Tyramine and antidepressants: an interaction that should not be ignored

In this session, we will focus on a little-known but highly relevant substance when discussing certain pharmacological treatments for depression: tyramine.

Although it is not a medication or supplement, this natural substance can have a significant impact on the body, especially when combined with certain types of antidepressants. Understanding how this interaction works is key to ensuring safe and effective treatment.

What is tyramine?

Tyramine is a natural compound formed from the breakdown of an amino acid called tyrosine, which is present in various plant and animal foods.

Under normal conditions, the body metabolizes tyramine thanks to an enzyme called monoamine oxidase (MAO), which is also involved in the breakdown of neurotransmitters such as serotonin and dopamine.

However, when a person takes medications that block this enzyme—known as monoamine oxidase inhibitors (MAOIs)—tyramine is not eliminated as effectively. As a result, its levels can rise rapidly in the body, causing significant adverse effects.

The interaction between tyramine and medications

The main risk arises when foods rich in tyramine are combined with MAOIs. This interaction can trigger a hypertensive reaction, i.e., a sudden and dangerous increase in blood pressure.

This type of response may be accompanied by symptoms such as palpitations, severe headache, neck stiffness, blurred vision, nausea, vomiting, anxiety, excessive sweating, and even nosebleeds or chest pain.

In extreme cases, this rise in blood pressure can lead to serious complications, such as cerebral hemorrhage or acute cardiovascular events. For this reason, people who are prescribed MAOIs are often advised to follow a low-tyramine diet to avoid these reactions.

Foods high in tyramine

Products that contain high amounts of tyramine include:

• Cured or fermented meats

• Aged or mature cheeses

• Alcoholic beverages such as red wine or craft beer

• Soy sauce, miso, or fermented foods

• Chocolate, certain dried fish, and pickles

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