chianti red wine, all beers, liqueurs, mixed drinks, non-alcoholic beers, sherry, vermouth, as well as colas, coffee and teas containing caffeine and hot chocolate should be avoided. One serving, or 12 oz., of tap beer contains 38 mg of tyramine.
Miscellaneous
Other foods you cannot eat when taking an MAOI include chocolate, herbal ginseng, yeast extracts like brewer's yeast, yeast supplements and yeast-extract spreads. The National Institute of Health also warns against eating fermented soy products including soy sauce, teriyaki, soybean paste, fermented bean curd (fermented tofu), miso soup, tamari, natto, shoyu and tempeh. Do not eat any combination foods such as sub sandwiches and stir-fried dishes if they contain foods to be avoided. Discard any spoiled or improperly handled or stored foods and liquids.
References
- Mayo Clinic.com: Monoamine oxidase inhibitors (MAOIs)
- Ohio State University Medical Center: Low Tyramine Diet
- National Institutes of Health: Important Drug and Food Information
- Meal Ideas and Menus: Avoiding High-tyramine Foods Made Easy; Kathrynne Holden, MS, RD; 2006
- Clinical Trials: Tyramine Restricted Diet
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