Monoamine oxidase inhibitors foods

Treatment is basically symptomatic and supportive no specific antidotes are available. Artificial ventilation with 100% humidified oxygen is necessary in cases of respiratory distress. If patient is cyanotic and cyanosis does not respond to oxygen administration, methemoglobin levels should be determined. Methemoglobinemia can be treated by intravenous administration of methylene blue. Support of cardiovascular function may also be required. Bladder damage can be determined by urinalysis. Hypotension may be treated with isotonic intravenous fluids. Dopamine or norepinephrine may be used if hypotension does not respond to infusion of fluids. Convulsions may be treated with intravenous benzodiazepines (diazepam or loraze-pam) phenobarbital may be used if the convulsions are recurrent. Because chlordimeform is a monoamine oxidase inhibitor, foods with large amounts of... 

Levodopa interacts with many different drugs. When levodopa is used with phenytoin, reserpine, and papaverine, there is a decrease in response to levodopa The risk of a hypertensive crisis increases when levodopa is used with the monoamine oxidase inhibitors (see Chap. 31). Foods high in pyridoxine (vitamin B6) or vitamin B6 preparations reverse the effect of levodopa However, when carbidopa is used with levodopa, pyridoxine has no effect on the action of levodopa hi fact, when levodopa and carbidopa are given together, pyridoxine may be prescribed to decrease the adverse effects associated with levodopa... 

Myelosuppression is the major side effect. Nausea, vomiting, and a flulike syndrome occur initially with therapy. Patients must be counseled to avoid tyramine-rich foods because procarbazine is a monoamine oxidase inhibitor. Patients should be provided a list of foods and beverages to avoid to prevent a hypertensive crisis. A disulhramlike reaction can occur with the ingestion of alcohol. 

Monoamine Oxidase Inhibitors (MAOIs). Early studies also evaluated the effectiveness of the MAOl phenelzine. Phenelzine, relative to TCAs, provided greater benefit for PTSD however, its usefulness is limited by its potential for drug and food interactions. A recent open label study suggests that the reversible MAOI moclobemide might be helpful for PTSD. It is not available in the United States. 

Arguably the first modern class of antidepressants, monoamine oxidase inhibitors (MAOIs) were introduced in the 1950s but are now rarely used in clinical practice because of toxicity and potentially lethal food and drug interactions. Their primary use now is in the treatment of depression unresponsive to other antidepressants. However, MAOIs have also been used historically to treat anxiety states, including social anxiety and panic disorder. In addition, selegiline is used for the treatment of Parkinson s disease (see Chapter 28). 

Monoamine oxidase inhibitors (eg, tranylcypromine, phenelzine) are older antidepressants that are occasionally used for resistant depression. They can cause severe hypertensive reactions when interacting foods or drugs are taken (see Chapters 9 and 30), and they can interact with the selective serotonin reuptake inhibitors (SSRIs). 

Synergism - a potentiation or prolongation which results in much greater than expected effects. This could involve competitive substrates for an enzyme or receptor, decreased excretion, displaced plasma protein binding, etc. The analgesic propoxyphene (Darvon ) slows down the excretion of ethanol and so increases the depressant effects of the alcohol. Recall the example given earlier of the monoamine oxidase inhibitors used as antidepressants and the tyramine-containing foods which could precipitate a hypertensive crisis. 

The high incidence of drug-food and drug-drug interactions rules out monoamine oxidase inhibitors as antidepressants of first choice. However, there are circumstances in which these agents may be used effectively and successfully ... 

S.B. Lipman, and K. Nash, Monoamine oxidase inhibitor update Potential adverse food and drug interactions. Drug Safety 5 195-204, 1990. 

Special interest has been focused on the presence of biogenic amines in food plants (45, 90, 360-362), since digestion of food products rich in, e.g., tyramine can induce physiological effects, especially in patients using monoamine oxidase inhibitors as antidepressants (see below). Concentrations of alkaloids reported in food plants are summarized in Table II. 

The monoamine oxidase inhibitors epitomize cyclical fashions in drug use and the impact of adverse effects. They were the first psychotropic drugs for which a clear biochemical action was defined. Early excitement was quickly tempered by reports of liver toxicity with the hydrazine derivatives, leading to synthesis of the cyclopropylamine drug, tranylcypromine, which in turn elicited the food and drug interactions that led to an overall decline in popularity. 

AKC = atopic keratoconjunctivitis FDA = U.S. Food and Drug Administration GI = gastrointestinal GPC = giant papillary conjrmctivitis OTC = over the cormter VKC = vernal keratoconjunctivitis URI = upper respiratory infection MAOI = monoamine oxidase inhibitor... 

St. John s wort is a monoamine oxidase inhibitor, and the authors believed that this explained how the concomitant use of a tyramine-rich food with St. John s wort had caused this problem. 

Phentolamine is a non-selective alpha-adrenoceptor antagonist. It is used to treat hypertensive crises attributable to the effects of noradrenahne, as in pheochromo-cytoma and during the interaction of monoamine oxidase inhibitors with amine-containing medicaments and foods (1). Its adverse effects are similar to those of phenoxy-benzamine. 

When explaining possible medication and/or food interactions, for example the importance of avoiding alcohol with certain drugs such metronidazole or cheese with monoamine oxidase inhibitors (MAOIs). 

Monoamine oxidase inhibitors are not commonly prescribed to Asians, because many traditional Asian foods, including fermented bean curd, soy sauce, and fermented soybeans, contain relatively high levels of tyramine (a pressor amine), ranging from 0.02 to 43.0 pmol/g (Sung et al. 1986). Because the vast majority of Asians are fast acetylators (Whitford 1978), the metabolism of phenelzine may be increased in Asians, resulting in higher dose requirements than in Caucasians. 

Walker SE, Shulman KI, Tailor SA, Gardner D (1996) Tyramine content of previously restricted foods in monoamine oxidase inhibitor diets. J Clin Psychopharmacol 16 383-388... 

Monoamine oxidase (MAO) is an enzyme produced in the human body which acts something like a chemical version of our white blood cells -that is, its function is to break down potentially destabilizing amines present in our food and render them harmless. One might think of monoamine oxidase as the active agent in a kind of "chemical immune system" which helps to regulate metabolism and maintain a healthy chemical balance in our bodies. A monoamine oxidase inhibitor (AAAOl) is... 

Tyramine-containing foods if taking a monoamine oxidase inhibitor Chemical Elements and Other Industrial Chemicals... 

Administered as a single, daily dose on an empty stomach Monoamine oxidase inhibitors drug-food interactions with tyramine-rich foods such as red wines, dark beers, aged cheeses, yogurt may precipitate hypertensive crisis drug interactions tricyclic antidepressants and SSRIs, sympathomimetics disulfiram-like reaction with alcohol... 

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