Posted by cornycon on February 18, 2004, at 8:36:03
In reply to Nardil and MAOI diet restrictions, posted by Bigdave on December 17, 2003, at 19:44:42
> I'm due to begin a trial course of Nardil in a few days and I've been researching as
> much as possible about the MAOI diet restrictions. Unfortunately I'm having to self-
> medicate myself as my doctor flatly refused to prescribe Nardil and told me it's unlikely
> any dr will prescribe it me for treatment of social anxiety. Very unfortunate for me
> since now I have to pay for the medication myself at a cost of £50 a month.
> My dr described it as a "dirty drug" and said it was no longer used! I wrote to my dr last
> week to give him the 'good' news about me taking Nardil myself privately and he wrote back
> to me saying "I strongly advise you not to take Nardil without supervision" and recommended
> that he refers me to a specialist, a road which I've been down several times already.
> I've decided that Nardil is something I want to try and I'm sure if I'm sensible
> and careful with the diet I'll be fine. That's really the reason for my post to get some
> answers and hopefully put to together an overall diet guide. From the posts I've read here
> I must say it seems very daunting and confusing with lots of conflicting and non-specific
> One thing which particularly worries me is people saying that certain things which are
> recommend to avoid, are ok, such as beers and wine and some food items. Surely
> it's better to be safe than sorry and avoid these items, period? Afterall everyone is
> different and what's fine for one person may produce a terrible reaction in another
> person. Another reason for sticking to the list rigidly is that it's impossible to say
> with any kind of accuracy what levels of tyramine may or may not be found in certain
> types of food on the things to avoid list. How can you possibly know how much tyramine
> is in a serving with so many different variations and other factors? I think if I start
> gambling with this and experimenting I would become very anxious and worried that I'd
> have a hypertensive reaction and that might bring one on anyway!
> If you stick to the guidelines then you're not taking chances is how it seems
> to me. It doesnt seem majorly difficult to me to maintain a strict diet, certainly for
> vegetarians anyway. The only real sacrifice for me will be cheese and beer which I enjoy
> It's puzzling to me how since the diet restriction is such an important issue for people
> taking MAOI medication, why there isnt a single authorative published list somewhere
> on the web with very specific and detailed information which is updated regularly. Perhaps
> maintained by the drug manufacturer?
> One point which is seldom discussed as well is that it's better to take your MAOI
> medication sometime AFTER a meal which is likely to contain tyramine. I've read that
> this can minimise the chance of a hypertensive reaction or make it considerably less.
> This sounds like good sound advice to me and makes sense. Does anyone agree with this
> and use this approach with taking MAOI meds?
In regard to the safety of taking foods in the groups that have tyramine in them.
I have found that the degree of reaction to these foods is more than just the levels of tyramine that they contain. For example the rate of the digestive process, the regularity of Bowel motions, Blood pressure, Medication combinations, Season of the year.
I live in the southeastern part of Australia, My greatest reaction period is in the period between February and June. During this period even very minor levels will result in severe migraine attacks. At other times I am able to eat almost whatever I feel like. As a comparrative example: I like tasty/aged chese, am of Dutch descent and eat Edam and Liverwurst. In my safe period I can eat 250 grams of aged cheese with only a minor fuzzing effect, however in my unsafe period I am restricted to approx. 15 grams. Other foods however are a no-no at all times. Yeast extracts, wine,beer and a number of others.
I am still trying to compile my lists. The process for me is a little more difficult than it would normally be due to mittigating circumstances.
I have the following on my problem list:
Depression: 1 Script
Epilepsy: 3 Scripts
Arthritis: 1 Script
Injury management: 2 Scripts
Resectioned Bowel & Lower Intestines resulting in digestive and elimmination problems
My level of tolerance is dependant on how much of an impact one or more of the above conditions with their associated medication levels is having on me.
As to the question of taking your meds before or after a meal, my experiance has been that this only results in a shift in the onset time, rather than the severity of the attack.
In a consultation with one Dr. I was prescribed Medical Oxygen to treat what he detirmined as stress pains. (This Diagnosis has turned out to be inaccurate, this detirmination being established by a lifestyle study that found no corroborative evidence. The sensitivity to Tyramine has since been detirmined.) This has had a very positive effect to date. Prior to the Oxygen the severity of the pain was about 9/10 while the attacks would last anywhere from 3 hours to 9 hours. With the Oxygen I have been able to contain the length of the attack to about 15 Minuites, breathing the Oxygen for the whole period. This is generally the end of the attack, however there have been occasions where I have inadvertantly been caught out with the Tyramine content, and this results in an on off pattern. (start of attack; 15 min O2; 2 hour break; attack return; 15 min O2. I had one time that this start stop went for a whole night, bad eating habits. But with checking I found that my BP was only 100/70. Normally my BP is 130/80, so I am assuming that this has some bearing on the case.Blood flow volume v Flush time.
The upshot of all of the preceeding is that from my experience it is better to start with a small amount and gauge its effect on you, then make a decision based on this about it's safety for "YOU"
Because as is shown in test reports done on the content of Tyamine in the same product from different batch's, there is wide variation, the same conclusion should be applied to people and their tollerance levels.