Dietary Precautions While Taking MAOIs

Monoamine oxidase inhibitors (MAOIs) are sometimes used to treat depression, Parkinson's disease, anxiety disorders, and post-traumatic stress disorder (PTSD). 

MAOIs can cause dangerously high blood pressure (hypertensive crisis) if you eat certain foods and beverages.

How MAOIs Work

MAOIs work on neurotransmitters, naturally occurring substances in the brain that help regulate various bodily functions  MAOIs work on three neurotransmitters: dopamine, norepinephrine, and serotonin  These neurotransmitters help regulate mood, sleep, energy, and motivation.

Reason for Food Restrictions 

MAOIs restrict the MAO enzyme to reduce symptoms of depression and anxiety  MAOIs inhibit the MAO enzyme, which can cause dangerously high levels of tyramine in your body  Elevated tyramine can cause your blood vessels to narrow, possibly leading to critically high blood pressure 

Foods to Avoid with MAOIs 

Tyramine is found in certain foods, beverages, and other substances  Protein-rich foods typically contain high amounts of tyramine  Foods that are aged (such as cheese) are also high in tyramine 

List of Foods to Avoid while Taking MAOIs

Meat and Fish

AVOID: Aged, fermented, smoked, cured, pickled, or marinated meats, fish, and poultry, such as sausage, pepperoni, hot dogs, baloney, salami, summer sausage, smoked salmon, pickled herring, anchovies, and caviar  EAT: Fresh or frozen meat, fish, and poultry 

Cheese

AVOID: Hard cheeses, processed cheeses, blue cheese, cottage cheese, cream cheese, and cheese spreads  EAT: Cottage cheese and cream cheese if they are low in tyramine (check the label) 

Vegetables and Fruits

AVOID: Overripe fruits, fermented vegetables, and certain vegetables, such as avocado, broad bean pods, figs, snow peas, and eggplant  EAT: Fresh vegetables and fruits 

Beverages

AVOID: Beer, wine, sherry, vermouth, and other alcoholic beverages containing tyramine  EAT: Fruit juices and soda (check the label to make sure there is no tyramine) 

Other Foods and Substances

AVOID: Soy sauce, miso soup, yeast extract, meat tenderizers, and caffeine, including coffee, tea, chocolate, and energy drinks  EAT: Decaffeinated coffee and tea 

Continue to Avoid Foods High in Tyramine for 2-4 Weeks After Stopping an MAOI 

Talk to Your Doctor or Pharmacist About Foods and Beverages to Avoid While Taking an MAOI 

Seek Immediate Medical Attention if You Experience Symptoms of Hypertensive Crisis