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Tyramine and Irreversible Monoamine Oxidase Inhibitors in Clinical Practice

Published online by Cambridge University Press:  06 August 2018

A. J. Cooper
A. J. Cooper*
Affiliation:
St Thomas Psychiatric Hospital, St Thomas, Ontario, Canada; Professor of Psychiatry, University of Western Ontario
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Abstract

The cheese reaction following use of the irreversible monoamine oxidase inhibitors (MAOIs) began to be reported in the UK with increasing frequency from about 1961. By 1965, the underlying mechanism (tyramine-provoked hypertension) had been essentially elucidated. Thereafter, this potentially severe side-effect could have been largely avoided by the use of fairly simple dietary precautions. Unfortunately, suspicion and fear burgeoned, and both the seriousness and the frequency of risk were dramatically inflated. This was a major factor in the subsequent general disuse of the irreversible MAOIs. Second-generation MAOIs which are selective for monoamine oxidase-A and B are now being synthesised and may eliminate the eventuality of hypertension without special dietary precautions.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 155 , Issue S6: Depression and Reversible Monoamine Oxidase Inhibitors-New Perspectives , October 1989 , pp. 38 - 45
Copyright
Copyright © 1989 The Royal College of Psychiatrists 

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