MAOI;S and foods that CAN INTEFERE WITH THE WAY THEY WORK.

[lilly hunt]

I read somewhere that certain strange odd foods can intefere with the affect of these? Some being mackerel,do you know any others? What is in the drug that interacts with the food? Very interesting-----good to know to give patient counselling.DOES THIS APPLY TO ALL MAOI:S SUCH AS CITALOPRAM IS IT MORE THE OLD ANTIDEPRESSANTS?LILLY

[Nik]

Citalopram is not an MAOI. The only three licensed here are phenelzine, isocarboxazid and tranylcypromine (and moclobemide). Extremely unusual to find patients on these now. The BNF categorises the anti-depressants nicely and there is stuff in there about MAOI and drug/food interactions.

[Asterix]

You tell them to avoid tyramine rich foods such as bovril. Also avoid out of date food. Combination of MAOI's and Tyramine foods can cause hypertensive crisis.
This is only applicable to MAOI's.

Interestingly MAO-B inhbitiors such as rasigline and seligiline have this interaction too but not routinely counselled.

I am sure Nik will tell you whether my sexy knowledge is correct or not.

[johnep]

MAOIs work as they say, Mono Amine Oxidase Inhibitor. They slow the break down of 5HT. Tryptophan is a precursor of 5 Hydroxy Tryptophan and foods rich in this can cause problems..... Cheese and Chocolate.
Tryptophan mixed into Cadburys drinking chocolate was marketed as an anti-depressant.
I used to sell Isocarboxazide (Marplan).
johnep

[hibernia]

Didn't MAOI's start life as anti TB drugs?
Remember an old hand telling me that they then noticed the patients perking up generally. Of course these were patients spending months isolated in a sanatorium, with a real risk of dying and a new drug that might cure them was bound to improve their mood.
He reckoned that if there had been placebo controlled trials the MAOIs wouldn't have done any better than the placebo, but then there is a fairly marked placebo effect from all anti-depressants.

[johnep]

Yes, noticed that pts treated with Isoniazide (Isonicotinyl acid hydrazide) showed elevated mood. Roche marketed isoniazide as Rimifon.
They looked for something to patent and developed Iproniazide. This had tuberculostatic action but not as good as INAH. It was very potent as an anti depressant, but toxic.
Interesting molecular roulette:
Nicotinic acid (vasodilator and vitamin), Nicotinamide (Vitamin and topical anti acne), Nicotinyl Alcohol (Ronicol...vasodilator), INAH (tuberculostatic), ipro ( Marsilid, tuberculostatic and MAOI),
Carboxazide (marplan, MAOI), Procarbazine (Natulan , cytotoxic).

I used to use this sequence when being accused of 'me too' molecular roulette to illustrate the twists and turns of research.
johnep

[Nik]

You tell them to avoid tyramine rich foods such as bovril.

Does any one actually still eat this ?

There is a reason why (a good reason) the tyramine reaction isn't noted in the Parkinson's drugs compared to the anti-depressant ones.
There is also another drug which has MAOI actions.

[johnep]

An allied substance to 5HT (catechol amines) is dopamine. When L Dopa came on the scene, there was mention of its presence in Broad Beans. I did some research and found Macuna Beans from E Africa contained L Dopa and were available from Gunsons. We did a great deal of work on extraction and were then forestalled by synthesis from Vanillin. One of the reasons why Roche bought Gevaudan, also to secure raw material for production of Trimethoprim.
johnep

[laurabuk]

Also applies to Linezolid (antibiotic)

[bobbin]

An allied substance to 5HT (catechol amines) is dopamine. When L Dopa came on the scene, there was mention of its presence in Broad Beans. I did some research and found Macuna Beans from E Africa contained L Dopa and were available from Gunsons. We did a great deal of work on extraction and were then forestalled by synthesis from Vanillin. One of the reasons why Roche bought Gevaudan, also to secure raw material for production of Trimethoprim.
johnep

John, is there any company you haven't worked for at some point? You seem to have done absolutely everything!