MONOAMINE-OXIDASE INHIBITOR DIETARY RESTRICTIONS - WHAT ARE WE ASKINGPATIENTS TO GIVE UP

Background: Though the list of possible indications for monoamine oxid ase inhibitors (MAOIs) continues to expand, many psychiatrists remain hesitant about prescribing MAOIs, citing concerns about dietary prohib itions and hypertensive reactions. Data about psychiatric patients' fr equency of consumption of foods, beverages, and medications prohibited during MAOI use are lacking. Method: We conducted a survey of 139 psy chiatric patients admitted to either an inpatient unit specializing in the treatment of mood disorders or an outpatient anxiety disorders cl inic specializing in the treatment of social phobia. At inclusion, pat ients were not being treated with MAOIs, although they might have rece ived such treatment afterward. All patients completed a self-report qu estionnaire created for this study to ascertain their consumption of f ood, beverage, and medication items frequently found on MAOI diet list s. Demographic and diagnostic information was also recorded. Results: The most frequently used high-risk items were the hard cheeses. Ninety percent of patients reported daily or weekly consumption of some food containing cheese, while less than 1% of patients reported never eati ng hard cheese. Yeast products, dry sausage, corned beef, broad beans, sauerkraut, and beer were used at least monthly by more than 50% of p atients. Of the intermediate-risk foods, chocolate was the most freque ntly consumed, with almost 30% of the patients eating some chocolate d aily, Over 40% of patients reported using over-the-counter cold prepar ations on a monthly basis. Conclusion: A wide variety of tyramine-cont aining foods and contraindicated medications were commonly used by our patients prior to evaluation for possible MAOI pharmacotherapy. The n umber and diversity of frequently consumed items do not support recomm endations to reduce the breadth of restrictions in MAOI diets. Individ ually targeted dietary assessment and education are recommended to red uce the risks of prescribing MAOIs.