Monoamine Oxidase Inhibitors (MAOIs)
MAOIs work in a similar fashion as tricyclics and the newer SSRIs by their affect on the neurotransmitters serotonin and norepinephrine, but they also act on dopamine, a neurotransmitter in the brain that influences movement. MAOIs block the decrease of these neurotransmitters, called monoamines, whose low levels cause depression. The common names of MAOIs are: Marplan (isocarboxazid), Nardil (phenelzine), and Parnate (tranylcypromine).
The downside to MAOIs is that at the same time that they block the destruction of monamines, levels of another neurotransmitter, tyramine, is increased, which creates an instant rise in blood pressure, which can burst blood vessels in the brain, causing death. Though it is rare, it can happen.
Foods to Avoid on MAOIs
Certain foods have small doses of tryamine. Eating those foods, coupled with the drug, can lead to an overdose and serious side effects. Foods to avoid are: alcoholic beverages, especially wines, sherry, liqueurs, and beer; sausages; pepperoni; salami; bologna; cheeses, especially aged varieties; chicken livers; figs, fruits, such as raisins, bananas, any overripe fruit; meat tenderizer; smoked or pickled meat; poultry and fish; and soy sauce.
Because of the potential for death due to an overdose, MAOIs are not a good coice for people with a high risk for suicide, who might intentionally overdose. People with heart problems, epilepsy, asthma, or high blood pressure have to be careful taking MAOIs. And if you get agitated or hyper easily, these drugs may be too stimulating.
Foods that can only be eaten occasionally and in moderation are: avocados, caffeine, chocolate, raspberries, sauerkraut, any commercial soup, sour cream, and yogurt. The diet is so restrictive and difficult to follow that many people find it impossible to stay on MAOIs, though it may be the only medication that has helped their depression. For thatreason, and the danger of the drop in blood pressure, most doctors prescribe the newer SSRIs first, and MAOIs only if other antidepressants do not work. Another problematic side effect is the level of sedation; people report they feel like “zombies” on this medication, but many people do adjust and get good results on MAOIs.