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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by ross on November 19, 2001, at 18:53:50
has anyone ate pizza on nardil or any other ,mao?
thanks
Posted by vincent on November 19, 2001, at 19:35:12
In reply to ANYONE HAVE A SLICE OF PIZZA WHILE ON MAO??, posted by ross on November 19, 2001, at 18:53:50
I think it depends about what kind of cheese you use! If use old cheese or fresh cheese like "mozzarella".
If it is real italian pizza you MUST use Mozzarella!
You could eat Turist Pizza, prepared using classic cheese.
But, in this case, I think...it's better go to chinese restaurant!!!
Bye
Posted by snowpony on November 19, 2001, at 20:07:47
In reply to ANYONE HAVE A SLICE OF PIZZA WHILE ON MAO??, posted by ross on November 19, 2001, at 18:53:50
Yes sir and love it, I'm on nardil, been for 5 years no trouble with pizza, give it a try. I have tried all the things we are not supposed to have (drugs and food) just to find out what affects me, and no food seems to make me sick, only OTC meds.
Posted by tina on November 20, 2001, at 13:30:20
In reply to Re: ANYONE HAVE A SLICE OF PIZZA WHILE ON MAO??, posted by snowpony on November 19, 2001, at 20:07:47
> Yes sir and love it, I'm on nardil, been for 5 years no trouble with pizza, give it a try. I have tried all the things we are not supposed to have (drugs and food) just to find out what affects me, and no food seems to make me sick, only OTC meds.
You don't have to watch your diet on moclobemide so closely. Nardil and parnate are the pains in the ass for diet interactions. If you're on moclobemide, don't worry about it. Eat, drink and be merry.
Posted by Cam W. on November 21, 2001, at 0:14:36
In reply to ANYONE HAVE A SLICE OF PIZZA WHILE ON MAO??, posted by ross on November 19, 2001, at 18:53:50
Ross - Most of the chain pizza joints use unaged mozzarella. If you stay away from the gourmet (aka real) pizzas and aged toppings (eg. real italian sausage and pepperoni) there usually isn't any problem with the MAOIs. - Cam
Posted by Elizabeth on November 23, 2001, at 20:35:42
In reply to ANYONE HAVE A SLICE OF PIZZA WHILE ON MAO??, posted by ross on November 19, 2001, at 18:53:50
See:
Shulman KI, Walker SE. Refining the MAOI diet: tyramine content of pizzas and soy products. J Clin Psychiatry 1999 Mar;60(3):191-3.
Mozzarella cheese on pizza is generally fine. It doesn't need to be fresh mozzarella (a pretty flavorless substance) -- the stuff that most ordinary American pizza places use is not aged enough to be a problem. Even pepperoni seems to be all right (again this is on "ordinary" pizza rather than that gourmet s---).
I had many, many slices of pizza (including pepperoni pizza) while taking various MAOIs (Nardil, Parnate, Marplan, selegiline).
-e
Posted by Adam on November 26, 2001, at 13:24:20
In reply to pizza and MAOIs » ross, posted by Elizabeth on November 23, 2001, at 20:35:42
I can second what Cam W. and Elizabeth have said: Fast-food pizza (even with pepperoni) doesn't seem to be a problem, at least in moderate amounts. What, say, Domino's uses on their pizzas is some gooey-when-hot substance that only passes for cheese in the minds of many a gourmand and connoisseur. I've actually had four slices of pepperoni pizza from Papa Gino's (not exactly gourmet) and a bottle of domestic beer (Cheap American Brewskienweiser) in one sitting and nothing happened to my blood pressure at all.
Such a report is bound to send many a physician into fits of apoplexy, but it's the truth, all the same. As always, your milage may vary.
Posted by SLS on November 27, 2001, at 12:56:09
In reply to Re: pizza and MAOIs, posted by Adam on November 26, 2001, at 13:24:20
Hi Adam.
> I can second what Cam W. and Elizabeth have said: Fast-food pizza (even with pepperoni) doesn't seem to be a problem, at least in moderate amounts.
> I've actually had four slices of pepperoni pizza from Papa Gino's (not exactly gourmet) and a bottle of domestic beer (Cheap American Brewskienweiser) in one sitting and nothing happened to my blood pressure at all.
> As always, your milage may vary.
I think the phrase "your mileage may vary" is particularly appropriate when it comes to discussing the MAO-inhibitor diet.I have eaten tons of pizza while taking high dosages of Parnate and Nardil. My doctor at that time (1987), whose experience I regarded highly, explained to me with confidence that cheeze pizza is quite safe to eat, as long as the cheese used is of the cheap processed variety of mozzarella. He cautioned me to avoid the more expensive imported cheeses that tend to be aged considerably. I have not yet heard of anyone reacting badly to cheese pizza. This doctor also said that it was imperative to avoid pepperoni. I think any aged meat should be suspect, including certain sausages and salami. If I had to choose between pepperoni and sausage to put on a pizza, I would choose the sausage.
There is great variability between individuals as to how they will react to a given food. Equally true is that there is great variability as to how any one individual will react to a specific food on different occasions. Someone can eat pepperoni 36 times and be fine. Then, on the 37th time, he will experience the classic occipital headache that indicates an accute pressor reaction to tyramine.
I know I've told this story before, but...
I had been eating cheese pizza regularly while taking a combination of Parnate 60mg + desipramine 150mg. I would eat it every Saturday for lunch at work, as was ritual. One day, things were so busy such that I had just a fraction of a minute to run back to the conference room and grab a few bites of a slice between customers. I really wasn't paying attention to what I was doing because things were so busy. After chomping down twice and swallowing, I backed my hands away and saw that I was holding a slice of pepperoni. I yelled out "What the fuck am I doing!". Some of my coworkers turned around with puzzled looks on their faces, but I pretending like nothing happened. I consumed exactly 1 1/2 pieces of thinly-sliced pepperoni. I wasn't worried because it seemed like such a negligible amount. Within 10 minutes, the back of my head near where it meets the neck was throbbing with intense pain. It felt like someone was beating it with a hammer in synchrony with my pulse. I had never experienced anything like that before. I didn't happen to have any nifedipine with me, but I decided to take a chance and not leave work to run to the hospital, hoping that the reaction would dissipate. I didn't take my blood pressure, but the symptoms were unmistakable as a tyramine reaction. When I sat down, it got worse. So I ended up standing and walking around for 45 minutes until the headache disappeared.
Regarding alcohol, this doctor used as a rule of thumb to avoid any colored liquors. Similarly, he recommended that I stick to white wines. I don't recall him saying anything about beer, but he didn't go out of his way to say that it was safe to drink. I'm not sure that these proscriptions are warranted, but I have followed them in the past. I'm not much of a drinker, anyway.
Anyway, given my mileage, I would strongly recommend that one not eat pepperoni, dry sausage, or any other meats that are left hanging to age.
- Scott
Posted by Elizabeth on November 28, 2001, at 16:58:20
In reply to Re: pizza and MAOIs » Adam, posted by SLS on November 27, 2001, at 12:56:09
> Regarding alcohol, this doctor used as a rule of thumb to avoid any colored liquors. Similarly, he recommended that I stick to white wines. I don't recall him saying anything about beer, but he didn't go out of his way to say that it was safe to drink. I'm not sure that these proscriptions are warranted, but I have followed them in the past.
Scott --
I'm not into alcohol either, but for the record, red wines and other "colored liquors" have never been shown to be a problem (i.e., no well-documented cases of reactions, no accurately measured high levels of tyramine or other relevant biogenic amines). I think the only alcoholic drinks that are known to be unsafe are certain obscure European (Czech and Irish) bottled beers and tap beer.
> Anyway, given my mileage, I would strongly recommend that one not eat pepperoni, dry sausage, or any other meats that are left hanging to age.
BTW: The article on pizzas said that even the pepperoni pizzas were safe (this was from American and Canadian pizza chains), although given your experience one might want to exercise caution.
-elizabeth
Posted by michael on December 4, 2001, at 18:04:29
In reply to Re: pizza and MAOIs, posted by Elizabeth on November 28, 2001, at 16:58:20
Elizabeth -
Did you not post at one time, an "updated" maoi diet, which was less restrictive than the older "classic" maoi diet restrictions?
I may have saved it, and could look for it... michael
> > Regarding alcohol, this doctor used as a rule of thumb to avoid any colored liquors. Similarly, he recommended that I stick to white wines. I don't recall him saying anything about beer, but he didn't go out of his way to say that it was safe to drink. I'm not sure that these proscriptions are warranted, but I have followed them in the past.
>
> Scott --
>
> I'm not into alcohol either, but for the record, red wines and other "colored liquors" have never been shown to be a problem (i.e., no well-documented cases of reactions, no accurately measured high levels of tyramine or other relevant biogenic amines). I think the only alcoholic drinks that are known to be unsafe are certain obscure European (Czech and Irish) bottled beers and tap beer.
>
> > Anyway, given my mileage, I would strongly recommend that one not eat pepperoni, dry sausage, or any other meats that are left hanging to age.
>
> BTW: The article on pizzas said that even the pepperoni pizzas were safe (this was from American and Canadian pizza chains), although given your experience one might want to exercise caution.
>
> -elizabeth
Posted by Elizabeth on December 7, 2001, at 23:59:58
In reply to Re: pizza and MAOIs » Elizabeth, posted by michael on December 4, 2001, at 18:04:29
> Did you not post at one time, an "updated" maoi diet, which was less restrictive than the older "classic" maoi diet restrictions?
Yes, I did. You can find it by searching the psycho-babble archives (I know I've posted it in the last year).
-e
Posted by michael on December 8, 2001, at 15:57:47
In reply to Re: pizza and MAOIs » michael, posted by Elizabeth on December 7, 2001, at 23:59:58
> > Did you not post at one time, an "updated" maoi diet, which was less restrictive than the older "classic" maoi diet restrictions?
>
> Yes, I did. You can find it by searching the psycho-babble archives (I know I've posted it in the last year).
>
> -eJust in case anyone else wants it, I found my copy... I figured this'd be easier than having to search for it in the archives. michael
So, here it is -- a list of some things that I felt merited avoidance, and others that I felt were safe (and had no problems with, of course):
WINE is fine. Some people may get histamine-related headaches from it and think they are having a hypertensive episode when they are not.
BOTTLED BEERS are usually fine (American and Canadian ones are the best studied).
TAP BEER should be avoided.
Most AGED CHEESES are out. Of note, the mozzarella generally used on most pizzas has been found to be okay. So unless it's some weird exotic pizza with sharp cheeses (feta, cheddar, fontina) it should be okay to eat pizza. (In general, cheeses described as "sharp" are the most dangerous ones.) Ricotta cheese, cottage cheese, cream cheese, and "pasteurized process cheese food" (American cheese -- the cheesiest kind) are okay as well. In regard to the intermediately-aged cheeses, I personally had no problem with jack or brie in moderation. I would be careful if you're going to try this, though, and it's not something I'm willing to say is definitely safe.
OTHER DAIRY PRODUCTS, such as milk, yogurt, and sour cream, are generally safe as long as they are fresh.
SOY FOODS are controversial: one sample of soy sauce was reported to have quite a lot of tyramine in it, but there aren't any documented interactions. My experience has been that a little bit of soy sauce is okay. I would avoid other soy products, such as soy milk and tofu. The Taiwanese dish called "stinky tofu" is probably right out. < g >
Similarly, SAUERKRAUT has been found to contain a large amount of tyramine in some analyses, but there aren't any reactions documented that were associated with sauerkraut.
PROTEIN-CONTAINING FOODS that have passed the expiration date or that may have been stored improperly should be avoided. Fresh milk, meat, etc. are okay. One exception that I make, just because there have been so many problems reported with it, is LIVER; it seems possible that the proteins in liver are especially readily broken down to tyramine (perhaps they include more tyrosine than other proteins do, or perhaps the bacteria that turn tyrosine into tyramine are fond of liver).
Certain AGED MEATS, such as salami, bologna, and some sausages, may be problematic. Err on the side of caution. Some telltale words to look for are "aged," "smoked," "air-dried," and "fermented."
PICKLED HERRING itself isn't a problem, just don't eat the brine (yuck!).
To many people's relief, CHOCOLATE is fine. (If my experience with carb cravings on phenelzine is any indication, it's fine in *huge* amounts!)
Some miscellaneous peculiar foods, such as FAVA BEAN PODS and BANANA PEELS, also cause problems. Shouldn't be a major issue for most people. Watch out for Middle Eastern cuisine, which sometimes contains fava beans. MISO SOUP and other Oriental soup stocks have also been reported to cause problems.
I hope that people find this helpful. As I said, I can provide a list of references if anyone is interested.
-elizabeth
This is the end of the thread.
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