Questions and Answers
My wife has recently been prescribed Nardil. Prior to this, she has been prescribed antidepressants such as effexor, zoloft, paxil, dimipramine (sorry but I think I have spelled it incorrectly) and a series of other tricyclics. All of these have failed to assist her with her depression, although some, such as effexor, seemed to work for a period of time only to have the depression and anxiety attacks return. Thus the decision was made to place my wife on MOAI's.
We are aware of the many drug and food restrictions which come with this new medication but we remain a little confused on a few. I apologize for troubling you with what may be obvious questions but I have been unable to obtain clear answers from the pharmacists or the physicians. Any insight would be greatly appreciated.
1. I understand aged or processed meats such as pepperoni, salami, farmer sausage, etc are to be avoided. While not the healthiest choice, my wife does enjoy the occasional hot dog. Should wieners be avoided? What about ham?
2. It is clear aged cheeses must be avoided. What about mild/medium Cheddar? Is white cheese such as mozzarella safe? Is the cheese found in products such as crackers, cheezies, etc to be avoided. I assume it should not be consumed but no one has been able to confirm this.
3. My wife does not drink coffee or tea and I understand the need for avoiding products containing caffeine. Is this to be avoided completely or are small amounts safe. I ask because a growing number of products contain the substance. If a small amount is safe, is there a guideline we can follow.
4. I know bread products are safe, but yeast products are not. Does this mean products, such as some prepared soups, which contain yeast extracts should be avoided?
5. I read some literature indicating bananas are not to be eaten (especially green ones). Are other fruits safe?
Hi Franke ... sorry to hear of your wife's problem.
First the list I have of items to be avoided :- alcoholic beverages, especially beer and wine (also alcohol-free beer) - all cheeses - bananas and raisons - sour cream and yogurt - pickled herring - snails - liver - dried sausages (including hard salami and pepperoni) - canned figs - avocados - broad bean pods - fava beans - soy sauce and yeast extracts - papaya products (including meat tenderizer) - excessive amounts of coffee, tea and chocolate. I have also seen mention of citrus fruits. All these contain a substance called tyramine in greater or lessor quantities - normally rapidly broken down in the body, but protected by any MAO inhibitors such as Nardil (phenelzine).
The danger is the production of a possibly life-threatening hypertensive crisis caused by tyramine's reaction with the cardiovascular system. The most threatening are aged cheeses and yeast products used as food supplements.
Answers to your numbered points :-
1. these are not on the list - realistically, caution should rule the day - try a small amount,
2. these are on the list - best avoided, but a small amount shouldn't present
problems - again, caution! I don't know how much 'cheese' is in cheesy snacks.
3. the rules state 'excessive' amounts - try cautiously.
4.absolutely!
5. see outline above - those mentioned are bananas and raisons,
perhaps also citrus fruits. Others such as apples, pears, peaches and such
fruit should be O'K'.
Best wishes to you and your wife.