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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by jade k on July 18, 2010, at 21:24:14
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.
J Clin Psychiatry 1996 Mar; 57(3):99-104ABSTRACT
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.Roslynn, I like this one, but google MAOI Diet and make sure you are most comfortable with this.
About.com has a decent one also.
Take Care,
~Jade
Posted by jade k on July 19, 2010, at 16:18:07
In reply to MAOI Diet for Roslynn, posted by jade k on July 18, 2010, at 21:24:14
Hi again Roslynn,
This was the diet list I was hoping to find in the arcives. These should give you an idea what changes you may have to make should you decide to use an MAOI. She says at the end that she can provede ref's, which I can't do. Your pdoc will be the final say.
~Jade
MAOI diet short list
Posted by Elizabeth on August 17, 2001, at 13:43:12Hi. A couple of people have requested that I repost the dietary restrictions that I followed while taking MAOIs. Please don't take this as gospel; it's what worked for me and it's based on some fairly meticulous library research (I can provide a reading list for anyone who's interested). A lot of the "menus" that get handed out by pharmacies, hostpials, doctors, etc. are not very accurate because they are out of date and place extreme and unnecessary restrictions on what you can eat. This results in a number of problems. Many people are scared off by long, intimidating lists of restrictions. In other cases, a person will discover that s/he can "cheat" on some of the foods (the ones that really shouldn't be on the list) and will therefore take the entire list less seriously. There are some things that you definitely should avoid, but they are relatively few.
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
Posted by jade k on July 19, 2010, at 17:36:51
In reply to Re: Archived MAOI Diet » jade k, posted by jade k on July 19, 2010, at 16:18:07
You're gonna have to give up the bannana peels, so if thats a deal breaker....
Posted by Roslynn on July 19, 2010, at 17:40:18
In reply to Re: Archived MAOI Diet » jade k, posted by jade k on July 19, 2010, at 16:18:07
Hi Jade,
Thank you so much! I really appreciate this. I am going ahead with a Prozac washout period of 5 weeks (which I am also scared about) but I will be "bridging" this gap by adding clomipramine to my current combo as a temporary measure.
My pdoc does not have the best bedside manner..I wish he was a little friendlier, because i am scared of all this...
Thank you again for the lists! Much appreciated.
Roslynn
Posted by jade k on July 19, 2010, at 18:02:11
In reply to Re: Archived MAOI Diet, posted by Roslynn on July 19, 2010, at 17:40:18
> Hi Jade,
>
> Thank you so much! I really appreciate this. I am going ahead with a Prozac washout period of 5 weeks (which I am also scared about) but I will be "bridging" this gap by adding clomipramine to my current combo as a temporary measure.
>
> My pdoc does not have the best bedside manner..I wish he was a little friendlier, because i am scared of all this...
>
> Thank you again for the lists! Much appreciated.
>
> RoslynnHey, no problem. Your pdoc, will he answer your questions to your satisfaction, and is he knowledgable about MAOI's? You're gonna have questions for him along the way.
When I started a MAOI I was scared too. Thats when I came here. I hooked up with a few posters that had lots of knowledge and experience. Posters don't replace you're doc, but will generally be happy to answer your questions. Especially about MAOI's if they can.
~Jade
Posted by emmanuel98 on July 19, 2010, at 20:42:33
In reply to Re: MAOI 's, posted by jade k on July 19, 2010, at 18:02:11
If you search MAOIs on wikipedia, there is a link at the bottom to dietary restrictions. To the lists already posted, I would add that I have been told to limit (but not avoid) raspberries and eggplant. Don't ask me why. Not exactly staples of my diet anyway.
I have also found that small amounts of cheese don't effect me at all (though you can't count on that). I've had salads with small amounts of blue or feta. I've sprinkled parmesan on pasta. I'm talking an ounce or less, which my p-doc thinks is probably safe enough.
Posted by Roslynn on July 20, 2010, at 16:00:10
In reply to Re: MAOI 's, posted by jade k on July 19, 2010, at 18:02:11
Hi Jade,
About my pdoc, I am not so sure. I think he would call me back if I had a serious question or concern. I think he has some experience with MAOIs, although I think recently he mostly uses EMSAM.
>
> > Roslynn
>
> Hey, no problem. Your pdoc, will he answer your questions to your satisfaction, and is he knowledgable about MAOI's? You're gonna have questions for him along the way.
>
> When I started a MAOI I was scared too. Thats when I came here. I hooked up with a few posters that had lots of knowledge and experience. Posters don't replace you're doc, but will generally be happy to answer your questions. Especially about MAOI's if they can.
>
> ~Jade
>
>
>
Posted by jade k on July 20, 2010, at 17:03:19
In reply to Re: MAOI 's » jade k, posted by Roslynn on July 20, 2010, at 16:00:10
Hi Roslynn,
Thats a tough one. If you trust him to know enough about MAOI's and you want to stay with him, I geuss educate yourself as best you can. Someone close to you should know what you are doing (MAOI) and be familiar with what to look for in case of a problem.
Oh, talk to him about getting a blood pressure cuff and your bp.
Ask him for a remedy to keep with you. If you suddenly get a terrible headache, you may need it if out or at home.
I'm sorry, I'm rambling. You'll do fine, ask people on the board, they will answer in my experience. If you are not comfortable with your pdoc, I'm not sure I'd do a MAOI in his care.
I'm about to be blocked an gone for a while, you'll get help here and cover everything with your pdoc. MAOI's work wonders for many people.
~Jade
Posted by MoonageDaydream on July 20, 2010, at 20:43:41
In reply to Re: Archived MAOI Diet » jade k, posted by jade k on July 19, 2010, at 16:18:07
> 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 >I'd just like to add that "soybean oil", which is in all sorts of different foods, is perfectly fine. I eat it all the time. Pretty much any frozen dinner contains it. Having read quite a few food labels now, a lot of frozen meals of all sorts have dehydrated soy sauce in them (like Stouffer's Meatloaf and Marie Calendar's Honey Roasted Chicken)...perhaps these contain small enough amounts of soy sauce to be safe, I haven't tried them. Either way, people on MAOIs should probably be careful with frozen foods even if they're things you wouldn't think would have soy sauce. Does anyone have experience with this? I don't have the guts to try and eat these things.
Posted by Roslynn on July 22, 2010, at 12:12:42
In reply to Re: MAOI 's » Roslynn, posted by jade k on July 20, 2010, at 17:03:19
Dear Jade,
Thank you for all the information you've given me. Best of luck to you.
Roslynn
This is the end of the thread.
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