Dietary restrictions and drug interactions with monoamine oxidase inhibitors: An update

Indiana University School of Medicine, Wishard Memorial Hospital, 1001 West 10th St, Indianapolis, IN 46202 .
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 07/2012; 73 Suppl 1(suppl 1):17-24. DOI: 10.4088/JCP.11096su1c.03
Source: PubMed


Monoamine oxidase inhibitors (MAOIs) are effective treatments for depression that has atypical features or that has failed to respond to other antidepressants. However, MAOIs are underused because clinicians are concerned about dietary and drug interactions with this class of medication. Hypertensive crisis and serotonin syndrome can occur in rare cases due to interactions between MAOIs and foods containing tyramine as well as interactions with serotonergic and sympathomimetic agents. A better understanding of the foods and drugs that can cause adverse reactions, as well as knowledge of newer MAOIs with mechanisms of action and delivery methods that reduce these risks, may help clinicians to consider the use of these medications, when appropriate, in their patients with depression.

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    • "The reluctance to use MAOI except in patients with refractory depression may be a cause of therapeutic failures. Reviewing the literature on MAOI therapy, the risks of hypertensive crisis from food containing tyramine or postural hypotension from false neurotransmitters are quite small, but can be catastrophic.17,18 The former can be avoided through proper diet and the latter through hydration, compressive stockings, and if needed mineralocorticoid supplementation. "
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