Alzheimer’s Delirium and Dementia Q 38
Jose who is receiving monoamine oxidase inhibitor antidepressant should avoid tyramine, a compound found in which of the following foods?
A. Figs and cream cheese
B. Fruits and yellow vegetables
C. Aged cheese and Chianti wine
D. Green leafy vegetables
Correct Answer: C. Aged cheese and Chianti wine
Aged cheese and Chianti wine contain high concentrations of tyramine. MAOIs prevent the breakdown of tyramine found in the body as well as certain foods, drinks, and other medications. Patients that take MAOIs and consume tyramine-containing foods or drinks will exhibit high serum tyramine level. A high level of tyramine can cause a sudden increase in blood pressure, called the tyramine pressor response. Even though it is rare, a high tyramine level can trigger a cerebral hemorrhage, which can even result in death.
Option A: Eating foods with high tyramine can trigger a reaction that can have serious consequences. Patients should know that tyramine can increase with the aging of food; they should be encouraged to have foods that are fresh instead of leftovers or food prepared hours earlier. Tyramine is found in certain foods, beverages, and other substances. Protein-rich foods, for example, typically contain high amounts of tyramine. Foods that are aged (such as cheese) are also high in tyramine because the content of the substance in a food or beverage increases as they age.
Option B: Examples of high levels of tyramine in food are types of fish, as well as types of meat, including sausage, turkey, liver, and salami. Also, certain fruits can contain tyramine like overripe fruits, avocados, bananas, raisins, or figs. Tyramine is a compound that affects your blood pressure. It’s regulated and broken down by the MAO enzyme. MAOIs restrict the MAO enzyme to reduce symptoms of depression and anxiety. However, if the MAO enzyme is inhibited, tyramine can reach dangerously high levels in your body. Elevated tyramine can cause your blood vessels to narrow, possibly leading to critically high blood pressure.
Option D: Further examples are cheeses, alcohol, and fava beans; all of these should be avoided even after two weeks of stopping MAOIs. Anyone taking MAOIs is at risk for an adverse hypertensive reaction, with accompanying morbidity. Only eat fresh and freshly cooked foods while taking MAOI as tyramine levels in food increase during the spoiling or decay process. Always use proper food handling, preparation, and safety practices to help prevent spoilage and food poisoning. Cook all foods to the proper temperature indicated for food safety.