MAOI Restrictions: What You Can't Eat, Drink, or Take with These Antidepressants

When you take monoamine oxidase inhibitors, a class of antidepressants that work by blocking enzymes that break down key brain chemicals. Also known as MAOIs, they’re often used when other antidepressants fail—but they come with strict, non-negotiable rules. One wrong bite, sip, or pill can trigger a dangerous spike in blood pressure, leading to stroke, heart attack, or worse. These aren’t just warnings—they’re survival guidelines.

At the heart of MAOI restrictions is tyramine, a naturally occurring compound found in aged, fermented, or spoiled foods. Your body normally breaks down tyramine with the help of monoamine oxidase enzymes. But when those enzymes are blocked by an MAOI, tyramine builds up fast. That causes your blood pressure to skyrocket. Common foods like aged cheese, cured meats, soy sauce, tap beer, and even overripe bananas can set this off. Even some OTC cold medicines and herbal supplements like St. John’s wort can interact dangerously. This isn’t about being careful—it’s about avoiding a medical emergency.

People on MAOIs also need to watch out for serotonin syndrome, a life-threatening reaction caused by too much serotonin in the brain. It can happen if you combine MAOIs with SSRIs, SNRIs, certain pain meds like tramadol, or even dextromethorphan in cough syrups. Symptoms include confusion, rapid heart rate, high fever, and muscle rigidity. If you’re switching from one antidepressant to an MAOI, you must wait weeks—sometimes over a month—to let the old drug clear out. No shortcuts. No guesses. This is why doctors spend so much time explaining these rules: they’ve seen what happens when people ignore them.

There’s no wiggle room here. You can’t just "try a little" of the blue cheese or take your usual migraine pill. These restrictions aren’t outdated—they’re backed by decades of real hospital cases. Even modern MAOIs like selegiline patches have dietary limits, especially at higher doses. The good news? Once you learn the list, it gets easier. Many people adapt without feeling deprived. You’ll find plenty of safe, tasty alternatives. And if you ever forget what’s risky, you can always check with your pharmacist—most have printed guides ready.

Below, you’ll find real-world guides on how MAOIs interact with other drugs, what supplements to avoid, and how to manage your diet without feeling trapped. These aren’t theoretical warnings. They’re stories from people who lived through the consequences—and learned how to stay safe.