The Prescriber's Guide to the MAOI Diet-Thinking Through Tyramine Troubles.

Q3 Medicine
Psychopharmacology bulletin Pub Date : 2022-05-31
Vincent Van den Eynde, Peter Kenneth Gillman, Barry B Blackwell
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引用次数: 0

Abstract

This review article features comprehensive discussions on the dietary restrictions issued to patients taking a classic monoamine oxidase inhibitor (phenelzine, tranylcypromine, isocarboxazid), or high-dose (oral or transdermal) selegiline. It equips doctors with the knowledge to explain to their patients which dietary precautions are necessary, and why that is so: MAOIs alter the capacity to metabolize certain monoamines, like tyramine, which causes dose-related blood pressure elevations. Modern food production and hygiene standards have resulted in large reductions of tyramine concentrations in most foodstuffs and beverages, including many cheeses. Thus, the risk of consequential blood pressure increases is considerably reduced-but some caution remains warranted. The effects of other relevant biogenic amines (histamine, dopamine), and of the amino acids L-dopa and L-tryptophan are also discussed. The tables of tyramine data usually presented in MAOI diet guides are by nature unhelpful and imprecise, because tyramine levels vary widely within foods of the same category. For this reason, it is vital that doctors understand the general principles outlined in this guide; that way, they can tailor their instructions and advice to the individual, to his/her lifestyle and situation. This is important because the pressor response is characterized by significant interpatient variability. When all factors are weighed and balanced, the conclusion is that the MAOI diet is not all that difficult. Minimizing the intake of the small number of risky foods is all that is required. Many patients may hardly need to change their diet at all.

MAOI 饮食处方指南--思考酪胺酸的困扰。
这篇综述文章全面论述了服用经典单胺氧化酶抑制剂(苯乙肼、氨甲环丙胺、异卡西酮)或大剂量(口服或透皮)西格列汀的患者的饮食禁忌。它使医生掌握了向病人解释哪些饮食预防措施是必要的以及为什么要这样做的知识:MAOIs 会改变某些单胺类药物(如酪胺)的代谢能力,从而导致与剂量相关的血压升高。现代食品生产和卫生标准已经大大降低了大多数食品和饮料(包括许多奶酪)中的酪胺浓度。因此,血压随之升高的风险大大降低,但仍需谨慎对待。此外,还讨论了其他相关生物胺(组胺、多巴胺)以及氨基酸 L-多巴和 L-色氨酸的影响。MAOI 膳食指南中通常列出的酪胺数据表本质上是无益和不精确的,因为同一类食物中的酪胺含量差异很大。因此,医生必须了解本指南中概述的一般原则;这样,他们才能根据个人的生活方式和情况,为其量身定制指导和建议。这一点非常重要,因为患者之间的加压反应具有显著的差异性。权衡所有因素后得出的结论是,MAOI 饮食并非难事。只需尽量减少摄入少量高风险食物即可。许多患者可能根本不需要改变饮食习惯。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Psychopharmacology bulletin
Psychopharmacology bulletin PHARMACOLOGY & PHARMACY-PSYCHIATRY
CiteScore
2.70
自引率
0.00%
发文量
32
期刊介绍: Information not localized
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