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The MAOI antidepressants were
developed in the 1960’s and have been used to treat depression and anxiety. Although they are very effective, and
sometimes work well for people who didn’t respond to other antidepressants,
their use is limited by side effects and dietary restrictions. In order to prevent potentially serious
elevations in blood pressure (“hypertensive crisis”), people who take MAOIs
need to avoid wine, beer, smoked meats and cheeses, pickled foods, bananas
and certain other foods that are high in a chemical called tyramine.
New versions of MAOIs are
currently being developed which may provide their benefits without the
dietary limitations. Meanwhile,
MAOIs are currently used only when other treatments fail to work.
The available MAOIs are: Phenelzine (Nardil) and tranylcypromine (Parnate) and
the newer version Emsam (selegiline). All of these medications have important
drug interactions; the following is a list of medications that should be
avoided while taking them (this list is not comprehensive; consult with
your physician if you have questions about a new medication):
Antidepressants [SSRIs, eg, Prozac(fluoxetine),
Zoloft(sertraline),
Paxil(paroxetine);
SNRIs, eg, Effexor (venlafaxine),
Cymbalta (duloxetine); TCAs, eg, Tofranil (imipramine),
Elavil (amitriptyline); MAOIs, eg, Marplan(isocarboxazid),
Nardil (phenelzine), Parnate (tranylcypromine); Remeron (mirtazapine);
Wellbutrin (bupropion)]; other medicines that
contain selegiline (eg,
Eldepryl); the herbal supplement St. John’s wort; certain pain medicines [eg,
Demerol (meperidine), Ultram
(tramadol), Dolophine
(methadone), Talwin (pentazocine),
or Darvon (propoxyphene)];
Flexeril or other medicines that contain cyclobenzaprine, a medicine used to treat muscle
spasms; BuSpar (buspirone),
an anxiety medicine; certain seizure medicines [eg,
Tegretol (carbamazepine)
and Trileptal (oxcarbazepine)];
Zyban (bupropion); and
amphetamines (also called stimulants or “uppers”)
Cold/cough preparations and
over-the-counter diet pills or herbal weight loss products containing
pseudoephedrine, phenylephrine, phenylpropanolamine, dextromethorphan,
or ephedrine; herbal or dietary supplements that contain tyramine
This page is currently under
construction. To read more about these medicines, go to:
Index of
Drug Information
Updated 5/12/9 by
Chris Aiken, M.D.
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