maoi
9 interactions related to maoi
nutmeg + maois
Nutmeg contains myristicin, which has weak monoamine oxidase inhibitor (MAOI) activity. Combining nutmeg supplements or large culinary doses with prescription MAOIs can theoretically precipitate hypertensive crisis or serotonin syndrome through additive MAO inhibition.
maoi + tyramine foods
Monoamine oxidase inhibitors block MAO-A in the gut and liver, preventing the breakdown of dietary tyramine. Unmetabolized tyramine triggers a massive release of stored norepinephrine, producing a hypertensive crisis ('cheese reaction') with severe blood pressure spikes, stroke, or death.
maoi + st. john's wort
St. John's Wort inhibits serotonin, dopamine, and norepinephrine reuptake and has weak MAOI activity in vitro. Combined with a prescription MAOI, monoamine clearance is blocked at multiple levels, producing serotonin syndrome and/or hypertensive crisis.
maoi + 5-htp
5-HTP is the direct precursor to serotonin and bypasses the rate-limiting step of serotonin synthesis. Combined with an MAOI, which blocks serotonin breakdown, intracellular and synaptic serotonin can rise to toxic levels, producing serotonin syndrome.
yerba mate + maois
Yerba mate contains caffeine plus trace monoamine oxidase inhibitor-like compounds, but its bigger risk with prescription MAOIs (phenelzine, tranylcypromine, isocarboxazid, selegiline) is its sympathomimetic load: caffeine, theobromine, and modest tyramine content can amplify the pressor response in patients with inhibited MAO. Combining the two can trigger hypertensive crisis or serotonergic adverse effects.
aged cheese + linezolid
Linezolid is a reversible monoamine oxidase inhibitor, and aged cheeses (cheddar, parmesan, blue cheese, brie, gruyere) accumulate large amounts of tyramine through protein breakdown during aging. With MAO inhibited, ingested tyramine triggers massive norepinephrine release and can produce a hypertensive crisis with severe headache, palpitations, and blood pressure spikes of 30 to 50 mmHg within 30 to 120 minutes.
fermented foods + maois
Fermented foods accumulate tyramine through microbial decarboxylation of tyrosine during fermentation, and MAOIs block the monoamine oxidase enzyme that normally clears tyramine from the gut and bloodstream. Unmetabolized tyramine then triggers massive norepinephrine release, which can produce a hypertensive crisis with systolic blood pressure spiking above 180 mmHg.
cacao + maois
Raw, unroasted cacao (often sold as ceremonial cacao or raw cacao paste) contains higher levels of tyramine, tryptamine, and phenylethylamine than processed chocolate. With irreversible MAOIs in the system, these vasoactive amines can drive a hypertensive reaction and, theoretically, contribute to serotonin syndrome.
coffee + antidepressants
Many antidepressants (especially fluvoxamine, fluoxetine, sertraline, duloxetine) inhibit CYP1A2 to varying degrees and slow caffeine clearance, while caffeine itself can worsen the anxiety, insomnia, tremor, and tachycardia that antidepressants are often prescribed to treat. MAOIs add a risk of caffeine-induced hypertensive episodes.