Safety issues with MAOIs

Talk with your healthcare professional about these safety issues before you take an MAOI.

• Antidepressants and pregnancy. Some antidepressants may harm your child if you take them during pregnancy or while breastfeeding. If you are pregnant, are thinking about getting pregnant or are breastfeeding, talk with your healthcare professional about the possible dangers of certain antidepressants. Don't stop taking your medicine without talking with your healthcare professional first.

• Food and beverage interactions. MAOI antidepressants block an enzyme called monoamine oxidase. This enzyme breaks down tyramine, an amino acid in the body. Blocking the enzyme means that the body can't get rid of extra tyramine. For some people, eating or drinking foods or beverages high in tyramine while taking an MAOI causes dangerously high blood pressure.

  While you take an MAOI and for a few weeks after stopping, stay away from foods high in tyramine. These include aged cheeses, cured meats, draft beer, and other fermented, aged, overripe or spoiled foods. Ask your healthcare professional for a complete list of foods and beverages to stay away from. Also ask if you need to limit caffeine or alcohol.

• Medicine interactions. MAOIs can cause serious reactions when you take them with certain medicines. These medicines may include other antidepressants, certain pain medicines, and certain cold and allergy medicines. Some herbal supplements also can cause reactions when taken with MAOIs. Always check with your healthcare professional or pharmacist before you take any other prescription or nonprescription medicine, herbs or other supplements while taking an MAOI.

• Serotonin syndrome. Rarely, an MAOI can cause dangerously high levels of serotonin in the body. This is known as serotonin syndrome. It most often happens when you take two medicines that both raise serotonin levels. This includes taking an MAOI with other antidepressants, certain pain or headache medicines, or the herbal supplement St. John's wort.

  Symptoms of serotonin syndrome include anxiety, agitation, high fever, sweating, confusion, tremors, restlessness, lack of coordination, major changes in blood pressure, and rapid heart rate. Get medical help right away if you have any of these symptoms.