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  • EADD Moderators: axe battler | Pissed_and_messed

Danger of tyramine with MAOI, dose related?

Woodburner

Bluelighter
Joined
Jan 23, 2017
Messages
108
This question has been floating around in the back of my mind for a while now, but has only just crystallized out.

All this talk about oooh don't eat anything with tyramine in it while you're on MAOI's, it''ll kill you!

For starters, a lot of common foods and spices contain MAOIs. No-one ever warns of the danger of drinking too much coffee when you've had a cheese sandwich, and in lots of countries turmeric is traditionally added in pretty large quantities to every meat dish, and no-one even gets a headache from it. Smokers aren't warned off eating pepperoni. . .

And then there's the point that most foods with tyramine in are also foods that you need to be eating because otherwise you don't have enough amino acids to make the neurotransmitters in the first place!

There's a lot of OTT stuff about the dangers of e.g. dex, to the extent that doctors are massively reluctant to prescribe it, even to people that actually NEED it, and I don't mean people who have developed tolerance to it, I mean people like ADHDers, who need it the same way (well almost) that a diabetic needs insulin.

And a lot of that stuff about dex being dangerous, is actually based on abusers experiences at much higher doses than any doc is allowed to prescribe anyway.

It also seems that the doses of MAOIs that doctors prescribe, are way too high anyway!

For instance selegiline is an irreversible MAOI, that means that whatever MAO is knocked out stays knocked out, to me that already tells me to be very careful about how much to take, and not to take a second dose until I can be absolutely sure that the first one hasn't helped.

Why on earth would anyone take a daily dose of something that takes two weeks for the effects to clear from your system?! Yet that is how it's prescribed, if you can get it at all!



Ok, this has turned into a bit of a rant.!

The powers that be are so fixated on the tyramine thing, that they are ignoring the fact that it's almost certainly, their prescribing of excessive doses that is the problem. And I expect that folks on here are mostly taking high doses too?

So, I'm figuring that it's only if you're taking refined versions that are really too strong or too long lasting that there is any real cause for concern over tyramine?
 
And seconds after I post that, having not been able to find much at all about dosage for days, I find this:-

[SIZE=-1]Three different strengths of EMSAM patch are currently marketed: 20mg/20cm2, 30mg/30cm2, and 40mg/40cm2. The three patch sizes deliver daily doses of selegiline averaging 6mg, 9mg and 12mg respectively. Use of the lowest dosage EMSAM 6 mg/24 hour patch doesn't call for dietary modification. Certainly at the lower dosage range, MAO-A in the digestive tract is preserved at levels more than adequate to break down tyramine, while MAO in the brain is inhibited at levels adequate to induce an antidepressant effect. A restricted "MAOI diet" is prudently advised for the higher dosage EMSAM 9 mg/24 hr patch and the 12 mg/24 hr patch to avoid any risk of hypertensive crisis. But it's worth noting that (as of 2008 ) no hypertensive crises following dietary indiscretions have been reported even in users of the high strength patches.[/SIZE]
 
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