Van den Eynde, External Research Consultant for PsychoTropical Research, NeuraWell Therapeutics, Aristo Pharma GmbH. Gillman, Director of PsychoTropical Research and MAOI Expert Group Convener. Blackwell, Retired Professor and Chair of Psychiatry at the Milwaukee Campus of the University of Wisconsin School of Medicine.
Psychopharmacol Bull. 2022 May 31;52(2):73-116.
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.
这篇综述文章全面讨论了经典单胺氧化酶抑制剂（苯乙肼、反苯环丙胺、异卡波肼）或高剂量（口服或透皮）司来吉兰服用患者的饮食限制。它为医生提供了向患者解释哪些饮食注意事项是必要的，并解释原因的知识：MAOIs 改变了某些单胺（如酪胺）的代谢能力，导致与剂量相关的血压升高。现代食品生产和卫生标准导致大多数食品和饮料中的酪胺浓度（包括许多奶酪）大幅降低。因此，继发血压升高的风险大大降低——但仍需谨慎。其他相关生物胺（组胺、多巴胺）以及氨基酸 L-多巴和 L-色氨酸的作用也进行了讨论。MAOI 饮食指南中通常呈现的酪胺数据表本质上是无益和不精确的，因为同一类别食品中的酪胺水平差异很大。因此，医生了解本指南中概述的一般原则至关重要；这样，他们可以根据个人、个人的生活方式和情况调整其指示和建议。这很重要，因为升压反应的特点是患者间存在很大的变异性。权衡所有因素后，结论是 MAOI 饮食并不那么困难。只需将少数危险食物的摄入量降到最低即可。许多患者可能几乎不需要改变饮食。
