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Posted July 9, 2006

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Medication Safety: Eating Safely While Using Depression Patch

Q. I'm currently taking 12mg of Emsam via the patch. Where would fast food and canned tuna come in under my restrictions? I also have read conflicting views on lunch meats, hot dogs, and ham. Any help or clarification is greatly appreciated. Thank you.

Nathan C., Green Bay, Wisconsin.

A. Thank you for your important question. While on Emsam (a MAO Inhibitor recently approved by the FDA to treat depression), your doctor may recommend that you avoid certain foods that contain tyramine, which can cause an increase in blood pressure while you are on Emsam. According to the FDA, foods that are high in tyramine and should be avoided while taking a MAO Inhibitor include:

American processed, cheddar, blue, brie, mozzarella and Parmesan cheese; yogurt, sour cream.

Beef or chicken liver; cured meats such as sausage and salami; game meat; caviar; dried fish.

Avocados, bananas, yeast extracts, raisins, sauerkraut, soy sauce, miso soup.

Broad (fava) beans, ginseng, caffeine-containing products (colas, chocolate, coffee and tea). In addition, it is recommended to avoid alcohol -- beer, red wine, other alcoholic beverages, non-alcoholic and reduced alcohol-beer and red-wine products.

Northwestern Medical Hospital in Chicago has a very good low tyramine food list on its website that might be helpful for you. Hot dogs and ham usually fall on the "to avoid" list, but regular canned tuna if eaten immediately should be all right.

As for eating out, it is important to check the ingredient list of all foods before eating them. Many restaurants post this information on their website so you can investigate before you visit them and make menu selections.

You also may want to discuss this diet with your doctor or schedule an appointment with a registered dietitian (find one here) to review your dietary plan and see if certain foods that you typically eat are high in tyramine.

This answer has been provided by Sharon Palmer, a registered dietician with 16 years experience managing healthcare food and nutrition departments. Her career has included clinical nutritional care for a broad spectrum of patients, from eating disorders to elderly. She also has managed the food and environmental services departments in several acute care hospitals. Ms. Palmer lives in Southern California and can be reached at

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