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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by MuseMemento on August 11, 2014, at 13:22:17
I'm currently undergoing a washout from wellbutrin xl and clomipramine in preparation for beginning treatment with either tranylcypromine or phenelzine in the next two weeks. I've been doing a lot of research into the low-tyramine diet required with these medications and I'm curious to hear from someone who's actually been on the medications how stringently they adhere to the diet. I don't want to be lax but the various diets I've seen have had different opinions on the necessity of restricting non-aged cheeses and some types of meat. One thing that concerns me is that I have a history of bulimia and I'm wary of the first few weeks until the antidepressant effect takes hold and I can be more stable and cognitively acute in order to more intuitively follow the diet. I plan on being meticulous for the first couple of weeks but if the medication finally works, it will be well worth it. Any response is appreciated. Thanks.
Posted by Tomatheus on August 11, 2014, at 19:41:33
In reply to MAOI diet, posted by MuseMemento on August 11, 2014, at 13:22:17
MuseMemento,
For the most part, I stayed completely away from all of the foods that are to be avoided when taking MAOIs while I was taking Nardil, Parnate, and Marplan. There was one time while taking Nardil when I ate some monterey jack cheese, thinking that it wasn't aged, only to find out later that it was aged. I didn't have a hypertensive crisis or notice anything out of the ordinary from eating the cheese.
Despite the fact that I didn't notice any of the symptoms associated with the hypertensive crisis when I ate the monterey jack cheese that I mentioned above, I continued to avoid eating monterey jack for as long as I stayed on MAOIs, even though I ate it once with no problem. Even though some individuals might be able to eat some of the foods to be avoided, at least some of the time, without any problems, I think that those who eat foods such as aged cheeses and certain meats (and others foods, of course) while taking MAOIs are taking a risk. Consuming foods that are high in tyramine (or foods that are restricted for other reasons) while taking an MAOI may not bring on a hypertensive crisis all of the time, but I can't say that I'd recommend eating the foods that those taking MAOIs are told to avoid.
Tomatheus
Posted by MuseMemento on August 12, 2014, at 11:28:22
In reply to Re: MAOI diet, posted by Tomatheus on August 11, 2014, at 19:41:33
Thanks, Tomatheus. I appreciate it. I think I'm most worried about dining at restaurants for social activities. Did you have much difficulty in such situations? I know all the effort will be worth it if I finally attain an antidepressant response but the washout coupled with the unfamiliarity of the diet are causing some significant anxiety.
Posted by Tomatheus on August 12, 2014, at 12:14:15
In reply to Re: MAOI diet » Tomatheus, posted by MuseMemento on August 12, 2014, at 11:28:22
MuseMemento,
Thank you for your reply. I didn't dine out very much while I was taking Nardil, Parnate, and Marplan, but I don't recall running into many problems on the few occasions when I did. I think that I just stuck with eating foods that I knew were safe, although I know that doing this isn't always easy to do because some restaurants serve a lot of foods with complex recipes. I think that I remember somebody saying on an Internet forum (possibly here) that they made a list of all the restricted foods and that they would let someone in the kitchen of the restaurant they were eating at see the list to make sure that what they ordered didn't have the restricted foods in it. You might want to try taking that approach, especially if you're planning on eating out a lot. You don't necessarily have to say that you're taking an MAOI if you do make a list of the restricted foods. You could always just say something vague, like "I can't eat these foods for health reasons."
I think that it's understandable to have some anxiety about the washout that you need to go through while transitioning from other medications to MAOIs and also about the unfamiliarity of the diet. Some of the lists of restricted foods contain dated information and include a lot of foods that are actually safe to eat with MAOIs, and it can be hard to know for sure when looking at the lists of foods whether or not they're up to date. I can say that I didn't find following the diet to be too difficult, especially once I got used to not eating the restricted foods, but then again, I didn't dine at restaurants too often when I was taking MAOIs. I'd like to be able to say that dining out while following the MAOI diet will also be something that you'll likely get used to, but again, I only ate at restaurants every now and then while taking MAOIs.
I wish you the best of luck with your MAOI trial, and I hope that the rest of your washout won't go too badly.
Tomatheus
Posted by baseball55 on August 12, 2014, at 19:56:49
In reply to Re: MAOI diet » MuseMemento, posted by Tomatheus on August 12, 2014, at 12:14:15
I was on parnate for several years. I more or less followed the diet - no cheese, no draft beer, no soy sauce, no dried meats. Not such a restrictive diet at all -- I mean, how often do most people eat salami or soy sauce in the US. I cheated some with no problem.
If you search the web, you find all kinds of restrictions that I wasn't told about at the hospital - grapefruit, eggplant, on and on and on. I think this is a lot of BS and just scares people off from MAOIs.
I started parnate at McLean. They gave me a basic list of dangerous food and drink - draft beer, chianti, aged cheese and meat, soy, sauerkraut, marmite. Nothing that I couldn't easily do without. I did miss cheese and, as time went on, tried small amounts without a problem. Though, in retrospect, I should probably not have done this.
But I stuck with the restrictions McLean gave me and ignored all the alarmist stuff I found on the web.
Posted by MuseMemento on August 13, 2014, at 15:19:12
In reply to Re: MAOI diet, posted by baseball55 on August 12, 2014, at 19:56:49
Thanks, all. I truly appreciate it. I think I'm now starting to look forward to the MAOI rather than being terrified of it. I really appreciate it. I'll try not to become overwhelmed by the excessive food restriction lists and just listen to my psychiatrist.
Posted by Lamdage22 on August 26, 2014, at 13:21:46
In reply to Re: MAOI diet, posted by MuseMemento on August 13, 2014, at 15:19:12
> I'll try not to become overwhelmed by the excessive food restriction lists and just listen to my psychiatrist.
That sounds like a good idea.
If your BP goes up though (a lot) you need medical treatment. Don't wait.
My doc gave me emergency nifedipine. Maybe yours will, too.
Posted by Lamdage22 on August 26, 2014, at 13:23:38
In reply to Re: MAOI diet, posted by Lamdage22 on August 26, 2014, at 13:21:46
Im on the same page as baseball though. Its well worth it if it works for you.
Posted by MuseMemento on August 28, 2014, at 17:50:52
In reply to Re: MAOI diet, posted by Lamdage22 on August 26, 2014, at 13:23:38
Thanks for the replies, everyone. One thing I forgot to ask is how long after consuming the last forbidden item should I take my first dose of parnate. I'm trying to get the things that I know I'll miss in before I begin. I now have the prescription but I also want to make sure I have the diet well understood before beginning. He doesn't seem concerned by common cheeses (marble, mozzarella) but I'm content to try and stay away from them. He stressed staying away from marmite, soy sauce, red wine, guinness, cured meats, avocado. Anyone know about coffee while on an MAOI? I've checked all of the supplements I'm taking against parnate and seem to be in the clear but I'll converse with my pharmacist when I have the prescription filled. Thanks again!
Posted by musememento on September 1, 2014, at 13:08:43
In reply to Re: MAOI diet, posted by MuseMemento on August 28, 2014, at 17:50:52
Anyone know if soybean oil and yeast extracts are acceptable when used as ingredients in baking such as bread, cake, cookies, muffins, etc?
Posted by SLS on September 23, 2014, at 8:46:30
In reply to Re: MAOI diet, posted by musememento on September 1, 2014, at 13:08:43
> Anyone know if soybean oil and yeast extracts are acceptable when used as ingredients in baking such as bread, cake, cookies, muffins, etc?
They are okay to eat. I looked them up just to be sure.
- Scott
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