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MAOI Food and Drug Interactions
by Erowid

Cheddar Cheese and Moclobemide
Anonymous (1996)

We had this argument about tyramine and selective MAOI-A's some time ago, and the data shows that tyramine is NOT a *large* problem with selective / reversible MAOI-As.

"No rise in bloodpressure was noted in 6 healthy subjects whore received cheddar cheese with tyramine content of 65 to 70 mg before and after treatment with moclobemide. In 3 subjects treated with tranylcypromine the cheese caused a pronounced and sustained rise in blood pressure." A. Korn et al., J. Pharm. Pharmac. 1984 (36 - Sup 64W)

Note : tranylcypromine is also a reversible MAOi (enzyme activity recovers after 3-5 days) and that it's maoA that protects against tyramine.

More Thoughts on MAOI Interactions
Anonymous (1996)

>I've read that Peganum Harmala is very potent MAOI and that it can
>be harmful to eat foods containing tyramine after ingesting harmala
>alkaloids. Now this leads to my questions; what do you prefer
>to eat if we assume that somehow small amounts of alkaloids
>are active on your body and how long should one avoid tyramine?

Well, Peganum Harmala (Syrian Rue) contains harmaline and harmine, both potent, but selective (and short-term reversable) inhibitors of MAO-A. But there are three good arguments that tyramine is not a problem:

  1. Timing. Tyramine gets digested pretty quickly, and likely clears the gut in 12 hours or so. The harmala alkaloids are also short acting, and also clear in 12 hours, perhaps more like 6 hours. Most people who take Syrian Rue brews do not eat anything just before, since vomiting is so common, and few people eat a big meal right afterward. This means it's unlikely the two would be at high levels at the same time.
  2. Selectivity. Tyramine is also controlled by MAO-B, which is not affected by the harmala's, which inhibit MAO-A. Medical experience with moclobimide, another reversable MAOAI (but not as strong as harmaline), is also that tyramine is not as much of a problem as it is with the older, irreversable (2 weeks or so), and non-selective medical MAO-I's such as parnate.
  3. Experience. There are some anecdotal reports of ingesting tyramine foods just after a Syrian Rue experience without problems.

When one is first working with an MAOI, even the harmalas, it best to be cautious. Hypertensive reactions are not only unpleasant, but can be extremely unpleasant, do permanent damage, or be fatal. To be cautious, avoid aged cheese, red wine, and other aged/pickled/fermented foods (soy, yeast) for 12 hours before and after ingesting Syrian Rue or other reversible MAOI. I would not worry about chocolate, beer, or coffee, in reasonable amounts before or after harmala.

Each person is unique and there's no reason to take any health risks the first few times out with this stuff. Its hard enough on the body when you're 'clean'. It is not likely to be a coincidence that many of the South American cultures that used harmala had strong proscriptions around foods that were acceptable in the time leading up to ayahuasca ceremonies. Some psychonauts have also reported that when they have cleaned out their diet for a day beforehand, their experiences are far less nauseating and have less uncomfortable body load. There's too little data on this to say much with certainty, however.

Also, there are some drugs which are only cleared by MAO-A, stimulants and anti-histamines. I would avoid these, especially MDMA and other amphetamines.

Also, most anti-depressants (all medical MAOI's and SSRI's, others) can increase serotonin levels to dangerous levels when combined with MAOI-A's. The problem is called "serotonin syndrome". I would not take Syrian Rue if you're on any anti-depressants.

There's still much we (and I) don't know...