MAOI Diet - I am in trouble

[trg247]

Hi:

I just spent the last month and a bit in the hospital where I went from Effexor, Wellbutrin, Remeron, Lithium and Temazapam to Nardil, Seroquel and Temazapam.....this was not too much fun. Anyway the hospital has left me very unprepared in terms of the diet as it is vague at the best of times. All I know is I am allowed roast beef, potatoes and carrots as that seem to be the only thing they ever fed me...they fed me this other meat once but don't ask me what it was.

My question is does anyone know of a complete diet somewhere online. I tried to go grocery shopping when I got home but ended up scratching my head for the majority of the time. I checked a whole bunch of labels but I am unsure if the "bad" ingredient would even be listed or is it something a food develops with time....I am clueless. Who the heck eats banana peels?

take care

trg247

[quiet storm]

Here you go:

http://www.pccnaturalmarkets.com/health/Di...e_Free_Diet.htm

If you avoid anything aged, fermented or soy you'll be knocking out most of it.

[crazycatnapper]

I was on Parnate for the majority of my life and all the stuff they use in the lists of foods not to eat are hyped up. There is a new and improved list floating around and use that one. I'll see if I can dig it up and post the link.

The food restrictions are not nearly as bad as they sound. What does suck is the med restrictions. You are really fucked if you get a cold or the flu. Most of the meds to help are totally off limits, but a good GP can find alternatives.

I tolerated white wine, mozarella (sp?) cheese, and asian food quite well. Limit soy, any beer from tap, red wines and aged foods. Over time you will learn what you can tolerate and what you can't. Overripe fruit is a big no no, as are smoked foods.

[link=http://bipolar.about.com/od/maois/a/maois_and_diet.htm"'>http://bipolar.about.com/od/maois/a/maois_and_diet.htm" target="_blank][link=http://bipolar.about.com/od/maois/a/maois_and_diet.htm"'>http://bipolar.about.com/od/maois/a/maois_and_diet.htm" target="_blank]http://bipolar.about.com/od/maois/a/maois_and_diet.htm[/link][/link]

One decent article about food interactions.

I was able to eat many of the "restricted" foods, but not in major quantities because the enzyme that breaks them down in your body is affected by the medicine. I ate potato skins (cheese, bacon and sour cream), had a bottled beer or two (no more) on occasion and had no issues with white wines. When eating asian food I just never added extra soy and was fine too. I had a few bad reactions over the years, not worthy of an ER visit or anything extreme, and they were as follows:

-specialty pizza: was having blond moment and didn't think to check the type cheese used. STUPID

-tried my luck with a little smoked food at a cookout and ended up sick. STUPID

-alfredo noodles: always made my stomach sick as did caeser salad if I didn't have the cheese left off. LEARNING EXPERIENCES

-too much alcohol at once. STUPID

Feel free to ask me anything. I've been there and done it and although I'm no expert, I can share my experiences and what foods affected me. Your mileage may vary though.

[Velvet Elvis]

Fiona made several good posts on this back in the early days of the board. Search for those.

[crazycatnapper]

Here is another decent link that I found:

[link=http://www.erowid.org/chemicals/maois/maois_info2.shtml" target="_blank]http://www.erowid.org/chemicals/maois/maois_info2.shtml[/link]

I find it downright odd that you were prescribed this drug without being given good instructions about the things to avoid as it could be fatal. I suggest doing some research on the web so you feel more comfortable taking Nardil.

[trg247]

The hospital provided me with a couple of list but they are so vague its hard to distinguish between good and bad. I watched what they fed the others but couldn't figure out what could be wrong with it. They had ham one day and I got roast beef for example or they had lasagna and I got roast beef so I didn't know whether it was the pasta or the other ingrediants. I kept asking but all I ever seem to get was this drug is barely used anymore so most nurses or staff was not current with the information. Took over a week before the nutritionist had time to spare and she was useless basically giving me the same broad stroke with few details. They are suppose to set me up with a community diet specialist but they couldn't say in what time frame. To be honest they scared the hell out of me so it has me on edge. Thank you all for the links and I will search out those old posts.

take care

trg247

[Velvet Elvis]

The absolute no-nos are aged cheese, yeast extract, and pretty much any over the counter medications.

here's a couple old threads.

http://www.crazyboards.org/forums/index.php?showtopic=9441

http://www.crazyboards.org/forums/index.php?showtopic=1272

[null0trooper]

Here you go:

[link=http://www.pccnaturalmarkets.com/health/Diet/Tyramine_Free_Diet.htm" target="_blank][link=http://www.pccnaturalmarkets.com/health/Di...e_Free_Diet.htm"'>http://www.pccnaturalmarkets.com/health/Di...e_Free_Diet.htm" target="_blank][link=http://www.pccnaturalmarkets.com/health/Di...e_Free_Diet.htm"'>http://www.pccnaturalmarkets.com/health/Di...e_Free_Diet.htm" target="_blank]http://www.pccnaturalmarkets.com/health/Di...e_Free_Diet.htm[/link][/link][/link]

If you avoid anything aged, fermented or soy you'll be knocking out most of it.

Soy milk is safe - dietary tyramine is the amino acid that causes the dangerous rise in blood pressure associated with "the Cheese Effect" and there's just not that much in the minimally-processed soy products. Drinking soy sauce or Worcestershire sauce would be a BAD idea though.

It's safe to ignore the warnings about dopamine in fava beans and banana peels - it's all the MAO-A that's shut down in the gut that lets tyramine become a problem, but it's mostly MAO-B that chews up dopamine. Not that it would hurt to give up fava beans stewed with overripe banana peels.

OTC: aspirin and acetaminophen should be OK. Half the things they are mixed with won't be.

More information is compiled at [link=http://www.dr-bob.org/babble/20010804/msgs/73614.html" target="_blank]Psycho-Babble[/link]

Edit: Who really eats fava beans an overripe avocados anyway? And fresh figs get green and fuzzy too fast to get overripe.

(Well, they do in *my* fridge)

[Velvet Elvis]

fava beans go well with liver and a nice chianti

[trg247]

Again thank you all for your considerable time and effort that you have put in to your responses. The diet is definatly not as imposing as it once was just need to remember to keep my eyes wide open to the parameters in place. Needless to say I will keep referring to this thread over the next while.

I do have a couple of specific questions that I hope someone has some experience and insight into:

My little boy who visits on weekend love the alphagetti type food and kraft dinner (this one has me worried because of the cheese factor). He also loves pizza but I am going to wait a good while before exploring that aisle again.

Seasoning - More specifically meat tendirizer as it was used on a regular basis on my old diet - is this more a brand to brand decision or is it right off the shelf

Barbeque sauces/gravys - again is this an ingrediant by ingrediant check or just better to leave it alone and anyone know any good safe ones?

Canned soup more often then not the simple Campell types - tomato, chicken noodle, etc

there is probaly a lot more that I will bother you with in the future

take care

trg247

[null0trooper]

Brand-by-brand across the board. It's amazing how many things "hydrolyzed yeast" gets snuck into, and they never quite tell you how much of it went in. FWIW, a spent/hydrolyzed yeast slurry (trucked in from a local distillery) is literally the "slop" one feeds to hogs.

[crazycatnapper]

I never had problems with mac & cheese. Wait, if someone made a real gourmet dish it could be a problem. Regular old mac & cheese (not gourmet white cheese types) is fine to eat. Velveeta isn't really cheese (lol) and American cheese is fine. Any type box mix should be ok. I have never been a big fan of cheese anyway, but even I want some mac & cheese on occasion. Actually, it sounds good right now. YUM.

I was desperate once at my fiance's house and ate canned Ravioli and had no problems. I'd think any of those "kid" foods would be fine. I also had some cans of others (like skeetios) on various occasions without any issues. I never had a problem with basic soups either. I even had chicken boullion (sp?) some mornings at the office when I hadn't time for breakfast and it was ok. That stuff "should" be a no-no but I never had any reactions, even if I drank three cups.

As I said, pizza that uses only mozza is ok. Just make sure you avoid the famous three cheese kinds. Provolone didn't sit well with me, fyi, and some pizza chains use it instead of mozza. I just asked and stuck to the same brands of frozen or delivery pizza all the time.

I used chili powder (I love chili) and some other meat flavorings, but you have to be careful. Most won't cause problems unless you marinade the meat in a LOT of seasonings or many types of seasoning. Moderation is the key, at least from my experience. No problems with BBQ sauce or gravy. However, I must add I only eat homemade "real" gravy, not any box or processed stuff. I'd use caution with packaged gravy mixes. If you can, try to season with salts and peppers which are safe. Jane's crazy mixed up salt and crazy mixed up pepper are wonderful seasonings.

Null0trooper hit the nail on the head about painkillers too. The basics are ok, but once you move beyond that, watch out. Plain benedryl is fine, but make sure you don't get any of the "fancy" kinds. There should be warnings on the labels in case you ever have questions. And I have a great pharmacy (CVS) where the pharmacists more of less know me. I've been going to the same place for about 15 years. They are a wonderful source of info and I always checked ANY/ALL OTC meds through them before I took something. Luckily, my GP is fab and when I got sick, she'd research med options for me while I sat with her at her computer. (they are mostly paperless, so each room had a laptop) She even read up MAOi meds just for me. *she gets two gold stars for this!!!

The ham they served was probably smoked, so you got roast beef. The cheese in the lasagna was the reason for you getting roast beef that day. Are you sick of roast beef? LOL If you want lasagna, use cottage cheese instead and you will be good to go. I HATE cottage cheese, but even I can't tell the difference once it's all cooked up and on the plate.

Feel free to keep asking questions. As I said, I took Parnate for most of my life and really know this inside out. However, your mileage may differ. Each of us reacts in a unique way, so take my advice for what it is. I know how overwhelming it can be to be put on a drug that is "so old no one knows squat about it except horror stories". Back when I started it, there wasn't even internet (in our modern sense of it) and there were NO updated food lists. I learned most of my stuff from trial/error. I was lucky to have a good friend whose dad was a shrink and her mom had taken an MAOi for a while. Her dad told me most of the stuff on the list was "overly cautious" but that was off the record of course. Hell, my own shrink told me I would be ok to have a few glasses of wine, again, off the record.

One thing I did notice is that dark liquors have greater impact than clear ones. Plus, it's not really wise to drink much when you are depressed. But if you do, vodka and rum were better than most other "hard" liquors. Gin gave me the "blotchies" sometimes, so even though it's clear, it can cause problems.

Good luck. I know this class of drug is usually a last ditch effort, so I am hoping you find relief. It's a great drug and I think it should be used more than it is. However, it's hard to overcome the part where people died. It's a godsend for many though. I know I would never have made it as far as I have in life without it. Hell, I may end up back on Parnate. Time will tell.

[trg247]

Hi:

So I am going grocery shopping today and I have this feeling it is going to take awhile but if I eat another yellow or green bean my body is going to freak.

Roast Beef- By the fourth time in three days I told the lady I understand the people in the kitchen were not very creative but this meal was terrible the first time around, should have let the animal die a peacefull death and not have scared it in its old age causing the heart attack that killed it....she was not amused......not like it had any effect cause take a wild guess what I ate that night. They had some new guy on lunch during my first weekend on MAOI diet and he just gave me a plate of what ever everyone was eating, I can't remember exactly what it was or maybe just couldn't recognize it but I knew a heck of a lot of cheese was involved. "are you trying to kill me?" I asked then a nurse took notice ran over and said "this is terry, he can not have that" long story short turns out the kitchen failed to let him know and forgot to send up a special plate.......northern ontario hospitals

take care

trg247

[trg247]

Like I said earlier I went grocery shopping and at the same time picked up the rest of the Nardil, the hospital faxed them the prescription and it took hours to get a hold of enough to cover me for a week and then it took them three more days to fill the rest of the month....200,000 population in case you were wondering. The pharmacist asked how i liked it so far to which I responded it has only been a couple of weeks so nothing yet but the diet is a pain which responded it sure is which causes most people to stop using it...which I knew then she was nice enough to scan the cart and gave me a thumbs up on products I had selected.

The main obstacle as far as meal planning is breakfast, due to a family history I need to avoid eggs as much as possible and it seemed every cereal box I checked didn't appear very safe. Suggestions?

take care

trg247

[null0trooper]

The main obstacle as far as meal planning is breakfast, due to a family history I need to avoid eggs as much as possible and it seemed every cereal box I checked didn't appear very safe. Suggestions?

Peanut butter sandwiches

Pop Tarts

Oatmeal with apple sauce

Roast beef sandwiches

pumpkin pie

previous night's dinner

[crazycatnapper]

This may make me sound really stupid, especially since I was on an MAOi for years, but why does cereal seem unsafe? I ate it with no problems. I guess it depends on the type of cereal though. The "good for you" kinds with dried fruit, etc. could be bad, but I ate decent stuff when I ate that crap and never thought to look at labels on cereal. Cheerios, Honey Bunches of Oates with Almonds, Rice Krispies, etc.

I hope you begin to notice some good affects from the Nardil soon. I also promise the diet is not that bad once you get used to it. After a few years, I didn't even notice it anymore. Avoiding certain foods was just a way of life and the only time I had to ask about food was out to eat. Club sandwiches were always an issue because folks seem to like to use smoked turkey. grrr

And cold pizza was always one of my fav AM foods. Grab a slice and run out the door and you are good to go. I even made protein shakes when I was feeling good enough to function in the AM. You must be careful which types of mix you use though. Some are bad, but others are fine. Over time, I learned my specific "triggers" and avoided them. You'll get this down pat after a while. Just hang in there.

[trg247]

Tomorrow is a week since I have been on my own (with a lot of help from you guys) with the diet and so far no weird reactions to anything. Just a few questions that I hope you can help me with.

1. Meat - I normally buy pork shoulder cuts that come in twos. I get home freeze it then when I decide to have it I have one the first day and the next the next day. The unthawing takes place in the fridge and I have no problem with the first day but is the second one still safe, I ate it with no problems but did cut off some dryer pieces of meat.. the list the hospital sent says eat meat immediately or freeze do not let sit in fridge for two long.

2. Sour Cream - Half the lists say no problems the others say the opposite. I don't use it often and tend to use the whole container in one shot when I do. Unfortunately Sour Cream potato chips are my favorite and I have a bag upstairs that I have not dared to open yet.

3. Fruit and vegtables - the list says it basically has to be in perfect shape so I have stuck to the frozen kind, but is a banana (not the peel - who the hell eats the peel) or any other just before or just after that much a threat?

4. My almost four year old was not impressed when he found out I had no chocolate milk in the house, before its almost all I drank. I have a feeling the chocolate syrup is in the danger zone but what about the dairy mixed type?

Turns out the earlier mentioned cereal issue was a mistaken word, I thought I saw tyramine(sp) but what was actually thiamine

thats it for now and thanks again for your help.

take care

trg247

[null0trooper]

2. Sour Cream - Half the lists say no problems the others say the opposite. I don't use it often and tend to use the whole container in one shot when I do. Unfortunately Sour Cream potato chips are my favorite and I have a bag upstairs that I have not dared to open yet.

Probably more than half of the lists are copied from other lists without any actual research.

Never had a reason to look it up, but I think that milk souring has to do with conversion of lactose to lactic acid. The proteins curdle, but that's not the same as the denaturing and breakdown involved in aging cheese. Try looking up the tyramine content or sour cream - I'm sure someone's analyzed it instead of just guessing.

3. Fruit and vegtables - the list says it basically has to be in perfect shape so I have stuck to the frozen kind, but is a banana (not the peel - who the hell eats the peel) or any other just before or just after that much a threat?

Once again, the primary issue is tyramine content, not whether a chunk of colored cellulose and mixed carbohydrates fails to meet an arbitrary aesthetic standard. Probably you should avoid brown mushy bananas (there is some protein in the pulp) but the peel is where the majority of the nasty action is.

By the way, usually the canned and frozen foods are the ones that didn't look "perfect" enough to send to the grocer's shelves and risk going unsold.

Figure anything that's starting to grow any new fur is Off Limits for you, just because something has to be breaking down at that point and it's no longer worth the effort or risk.

4. My almost four year old was not impressed when he found out I had no chocolate milk in the house, before its almost all I drank. I have a feeling the chocolate syrup is in the danger zone but what about the dairy mixed type?

phenethylamine, theobromine, theophylline, and caffeine are not tyramine and do not cause the out of control BP rise that the MAOI "diet" is supposed to be concentrating on. Apparently someone once found a compound that could act as an MAOI in chocolate. OMG - a potential food/drug interaction! If someone can find the original report, maybe we can compute how many pounds of chocolate you'd have to consume (without throwing up) to have a reaction worth worrying about.

People may be more sensitive to the major active compounds in chocolate while on an MAOI, but I think the risk is extremely overhyped. For what it's worth, while I was on it I usually washed down Parnate with chocolate soy milk every morning, although I may have cut back on my coffee intake.

And remember, unless you're nursing your kids aren't also on the MAOI - let them have their chocolate and mushy bananas.

[crazycatnapper]

I must say it's good you take the diet seriously, but you really are worrying way too much. There were very few things (ok, categories of things) I could not eat while on an MAOi. Seriously, as long as I avoided smoked stuff, aged cheese and too much alcohol I was good to go.

I love sour cream and would never have thought twice about eating it unless it was way past the expiration date. I never gave any thought to chips, except the cheese flavors. Go hog wild on your chips and don't fret.

Null0trooper has hit the nail on the head again. As long as they aren't really gross (rotten spots or moldy) fruits and veggies are fine. The only thing I'd say to watch is bananas that get brown spots. And eating one won't really hurt you much anyway, even if it's mushy. I used to eat homemade banana ice cream and my grandfather used overripe bananas to make it. One bowl was always safe.

I ate chocolate syrup on ice cream. My mom was also on Parnate for years and drank chocolate milk like it was the only drink on earth. You don't have to worry about chocolate. You really would barf long before you'd have a reaction. Milk isn't a problem ever. You most likely will get sick if you drink outdated milk, but that doesn't have anything to do with your meds. LOL

In all the years I was on the drug, my BP only got funky one time. I did have a few cases of "splotches" and an upset stomach a few times, but there was only once that my BP get high and worried me. That was the time I ate the pizza and forgot to check the type of cheese that was used. I didn't even go to the ER; I just went to bed and propped up my feet until my BP came down. I have a monitor at the house due to my anuerysm, so I am able to check mine. That was the only time I felt truly horrid and worried about what I'd eaten.

As most of us have said, those lists are hyped up and very few things must be totally avoided. If you don't feel safe with chocolate milk then don't drink it, but you shouldn't ban it from the house or keep your kid from drinking it.

Regarding the meat, if it's not past the expiration date, it should be fine. I bought meat and kept it in the fridge until I used it later in the week with no problems. It's only when things begin to break down that problems occur, and that talkes time with any food. A day or two won't hurt anything that is purchased fresh. Watch the expiration dates though and never eat really outdated foods.

BTW, how are you feeling? I hope your moods are getting better.

[trg247]

Hi:

I am definately taking the rather be safe then sorry route a little bit far but it is starting to ease thanks to you guys.

Mood effect - I spend the majority of the day fighting keeping my head down to a normal speed and the depression front still has not been breached ............ I am sticking to I need to give it a good four to six weeks before I toss it away. Next appointment is the first week of December so hopefully this meds future will become more clear by then. Seroquel is keeping me in check for the most part.

Thanks again for the help

take care

trg247