Comment by dgdnt

12 years ago

http://en.wikipedia.org/wiki/Tranylcypromine (brand name Parnate) http://en.wikipedia.org/wiki/Phenelzine (brand name Nardil)

MAOIs are the last resort anti-depressants. There are two left on the US and they are extremely highly-regarded in effectiveness. They're more effective than the typical SSRIs of today but they are sadly not as prescribed today due to over-blown fears of interactions. It's a case of newer not always being better.

http://en.wikipedia.org/wiki/Tranylcypromine

They work by preventing the breakdown of dopamine, serotonin, etc. therefore increasing levels in your brain.

In fact the gold standard for anti-anxiety is an MAOI, Nardil, which has additional inhibition leading to increased levels of GABA (the target of alcohol/benzodiazepines.)

In fact two medications in my daily mix with Nardil are on that list and it's such a pain dealing with ignorant pharmacists that see a warning on my their screen and refuse to call my doctor to confirm their combined safety, even though he's been practicing for 50 years (really.)

I urge you to read the various reports from real users confirming the safety even with the supposedly not safe to mix.

The problem is that most of the recommendations in the list were added before precise measuring of tyramine levels in foods was developed and list is one big CYA. To make matters worse is that nobody has made a significant effort to do real testing to define safe levels so most users are left to responsible trial and error.

I.E. read this about pepperoni, debunking the conventional "wisdom":

> BACKGROUND: Continuous refinement of the monoamine oxidase inhibitor (MAOI) diet has resulted in much reduced and simplified recommendations that attempt to balance safety and practicality. In the spirit of evidence-based practice, dietary restrictions should be based on carefully documented case reports and valid tyramine analyses. Residual concerns have focused on combination foods such as pizza and a variety of soy products. We determined the tyramine content of pizzas and a variety of soy products in order to refine dietary recommendations for use with MAOIs. METHOD: High-pressure liquid chromatography analysis of tyramine content was performed on a variety of pizzas, soy sauces, and other soybean products. A tyramine level of 6 mg or less was considered safe. RESULTS: No significant tyramine levels were found in any of the pizzas, including those with double pepperoni and double cheese. Marked variability was found in soy products, including clinically significant tyramine levels in tofu when stored for a week and high tyramine content in one of the soy sauces. CONCLUSION: Pizzas from large chain commercial outlets are safe for consumption with MAOIs. However, caution must be exercised if ordering pizzas from smaller outlets or gourmet pizzas known to contain aged cheeses. All soybean products should be avoided, especially soy sauce and tofu. Individualized counseling and continuous surveillance of compliance are still essential. >

Bonus:

Tranylcypromine enhancement of nicotine self-administration.

http://www.ncbi.nlm.nih.gov/pubmed/17412372

The monoamine oxidase inhibitor phenelzine enhances the discriminative stimulus effect of nicotine in rats.