MAOI Diet: What to Eat and Avoid with Monoamine Oxidase Inhibitors

When you're taking monoamine oxidase inhibitors, a class of antidepressants that block the enzyme monoamine oxidase to regulate mood. Also known as MAOIs, they work differently than SSRIs and require strict dietary control to avoid life-threatening spikes in blood pressure. This isn't just a suggestion—it's a safety rule backed by real cases of hypertensive crises triggered by common foods.

The core issue is tyramine, a naturally occurring compound found in aged, fermented, or spoiled foods. Normally, your body breaks down tyramine using monoamine oxidase. But when that enzyme is blocked by an MAOI, tyramine builds up and causes your blood pressure to skyrocket. That’s why you can’t eat aged cheeses, cured meats, or tap beer. Even leftover food sitting in the fridge too long can be risky. Some people think they can get away with small amounts, but the reaction isn’t predictable—it doesn’t take much to trigger a medical emergency.

It’s not just about cheese and meat. Soy sauce, fermented tofu, draft beer, red wine, and even some overripe bananas can carry enough tyramine to cause trouble. Certain medications like decongestants and stimulants also interfere, making the risk even higher. That’s why people on MAOIs need to know not just what to avoid, but what’s safe to eat: fresh meats, plain dairy, most fruits and veggies, and freshly cooked meals. It’s a shift, not a punishment. Once you learn the rules, it becomes routine.

Many of the posts in this collection focus on drug interactions—like how St. John’s Wort can clash with antidepressants, or how NSAIDs increase bleeding risks. The MAOI diet is one of the most critical food-drug interactions in psychiatry. It’s not about willpower; it’s about biology. Skip the rules, and you could end up in the ER. Follow them, and you can manage your depression safely and effectively. Below, you’ll find real-world guides on how to navigate these restrictions, what alternatives work, and how to talk to your doctor about long-term management.