Talk:Foods containing tyramine

Amounts?
Anyone going to fill in these boxes? If not, we should take them off and just make it a list until someone finds the data... --Anaraug 10:04, 3 May 2006 (UTC)

I absolutely agree. This list is dangerously wrong. And I'm not sure it is right to even have one.

First off, the problem with MAOIs is rarely a food interaction. The number of recorded instances in decades is such that we can consider them to have an *excellent* track record, safetywise. And they lack the long-term effects on neuronal density, clotting, bone density, etc. seen elsewhere.

Such food interactions are simply treated. I have myself used 50mg QID (ergo 200mg/day, the maximum dosage) of tranylcypromine for an extended period of time, both as monotherapy, and in polytherapy.

Because of some freak circumstances, that were not food-related, I experienced three hypertensive crises in the span of two weeks. Nifedipine capsules resolved the issue every time; it's no big deal for the doctor to prescribe a minimum-size box of these, and using them isn't rocket science.

I've researched this topic extensively.

This one-sided focus on dietary restrictions has a triply negative effect:
 * Low complience due to overly restrictive diets with little understanding of the chances taken.
 * Doctor avoidance due to perceived danger in excess of actual danger.
 * Distracts from the real problems of drug-drug interactions, both pharmacodynamic and pharmacokinetic.

To illustrate the point about inadequate warnings, a single tablespoon of Marmite delivers 500mg of tyramine, which will raise the diastolic blood pressure of a non-medicated person by 30mmHg on average. The amount of tyramine required to achieve this effect in a patient treated with tranylcypromine is on the order of 5-15mg on average.

To illustrate the point about excessive warnings:
 * This page prohibits several foods/drinks that are perfectly safe, such as bottled beers and processed cheeses. The tyramine content of regular beer is negligible; however, improper hygiene and maintenance of the equipment may cause tap beer to gain a significant content.
 * Bananas, whether fresh, ripe or even spoiled do not contain relevant levels of tyramine. The peels do, however, regardless of the condition of the banana. The pulp contains some L-5-HTP, however.
 * Chocolate does not contain tyramine. It contains phenylethylamine and theobromine. The latter in generally insignificant quantities. The former in quantities that dictate caution to prevent the potential for psychosis. Essentially, regular servings are quite okay. A chocolate tasting party in Switzerland may not be okay.

As you can see, hard-and-fast rules end up generalized to the point that "the safest thing for you is to go back to depression; then, you'll kill yourself, rather than risk being killed by the food".

Note also that the tyramine sensitivity depends a lot on the MAO-inhibitor in use; tranylcypromine is generally the one with highest risk of a hypertensive crises. Realize that there is also on the order of a 10:1 difference in sensitivity between the most sensitive and least sensitive patients.

Such lists as these don't get across the point that it's okay for you to have a bit of aged cheese, but eating a single tablespoon of marmite has a mortality rate of 60% with intensive care.

I've ranted too much already. Maybe one of these days I'll register and start cleaning up these articles for real, but wikipedia is not a place to put much information, nor is neuropharmacology a field given to an alignment of consensus and truth. Verifiability, as practiced on wikipedia, is a dangerous policy to pursue in relation to drugs. -- 212.169.96.218 01:25, 7 August 2006 (UTC)


 * Yeah, but I find Wikipedia very useful for such articles... The more information, the better. You could help by improving the articles. Are you a doctor? -- 61.230.48.158 (talk) 13:33, 22 December 2007 (UTC)

This problem of MAOI and hypertensive crisis comes from the inhibition of MAO-B, which is the isozyme that metabolizes tyramine. As the writer above correctly noted sometime ago, tranylcypromine will do this, as it seems to inhibit all MAO (A&B) for long periods of time.Jace1 (talk) 11:31, 17 April 2009 (UTC)

I've added a Refimprove tag to the top of the article because of the vague quantity terms throughout and the impossibility of determining anything of clinical significance from them. Anyone being prescribed MAOIs should already have got the best possible information about the dietetic implications of their meds from their doctor or, failing that, by reading patient information leaflets from a good, trustable source. At best, the contents of this article could only replicate that information; at worst, they could be dangerously misleading. As it stands, we don't have that information: just slippery words like "little", "significant", "high", "great"... and an external link to one recipe book whichdoes give numerical quantities, but (so far as I can determine) which doesn't give its source(s) for that information. To be blunt, I wouldn't trust my cerebral vasculature with the current contents of this page or of the externally-linked items.

Do you think it's worth asking the good people of WikiProject Pharmacology for their opinions on what we should do?

As for Marmite, though - does anyone eat it by the tablespoon? I doubt it. At most, I might use a level teaspoon of it in a casserole for four people, and I like Marmite a lot! But that's a side-issue, I think :) --Kay Dekker (talk) 20:06, 11 November 2009 (UTC)

Telling reader what to do?
Its quite annoying telling me to avoid such beverages and foods.. —Preceding unsigned comment added by 82.24.159.222 (talk) 17:16, 5 September 2007 (UTC)


 * Agreed. "Should be avoided" should be replaced by "contains tyramine". &mdash;Ashley Y 22:57, 6 October 2007 (UTC)


 * Not only is the commanding language annoying, but it could be construed as medical advice, which has legal implications. 67.180.4.65 (talk) 00:37, 20 November 2007 (UTC)

Erroroneous information - should be MAO-A, not MAO-B
The text mentions that "... particularly MAOIs that inhibit the isozyme MAO-B can increase the sensitivity to tyramine". Isn't it supposed to be MAO-A? See the page on MAOIs (http://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitors) for clarification. But I can speak from personal experience - I'm taking MAO-B inhibitor (Selegiline), never had to trouble myself about dietary restrictions and the instruction leaflet for the medicine says that it's a MAOI-B and there's no risk of hypertensive crisis from tyramine-rich food (in recommended low dosage). The Wiki page on Selegiline (http://en.wikipedia.org/wiki/Selegiline) confirms that, too. —Preceding unsigned comment added by 92.50.229.252 (talk) 11:07, 7 May 2009 (UTC)

Tyramine and migraine evidence.
I've changed significant evidence to disputed evidence, since the material on the tyramine page shows lack of consensus on the evidence. --Kay Dekker (talk) 18:56, 11 November 2009 (UTC)

FUR INFURMASHUNAL PORPOIZUS ONRY
This list is for informational purposes only;

ok, wikipedia, from where exactly did you copy that article , eh? —Preceding unsigned comment added by 109.64.8.129 (talk) 09:54, 10 January 2011 (UTC)