Ann's NOTE (added 8/01/07): I was reading an article in the Science Times section of the New York Times for July 31, 2007 and found this article. Cases - "Missing a Diagnosis That Hit Too Close to Home" by Ronald Pies, M.D. Dr. Pies was discussing a patient with depression who actually worked at the psychiatric facility he was brought to as a patient. After being unable to treat this man successfully, he was released from the unit. When they remet a few weeks later this patient had begun taking an MAO inhibitor (referred to in the article as MAOI). The point made in this article was that the patient was told to avoid wine and cheese as he told Pies. Dr. Pies then states "Why had I not prescribed an MAOI? Perhaps on some level, I was afraid of exposing Mike to a medication I knew to be potentially lethal, IF PROPER PRECAUTIONS WEREN'T TAKEN..." Ann's emphasis. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For monoamine oxidase (MAO) inhibitors, the following should be considered: Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to any MAO inhibitor. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes. Diet—Dangerous reactions such as sudden high blood pressure may result when MAO inhibitors are taken with certain foods or drinks. The following foods should be avoided: Foods that have a high tyramine content (most common in foods that are aged or fermented to increase their flavor), such as cheeses; fava or broad bean pods; yeast or meat extracts; smoked or pickled meat, poultry, or fish; fermented sausage (bologna, pepperoni, salami, summer sausage) or other fermented meat; sauerkraut; or any overripe fruit. If a list of these foods and beverages is not given to you, ask your health care professional to provide one. Alcoholic beverages or alcohol-free or reduced-alcohol beer and wine. Large amounts of caffeine-containing food or beverages such as coffee, tea, cola, or chocolate. Older adults—Dizziness or lightheadedness may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to these effects of MAO inhibitors. Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking MAO inhibitors, it is especially important that your health care professional know if you are taking any of the following: Amphetamines or Antihypertensives (high blood pressure medicine) or Appetite suppressants (diet pills) or Cyclobenzaprine (e.g., Flexeril) or Fluoxetine (e.g., Prozac) or Levodopa (e.g., Dopar, Larodopa) or Maprotiline (e.g., Ludiomil) or Medicine for asthma or other breathing problems or Medicines for colds, sinus problems, or hay fever or other allergies (including nose drops or sprays) or Meperidine (e.g., Demerol) or Methylphenidate (e.g., Ritalin) or Monoamine oxidase (MAO) inhibitors, other, including furazolidone (e.g., Furoxone), procarbazine (e.g., Matulane), or selegiline (e.g., Eldepryl), or Paroxetine (e.g., Paxil), or Sertraline (e.g., Zoloft), or Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil])—Using these medicines while you are taking or within 2 weeks of taking MAO inhibitors may cause serious side effects such as sudden rise in body temperature, extremely high blood pressure, severe convulsions, and death; however, sometimes certain of these medicines may be used with MAO inhibitors under close supervision by your doctor Antidiabetics, oral (diabetes medicine you take by mouth) or Insulin—MAO inhibitors may change the amount of antidiabetic medicine you need to take Bupropion (e.g., Wellbutrin)—Using bupropion while you are taking or within 2 weeks of taking MAO inhibitors may cause serious side effects such as seizures Buspirone (e.g., BuSpar)—Use with MAO inhibitors may cause high blood pressure Carbamazepine (e.g., Tegretol)—Use with MAO inhibitors may increase seizures Central nervous system (CNS) depressants (medicines that cause drowsiness)—Using these medicines with MAO inhibitors may increase the CNS and other depressant effects Cocaine—Cocaine use by persons taking MAO inhibitors, including furazolidone and procarbazine, may cause a severe increase in blood pressure Dextromethorphan—Use with MAO inhibitors may cause excitement, high blood pressure, and fever Trazodone or Tryptophan used as a food supplement or a sleep aid—Use of these medicines by persons taking MAO inhibitors, including furazolidone and procarbazine, may cause mental confusion, excitement, shivering, trouble in breathing, or fever Other medical problems—The presence of other medical problems may affect the use of MAO inhibitors. Make sure you tell your doctor if you have any other medical problems, especially: Alcohol abuse—Drinking alcohol while you are taking an MAO inhibitor may cause serious side effects Angina (chest pain) or Headaches (severe or frequent)—These conditions may interfere with warning signs of serious side effects of MAO inhibitors Asthma or bronchitis—Some medicines used to treat these conditions may cause serious side effects when used while you are taking an MAO inhibitor Diabetes mellitus (sugar diabetes)—These medicines may change the amount of insulin or oral antidiabetic medication that you need Epilepsy—Seizures may occur more often Heart or blood vessel disease or Liver disease or Mental illness (or history of) or Parkinson's disease or Recent heart attack or stroke—MAO inhibitors may make the condition worse High blood pressure—Condition may be affected by these medicines Kidney disease—Higher blood levels of MAO inhibitors may occur, which increases the chance of side effects Overactive thyroid or Pheochromocytoma (PCC)—Serious side effects may occur Source: www.nlm.nih.gov/medlineplus/druginfo/uspdi/202054.html Remember we are NOT Doctors and have NO medical training. 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