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Monoamine oxidase inhibitors are antidepressants used by patients who have not responded to other antidepressant therapies, according to the National Institutes of Health. Patients taking MAOIs face dietary restrictions that limit the consumption of foods containing high levels of tyramine. The interaction of tyramine with MAOIs can cause a dangerously high increase in blood pressure, which can lead to a stroke. Tyramine is found in foods that are fermented, aged, or spoiled.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Aged Cheese and Matured Cheese
Patients taking MAOIs should avoid aged cheese and matured cheese because they contain high levels of tyramine, according to the National Institutes of Health. The only cheeses that can be eaten are cottage cheese, cream cheese, ricotta, part-skim mozzarella and American processed cheese. These types of cheese are allowed as long as they have been refrigerated for no more than two or three weeks. Normally, monoamine oxidase enzyme in the digestive tract keeps tyramine levels within a safe range. Taking MAOIs prevents monoamine oxidase enzyme from working, resulting in elevated levels of tyramine. When tyramine levels increase, they can cause potentially serious reactions such as:
- severe high blood pressure
- heart problems
- visual disturbances,
For this reason, patients need to avoid eating aged cheese and matured cheese that contain significant amounts of tyramine.
- Patients taking MAOIs should avoid aged cheese and matured cheese because they contain high levels of tyramine, according to the National Institutes of Health.
Meats, Dairy Products and Fruits and Vegetables
List of Foods Containing Tyramine
Fresh packaged meat, fish, poultry and dairy products should be stored in the refrigerator and eaten within three to four days. Fermented vegetables and sauces should also be avoided by patients taking MAOIs. Examples of fermented vegetable products include:
- soy sauce
- yeast extracts
- soybean paste
- miso soup
Examples of fruits containing tyramine that should be avoided by patients taking MAOIs include raspberries, bananas, avocado, spinach and banana peels. Foods containing monosodium glutamate are high in tyramine and should be avoided.
- Fresh packaged meat, fish, poultry and dairy products should be stored in the refrigerator and eaten within three to four days.
- Fermented vegetables and sauces should also be avoided by patients taking MAOIs.
Patients taking MAOIs should limit the intake of beer, wine and liquor to no more than two servings a day, according to the National Institutes of Health. Tap beer or unpasteurized beer and red wine should be avoided, according to MayoClinic.com 1. Chocolate and caffeinated beverages should also be avoided.
List of Foods Containing Tyramine
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- MayoClinic: MAOIs and Diet
- Dezsi L, Vecsei L. Monoamine Oxidase B Inhibitors in Parkinson's Disease. CNS Neurol Disord Drug Targets. 2017;16(4):425-439. doi:10.2174/1871527316666170124165222
- Brady KT, Haynes LF, Hartwell KJ, Killeen TK. Substance use disorders and anxiety: a treatment challenge for social workers. Soc Work Public Health. 2013;28(3-4):407–423. doi:10.1080/19371918.2013.774675
- Hillhouse TM, Porter JH. A brief history of the development of antidepressant drugs: from monoamines to glutamate. Exp Clin Psychopharmacol. 2015;23(1):1–21. doi:10.1037/a0038550
- Sathyanarayana Rao TS, Yeragani VK. Hypertensive crisis and cheese. Indian J Psychiatry. 2009;51(1):65–66. doi:10.4103/0019-5545.44910
- Andersen G, Marcinek P, Sulzinger N, Schieberle P, Krautwurst D. Food sources and biomolecular targets of tyramine. Nutr Rev. 2019;77(2):107-115. doi:10.1093/nutrit/nuy036
- Salkic S, Batic-Mujanovic O, Ljuca F, Brkic S. Clinical presentation of hypertensive crises in emergency medical services. Mater Sociomed. 2014;26(1):12–16. doi:10.5455/msm.2014.26.12-16
Esther Kinuthia is a registered nurse with extensive experience in health and wellness. She holds a B.S. in nursing, B.A in psychology and has worked for more than ten years in the health-care field. She enjoys writing articles on a variety of topics for the Internet. Her work has been published in various websites.