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Monoamine Oxidase Inhibitors (MAOIs)


MAOIs are often used to treat depression. Common MAOIs include:

  • Marplan (isocarboxazid)
  • Nardil (phenelzine)
  • Parnate (tranylcypromine)
If you are taking an MAOI, you will need to know about some important dietary restrictions. Disregarding the dietary restrictions may lead to hypertensive crisis (see below), which includes headaches, stiff neck, sweating, nausea, vomiting or much worse.

Is is also important to tell your doctor about any other medications that you are taking when you begin taking MAOIs. Particularily the medication Demerol (meperidine), which may cause a potentially fatal reaction when combined with MAOIs.

Avoid the following foods while taking an MAOI:

  • aged cheese (cream cheese and cottage cheese are okay)
  • alcohol (especially beer and wine)
  • avocados
  • bananas
  • beef or chicken liver
  • caffeinated beverages
  • canned meats
  • chocolate
  • dry sausages
  • eggplant
  • fava beans
  • figs
  • gravies that are preprocessed
  • green bean pods
  • homemade breads
  • Italian broad beans
  • liver
  • orange pulp
  • pickled or smoked fish, poultry or meats
  • raisins
  • red plums
  • salami
  • soups (packaged or soup cubes)
  • sour cream
  • soy sauce
  • spinach
  • tomatoes
  • yogurt

Along with the many positive effects of MAOIs, you may also experience some side effects. Side effects are unintended or undesirable reactions to medications. Most of the side effects you experience can be lessened with additional medications, dosage changes, or changes in your daily habits. If you experience any side effects, contact your doctor or clinician right away and continue taking your medication.

It is also important to be aware of the risks of antidepressant medication. The risks occur veryrarely, but it is important to know what to look for, just in case. If you think you are experiencing one of the risks, contact your doctor or clinician or go to the emergency room right away!

Most common side effects dizziness, insomnia, sexual difficulties, weight gain
Occasional side effects constipation, diarrhea, dry mouth, headache, skin problems
Risks hypertensive crisis, liver irritation

 

Most common side effects

 

Dizziness

If you feel dizzy when you sit or stand up quickly, there are some precautions that you can take to avoid injury. Get up very slowly from a laying or sitting position and make sure you have something to hold onto as you get up. Then, wait a moment or two before you start walking.
  Insomnia

If you experience insomnia as a result of your medication, your doctor may change your dose, prescribe a medicine to help you sleep, advise you to take the medication in the morning, or change your antidepressant altogether. To combat insomnia, avoid eating heavy meals, exercising, or drinking caffeinated beverages before bed.

 

Sexual difficulties

Some antidepressant medication may lead to decreased interest in sex or difficulty achieving orgasm, and in males, difficulty maintaining an erection. Another sexual-related problem that happens to both males and females is breast tenderness and enlargement due to antidepressant medication.

 

Weight gain

Some MAOIs may cause you to gain weight. Your doctor or clinician can help you monitor your weight and suggest a healthy diet and exercise program for you if weight gain is a concern.
 

Occasional side effects

 

Constipation

Antidepressant medication can sometimes cause constipation. This side effect usually does not go away, but you can learn how to control it by increasing the amount of high fiber foods in your diet, such as breads, fruits, and vegetables, and bran. It also helps to exercise regularly and drink plenty of fluids. If constipation is still a problem, your doctor may recommend a laxative or fiber product, or may prescribe an additional medication to reduce the side effect.
  Diarrhea

If you experience diarrhea, drink plenty of fluids to avoid dehydration. Your doctor can tell you which anti-diarrhea products are safe to take with your medication.
  Dry mouth

Some people taking antidepressant medications experience dry mouth. Although dry mouth may not go away completely, it usually gets better with time. Dry mouth may be relieved by sucking on hard candy or crushed ice, drinking plenty of fluids, or eating frozen grapes.

 

Headache

MAOIs can cause headaches, which often fade as your body adjusts to the medication. If you experience headaches, and they're disruptive, talk to your doctor before you take any pain medications. S/he can let you know which medications are safe to take with your antidepressant.

 

Skin problems

Some people taking MAOIs may develop an allergic reaction in the form of a rash, hives or itchiness. Increased sensitivity to the sun is another skin problem that some people notice. If you develop increased sensitivity to the sun, your skin will burn more easily in the sun than it normally would. You should always use sunscreen when you go out, wear a hat with a wide brim, and avoid staying out in the sun for long periods of time.
 

Risks

  Hypertensive crisis

This is a very serious condition in which your blood pressure rises and doesn't return to normal levels. Avoiding foods rich in tyramine (see list above) can prevent hypertensive crisis. The symptoms of hypertensive crisis include headaches, stiff neck, nausea and vomiting, sweating, and clammy skin. If you are experiencing these symptoms, call your doctor or go to the emergency room immediately!

 

Liver Irritation

The symptoms of liver irritation include extreme tiredness, severe nausea, and yellowing of the whites of the eyes and skin. If you experience these symptoms, contact your doctor immediately!