TYRAMINE

Three classes of antidepressants are generally used in the treatment of major depression: tricyclic antidepressants (TCIs, such as imipramine), selective sertotonin reuptake inhibitors (SSRIs, such as fluoxetine), and monoamine oxidase inhibitors (MAOIs, such as Parnate, Nardil [phenelzine], Marplan, Furoxone, Matulane, Eutonyl, Eutron).

The MAOIs block the action of the enzyme monoamine oxidase. Tyramine, a substance found in some foods, normally undergo conversion in the body to an inactive form through the action of monoamine oxidase. When MAO inhibitors are given, tyramine remains active and causes the release of norepinephrine. Headaches, severe hypertension, or a hypertensive crisis may ensue.

Foods high in tyramine should be avoided while on MAOI therapy. Avoid foods that are aged, fermented, or improperly stored. Foods with moderate or low tyramine content should be used in limited amounts (1/2 cup or 4 oz or less). Continue the diet four weeks beyond the cessation of drug therapy.

 

FOOD SOURCES OF TYRAMINE
Foods Very High in Tyramine
Cheese, aged
Boursalt
Camembert
Cheddar
Stilton
Yeast extracts
Foods High in Tyramine
Bologna
Dried. salted, or pickled cod
Dried, salted, or pickled herring
Pepperoni
Salami
Foods Moderately High in Tyramine
Cheeses
Blue
Brick natural
Brie
Gruyere
Mozzarella
Parmesan
Romano
Roquefort
Chianti wine
Meat tenderizers

Foods Containing Moderate Amounts of Tyramine
Broad beans (fava,k Chinese pea pods)
Caffeine (in large amounts)
Chocolate (in large amounts)
Liver, chicken and beef
Pineapple
Raisins
Soy sauce

 

Foods Low in Tyramine
Ale
Avocados
Bananas
Beer
Cheeses
American, processed
Cottage
Cream
Ricotta
Figs
Sherry
Sour cream
White wine
 

SOURCES
Understanding Normal and Clinical Nutrition. Whitney, Cataldo, Roilfes. 2nd Ed. West Publishing Co.1996
Conn's Current Therapy. 1996


Back to Lists & Tables