Monoamine Oxidase Inhibitors (MAOIs)

While MAOIs are effective against depression, they require eating a special diet and avoiding some types of prescription and over-the-counter medications to prevent serious side effects. If you're taking an MAOI medication, talk with your doctor about which foods, beverages, and other medications you must avoid and see Foods to Avoid When You Take an MAOI below. Also, wear a medical alert bracelet to warn others of medications, foods, and beverages that you must avoid.

How MAOIs Work

These antidepressants are believed to work by slowing the natural breakdown of norepinephrine and serotonin. They do this by blocking the enzyme that breaks down norepinephrine and serotonin, called monoamine oxidase, or MAO. Having more norepinephrine and serotonin available in the synapse results in reduced feelings of depression.

Possible Side Effects of MAOIs

Not all MAOIs produce side effects. For the types that do, not everyone who takes them will have side effects. Some side effects disappear quickly, while others remain throughout treatment. Elderly patients may be more sensitive to the effects of MAOIs, especially those who have high blood pressure, cardiovascular disease, renal disease, seizure disorders, or hyperthyroidism. If you are not sure your symptoms are from the medication, call your doctor immediately.

Bothersome Side Effects

  • agitation - extreme
  • constipation
  • diarrhea
  • dizziness
  • dry mouth
  • fatigue
  • flushed face
  • headache
  • low blood pressure when standing
  • mood swings
  • muscle pains
  • nausea
  • sexual dysfunction
  • sleeping problems
  • stomach pain
  • water accumulation
  • weight gain

More Serious Side Effects

  • blurred vision
  • brain disorders
  • heart irregularities
  • high blood pressure
  • liver toxicity
  • seizures
  • stroke

Possible Drug Interactions With MAOIs

Use caution when taking MAOIs with other drugs to help you avoid unnecessary side effects. Tell your doctor about all other drugs you are taking or have taken in the past several weeks - it's even a good idea to let your doctor see your other prescriptions. Extremely serious reactions can also occur if you mix this medicine with alcohol or with recreational drugs. See the list Drugs to Avoid When You Take an MAOI below.

When you take an MAOI, you must also follow a special diet and avoid some types of prescription and over-the-counter medications to prevent serious side effects. Talk with your doctor about which foods, beverages, and other medications you must avoid and see the list Foods to Avoid When You Take an MAOI below. Also, wear a medical alert bracelet to warn others of medications, foods, and beverages that you must avoid.

Drugs to Avoid When You Take an MAOI

Not all drugs in the categories listed below will react with MAOIs - your doctor is the best judge. Before you start taking an MAOI medication, make sure you tell your doctor if you take any drugs or substances from this list. Also check with the pharmacist before taking any over-the-counter medicine.

  • alcohol
  • allergy/cold remedies
  • anesthetics
  • anxiety pills
  • asthma medications
  • barbiturates
  • blood pressure medications
  • cocaine
  • cough or cold medications
  • diabetes medications
  • heart medications
  • migraine medications
  • muscle relaxants
  • narcotics or other pain medications
  • seizure medications
  • stimulant medications
  • recreational drugs
  • sulfur medications
  • tremor medications
  • weight reduction pills

Monoamine Oxidase Inhibitors: What to Avoid

Foods to Avoid When You Take an MAOI

When you take an MAOI, you must use caution when eating certain foods and beverages. You can have serious side effects with certain combinations. They contain chemicals that can react with MAOIs and cause severe high blood pressure. Your doctor can explain more about how they interact.

The following partial list of foods or beverages should not be taken with MAOIs. If you have questions, always call your doctor before eating these foods. You must entirely avoid some of these foods. You may eat others in small amounts. Ask your doctor for guidance. If you stop taking MAOIs, you should continue avoiding these foods and medications for at least 2 weeks.

Beverages

  • beer
  • caffeinated beverages, including cola, coffee, tea
  • liqueurs
  • red wine
  • sherry

Dairy Products

  • aged cheeses (such as cheddar, Parmesan, Camembert, Edam, American, blue, Romano, Roquefort, Gruyere, Swiss, mozzarella)
  • sour cream
  • yogurt

Fish and Meats

  • aged meats
  • anchovies
  • beef or chicken liver
  • caviar
  • meat extracts (Marmite)
  • fish, pickled or smoked
  • meats, pickled or smoked
  • poultry, pickled or smoked
  • summer (dry) sausage (such as pepperoni)

Fruits and Vegetables

  • avocados (overripe)
  • bananas (overripe)
  • eggplant (overripe)
  • fava or broad beans
  • figs
  • orange pulp
  • plums
  • prunes
  • raisins
  • spinach
  • tomatoes

Spices and Packaged Food

  • monosodium glutamate (MSG)
  • soups (packaged)
  • soy sauce
  • yeast vitamin supplements

Other

  • chocolate
  • soy
  • yeast products