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MAOIs, Tyramine and Hypertensive Crisis. Treatment Considerations with monoamine oxidase inhibitors 

Rittenhouse Psychiatric Associates
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Dr. Pagnani of Rittenhouse Psychiatric Associates discusses monoamine oxidase inhibitors (MAIOs), their mechanism of action, their role in treating depression and possible side effects. Monoamine oxidase inhibitors (MAOIs) prevent the oxidation (breakdown) of monoamines like serotonin, dopamine and norepinephrine in the central nervous system. This can result in the effective treatment of depression, and a trial may be warranted, particularly if an individual has failed more common treatment modalities. With that said, MAOIs carry a great deal of potential side effects, and one in particular (from the ingestion of foods high in tyramine) can result a serious / possibly deadly medical condition called a hypertensive crisis. This can occur as MAOIs prevent the breakdown of tyramine and tyramine can regulate blood pressure. Individuals taking MAOIs need to be under the direct supervision of a medical provider, and they also must be educated on keeping a low tyramine diet (avoiding foods such as [but not limited to] aged cheese, cured meats, fava beans, chianti, draft beer, pickled/ fermented foods, processed and tenderized meats, dried or overripe fruits, yeast extract spreads, various sauces (like soy sauce), brewer's yeast, and sour dough bread.
Dr. Pagnani is the founder and medical director of Rittenhouse Psychiatric Associates, an Instructor at The Johns Hopkins Hospital for the Department of Psychiatry, he supervises psychiatric residents at Jefferson Hospital, he serves on the Young Professional Board of Uplift, the Center for Grieving Children and he maintains a private practice of Psychiatry in Philadelphia where he sees patients for one-time psychiatric evaluations and second opinions. He is a licensed physician and surgeon in NJ, PA, NY, MD, DE, FL and CA and can provide consultations to individuals via HIPAA compliant Telehealth visits living in these locations.
Rittenhouse Psychiatric Associates is a private practice of psychiatry consisting of about 25 psychiatrists, psychiatric nurse practitioners and psychotherapists with physical locations in Philadelphia and Paoli, PA and serving all of PA, NJ, NY and FL virtually via HIPAA compliant tele-psychiatry. Individuals seeking not only evaluations but long-term psychiatric care, can contact Rittenhouse Psychiatric Associates directly.
These videos aim to increase awareness and discussion of mental health topics and to encourage struggling individuals to schedule an appointment directly with a mental health provider. Mental health needs to be normalized, and simply speaking about mental health topics openly, is an important first step.
Dr. Pagnani and Rittenhouse Psychiatric Associates are NOT advocating for or against the use of any mentioned psychiatric medications for any specific individual. Additionally, any side effects mentioned are not a complete list of potential side effects or contraindications to taking any mentioned medications, and all risks and benefits of a medication should be discussed with an individual’s provider at an appointment, before starting, stopping or making changes to a medication regimen.
This video is INFORMATIVE ONLY - NOT MEDICAL ADVICE.
If you are researching a specific topic, please view our RU-vid channel, click all videos and use the search function. Please also visit and follow us on instagram and FB: @RittenhousePsych.
www.RittenhousePA.com
www.ChrisPagnaniMD.com

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27 дек 2022

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Комментарии : 14   
@Kingboo1081
@Kingboo1081 6 месяцев назад
Foods nowadays don’t contain substantial amounts of Tyramine. One should still be mindful about it, but the tyramine restriction is very, very exaggerated. And most doctors are only familiar with research from decades ago, which for the most part isn’t accurate. Check out Ken Gillman, he has up to date knowledge on Maoi’s. People shouldn’t have to miss out on robust treatments due to doctors not being adequately educated.
@TheKingship
@TheKingship 4 месяца назад
I have the exact symptoms of low monoamine oxidase. I get horrible tyramine induced migraines. I dont take any ssris or other meds. What can I do?
@danielleroberts8252
@danielleroberts8252 7 месяцев назад
Does Tesofensine carry these same risks?
@DennisBolanos
@DennisBolanos Год назад
Dr. Pagnani, is it true that MAOIs are superior to SSRIs in improving social anxiety symptoms?
@RittenhousePsych
@RittenhousePsych Год назад
Thank you for watching and interesting question! MAOIs were indeed the first antidepressants to be shown to be effective in social phobia. However, they are not first line, as they carry much higher risk of side effects than your SSRIs. I have not used MAOIs in the treatment of social anxiety for patients, but it is something one could consider. I tend to be more likely to augment SSRIs/ SNRIs with low dose SGAs if symptoms are severe (and really recommend cognitive behavioral therapy [CBT] - particularly exposure therapy). - Dr. Pagnani
@DennisBolanos
@DennisBolanos Год назад
@@RittenhousePsych OK, thank you! Have a good day.
@Darag1123
@Darag1123 11 месяцев назад
Side effects? What about the suicide effects or ssri?? Like the fucking things literally tell people to kill themselves
@getwell587
@getwell587 9 месяцев назад
​@@RittenhousePsychinteresting information
@minepolz320
@minepolz320 6 месяцев назад
ssri are **it for me emotional anesthesia and apathy with abulia
@tr3vorb438
@tr3vorb438 Год назад
Dr., are the diet risks with tyramine reduced if medication is taken in the morning and the foods are consumed much later in the day?
@RittenhousePsych
@RittenhousePsych 10 месяцев назад
Thank you for your question, and I'm sorry for the delay with the reply. If someone is taking an MAOI, I would not recommend having foods with tyramine, regardless of the timing of medication doses. MAOIs can irreversibly block the effects of monoamine oxidase enzymes, and 12 or 18 hours would not be enough time, because it's irreversible. This is why there's actually a 2 to 6 week (depending on the medication) washout period for someone to stop an MAOI, before starting a new antidepressant. I hope that this is helpful, and be sure to discuss with your provider. Best, - Dr. Pagnani
@cn-123
@cn-123 Месяц назад
Try carnivore!
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