My boyfriend is taking a pill called Parnate and his doctor gave him a list of foods not to eat.

My boyfriend is taking a pill called Parnate and his doctor gave him a list of foods not to eat. Can’t he even have a little Colby cheese or chocolate? Some of his most favorite foods were cut out.

The pill he is on is called a MAO inhibitor (monoamine oxidase) which inhibits a brain enzyme that metabolizes noradrenalin also called norepinephrine (hormone produced by adrenal glands and neurons that carries messages to other nerves and is part of the fight or flight response and affects blood pressure) and serotonin (hormone that regulates mood, appetite, sleep, regulates pain and causes blood vessels to narrow). MAO inhibitors are used in antidepressant, anti-Parkinson, and anti-Alzheimer drugs. Newer MAO inhibitors are readily reversible in their action and cause less concern about drug-food interactions. Your friend should ask his doctor about some of these newer MAO inhibitors.

The nutrition therapy his doctor probably gave him probably restricts tyramine. The tyramine-free nutrition therapy is necessary because foods high in tyramine combined with Parnate or other MAO inhibitors could cause a sudden constriction of blood vessels with an increase in blood pressure which can result in a stroke. He must follow the nutrition therapy strictly while on this medication. Tryptophan (a protein amino acid) supplements are not recommended either.

He should follow his doctor’s nutrition therapy prescription. The medication may be used for a limited time and if discontinued, the tyramine nutrition therapy should be used an additional 2 weeks after stopping the MAO inhibitor. Here is a list of foods to avoid.

Foods High in Tyramine Not Allowed
Bread & Starches Cheese bread, cheese crackers, and desserts made with cheese other than cheesecake (cream cheese, cottage cheese, and ricotta cheese allowed, fruit cake, mincemeat cake or pie
Dairy Cheese and cheese sauces, chocolate milk, yogurt, sour cream
Meat Beef or chicken liver, liver sausage or liverwurst, sausages such as bologna, pepperoni, salami, summer sausage, smoked or dried meats like jerky, smoked, dried or pickled fish like pickled herring or anchovies, caviar, shrimp paste, wild game, meat processed with meat tenderizers, meat extracts, tofu bean curd
Fruits Bananas, red plums, canned figs, raisins, prunes
Vegetables Avocado, fava beans, Italian broad beans, sauerkraut, fermented pickles and olives, miso soup, spinach, tomatoes, tomato juice or sauce, tofu bean curd
Beverages Cocoa, alcoholic beverages including Chianti wine, red wine, port, Riesling, sauterne, sherry, vermouth, beer, ale, stout, non-alcoholic beer, distilled spirits such as bourbon, whiskey, scotch, brandy, gin, vodka, rum, tequila, caffeinated beverages like coffee (decaffeinated allowed), tea (decaffeinated allowed), cola, Mountain Dew, energy drinks
Miscellaneous Chocolate, licorice, brewer’s yeast or yeast extract, Marmite, meat tenderizer, MSG, soy sauce, teriyaki sauce, catsup, chili sauce, all aged and fermented foods