Kevin Black, M.D.
(if you're not my patient, please discuss this with your own doctor)
No medications including over-the-counter medications without notifying me or telling your doctor you are taking an MAO inhibitor.
Eat anything else you want in reasonable
quantities -- assuming it is a normal food (e.g., no banana peels!).
1: J Clin Psychopharmacol 1996 Oct;16(5):383-8
Comment in:
J Clin Psychopharmacol. 1997
Jun;17(3):226-7; discussion 227-8.
J Clin Psychopharmacol. 1997
Jun;17(3):227; discussion 227-8.
Tyramine content of previously restricted foods in
monoamine oxidase inhibitor diets.
Walker SE, Shulman KI, Tailor SA, Gardner D.
Department of Pharmacy, Sunnybrook Health Science Centre,
University of Toronto, Ontario, Canada.
Traditional monoamine oxidase inhibitors (MAOIs) remain
an important class of drugs for a variety of psychiatric conditions, including
depressive illnesses, anxiety, and eating disorders. It was the objective
of this study to refine the MAOI diet by determining the tyramine content
of a variety of untested and "controversial" foods that continue to appear
on MAOI diet-restricted food lists. A secondary objective of the study
was to evaluate the effect of freshness on the tyramine content of some
foods. Fifty-one food samples were evaluated for tyramine content by liquid
chromatography. Food samples included a selection of sausages, beverages,
sliced meat products, including chicken liver, and some fruits, including
raspberries, bananas, and banana peels. Foods that were found to have dangerously
high concentrations of tyramine (> or = 6 mg/serving) included chicken
liver aged 9 days (63.84 mg/30 g), air-dried sausage (7.56 g/30 g), soy
sauce (0.941 mg/ml), and sauerkraut (7.75 mg/250 g). Of the foods analyzed
in this study, only those with high tyramine content per serving should
continue to be absolutely restricted. All other foods are either safe for
consumption or safe in moderation. The data provided should be combined
with the data from other similar analytical studies to develop a list of
foods that should be absolutely restricted. A more accurate list of restricted
foods may enhance patient dietary compliance.
PMID: 8889911
2: J Clin Psychiatry 1996 Mar;57(3):99-104
Comment in:
J Clin Psychiatry. 2000 Feb;61(2):145-6.
The making of a user friendly MAOI diet.
Gardner DM, Shulman KI, Walker SE, Tailor SA.
Department of Pharmacy, Sunnybrook Health Science Centre,
University of Toronto, Ontario, Canada.
BACKGROUND: Many monoamine oxidase inhibitor (MAOI) diets
are considered to be excessively restrictive and founded on poor scientific
evidence. We present a safe and practical MAOI diet based on the related
clinical and analytic data. METHOD: We used a critical review of the literature
and our own tyramine assay results to categorize foods to be restricted
absolutely, taken in moderation only, or unrestricted. RESULTS: We recommend
that users avoid aged cheese; aged or cured meats (e.g., air-dried sausage);
any potentially spoiled meat, poultry, or fish; broad (fava) bean pods;
Marmite concentrated yeast extract; sauerkraut; soy sauce and soy bean
condiments; and tap beer. Wine and domestic bottled or canned beer are
considered safe when consumed in moderation. Other foods not mentioned
are considered unrestricted. CONCLUSION: The concerns about perpetuating
an overly restrictive MAOI diet include the avoidance by prescribers of
a potentially useful treatment option, excessive limitations on lifestyle
for patients, and increased risk to patients secondary to noncompliance
with the diet. We propose an MAOI diet that has a solid scientific and
clinical basis and that is, above all, practical.
PMID: 8617704