Dietary Precautions While Taking MAOIs

Dietary Precautions While Taking MAOIs Panic Disorder Treatment Print Dietary Precautions While Taking MAOIs By Sheryl Ankrom linkedin Sheryl Ankrom is a clinical professional counselor and nationally certified clinical mental health counselor specializing in anxiety disorders. Learn about our editorial policy Sheryl Ankrom Reviewed by Reviewed by Amy Morin, LCSW on August 31, 2019 facebook twitter instagram Amy Morin, LCSW, is a psychotherapist, author of the bestselling book 13 Things Mentally Strong People Dont Do, and a highly sought-after speaker. Learn about our Wellness Board Amy Morin, LCSW Updated on November 25, 2019 Piga Catalano s.n.c./Getty Images More in Panic Disorder Treatment Symptoms Diagnosis Coping Related Conditions In This Article Table of Contents Expand How MAOIs Work Reason for Food Restrictions Foods to Avoid Other Dietary Considerations Symptoms/Hypertensive Crisis Plan Ahead View All Back To Top Though not nearly as common as they once were, monoamine oxidase inhibitors (MAOIs) are still sometimes prescribed to treat depression, as well as off-label use for Parkinsons disease?? and anxiety disorders like panic disorder, social anxiety disorder, and post-traumatic stress disorder (PTSD).?? No matter what condition you may be taking these medications for, there are certain high-protein and aged foods that you should avoid in order to prevent harmful spikes in your blood pressure. How MAOIs Work Many people dealing with  panic disorder  are prescribed medications to treat anxiety,  panic attacks, and other panic-related symptoms. Antidepressant medications may sound like theyre only designed to treat depression, but  antidepressants  have increasingly been used to help alleviate the symptoms of panic disorder and other anxiety disorders.?? First  available to U.S. consumers in the 1950s, MAOIs were one of the earliest antidepressants prescribed. MAOIs work to impact  different  neurotransmitters, or naturally  occurring substances, in the brain that regulate various body functions. In particular, MAOIs are thought to affect the neurotransmitters of serotonin, norepinephrine, and dopamine. These are associated with the regulation of your mood, sleep, energy, and motivation and theyre also responsible for balancing the  fight-or-flight response,  which is linked to how you respond to stress and anxiety.?? These days, there are often more effective medications available that have fewer side effects, so MAOIs are usually reserved for cases when other medications havent done the job. Theyre a good choice for certain people, however. Common MAOIs include: Nardil (phenelzine)Parnate (tranylcypromine)Marplan (isocarboxazid)Emsam (selegiline) Reason for Food Restrictions Tyramine is a compound thats found in certain foods, beverages, and other substances and has an effect on your blood pressure. Tyramine is regulated by the  MAO  enzyme, which helps break it down. MAOIs work by restricting the MAO enzyme, which usually results in reducing the symptoms of depression and anxiety. However, when the MAO enzyme is inhibited, such as when youre taking an  MAOI, tyramine can reach dangerously high levels, causing your blood vessels to narrow and resulting in critically high blood pressure.?? If youre taking an MAOI, youll need to avoid foods and beverages that are high in tyramine to prevent potentially fatal blood pressure spikes that can land you in the emergency room. Foods to Avoid Protein-rich foods contain higher amounts of tyramine. Additionally, tyramine content rises in these foods as they age.  There are a few foods and beverages that are high in tyramine that you should avoid while taking an MAOI,?? including: Meat Products: Foods to avoid include  beef liver,  chicken liver,  fermented sausages like pepperoni and salami, bacon, hot dogs, corned beef, and luncheon meats.Fish Products: Stay away from  caviar,  cured fish,  dried or pickled herring, and anything that contains  shrimp paste.Milk Products: Aged and mature cheeses and other dairy products like sour cream and  yogurt are on the list of foods to avoid. You can have cottage cheese, processed cheese like American, cream cheese, ricotta, and part-skim mozzarella.Fruits and Vegetables: High-protein produce is also a concern. This includes  overripe fruits and avocados, as well as banana peels (not the bananas themselves). Also, try not to eat fava beans, Italian green beans, or snow peas. Its best to stay away from  sauerkraut, tofu, pickles, and  canned figs as well.Alcohol:  Certain fermented alcoholic beverages should be left out of your diet. This includes red wines and Chianti, vermouth, and sherry. A beer that contains yeast sh ould also be avoided, particularly home-brewed or tap beer.Yeast-Containing Foods: Its recommended that you avoid foods that contain  concentrated yeast products and  brewers yeast. Included in this group are items like miso, teriyaki, fermented tofu or bean curd, and soy sauce.Combinations: Snacks or meals that are made with any of these foods also need to be avoided. For example, you shouldnt eat foods that contain cheese such as pizza or lasagna, or foods that contain soy sauce like stir-fry. Youll also need to avoid high tyramine foods and beverages for two to four weeks after you go off of an MAOI. Your doctor will give you specific instructions. Other Dietary Considerations In foods that contain tyramine, the level increases even more during the spoiling or decay process. Its important that you eat only fresh and freshly cooked foods and use proper food safety practices, such as:?? Check packaged foods for freshness and dont consume products beyond the freshness date.Cook all foods to the proper temperature.Maintain cold foods at the proper temperature.Dont refreeze foods that have been thawed.Avoid leftovers, even if they have been refrigerated.Consume cooked foods promptly, making sure proper food temperature is maintained. Keep in mind that heat doesnt decrease tyramine, so cooking or heating up food thats high in tyramine wont make any difference. Symptoms of Hypertensive Crisis When your tyramine level starts to increase, you may notice symptoms that your blood pressure is quickly rising. When this happens, its an emergency situation called a hypertensive crisis. Symptoms include:?? Headache, which will likely be severeNauseaVomitingConfusionDisturbances in your visionFast or irregular heart ratePain in your chest that may be accompanied by shortness of breathSweatingNosebleedsSevere anxietyFainting If you notice any of the symptoms of a hypertensive crisis, and especially if you know you ate food thats high in tyramine, call your doctor or 911, or have someone take you to the emergency room. Plan Ahead In the event that your doctor prescribes an MAOI for you, talk to him or her about a complete list of foods and alcohol that you need to avoid. You may also need to avoid certain medications, whether over-the-counter or prescription, so ask about this too. Its also best to make a plan with your doctor about what to do in the event that you have a hypertensive crisis so you know exactly what to do.