PDF(Pubmed)
Abstract：
This review article features comprehensive discussions on the dietary restrictions issued to patients taking a classic monoamine oxidase inhibitor (phenelzine, tranylcypromine, isocarboxazid), or high-dose (oral or transdermal) selegiline. It equips doctors with the knowledge to explain to their patients which dietary precautions are necessary, and why that is so: MAOIs alter the capacity to metabolize certain monoamines, like tyramine, which causes dose-related blood pressure elevations. Modern food production and hygiene standards have resulted in large reductions of tyramine concentrations in most foodstuffs and beverages, including many cheeses. Thus, the risk of consequential blood pressure increases is considerably reduced-but some caution remains warranted. The effects of other relevant biogenic amines (histamine, dopamine), and of the amino acids L-dopa and L-tryptophan are also discussed. The tables of tyramine data usually presented in MAOI diet guides are by nature unhelpful and imprecise, because tyramine levels vary widely within foods of the same category. For this reason, it is vital that doctors understand the general principles outlined in this guide; that way, they can tailor their instructions and advice to the individual, to his/her lifestyle and situation. This is important because the pressor response is characterized by significant interpatient variability. When all factors are weighed and balanced, the conclusion is that the MAOI diet is not all that difficult. Minimizing the intake of the small number of risky foods is all that is required. Many patients may hardly need to change their diet at all.
摘要：
这篇综述文章全面讨论了对服用经典单胺氧化酶抑制剂（苯乙嗪，tranylcypromine,异卡波肼)，或高剂量（口服或经皮）司来吉兰。它使医生掌握了向患者解释哪些饮食预防措施是必要的知识，为什么会这样：MAOI改变了代谢某些单胺的能力，像酪胺,导致剂量相关的血压升高。现代食品生产和卫生标准导致大多数食品和饮料中酪胺浓度大幅下降，包括许多奶酪。因此，因此引起的血压升高的风险大大降低,但仍需谨慎.其他相关生物胺(组胺，多巴胺)，还讨论了氨基酸L-多巴和L-色氨酸。通常在MAOI饮食指南中提供的酪胺数据表本质上是无益和不精确的，因为在同一类别的食物中，酪胺的含量差异很大。出于这个原因,医生必须理解本指南中概述的一般原则；这样，他们可以为个人定制他们的指导和建议，他/她的生活方式和情况。这是重要的,因为升压响应的特征在于显著的患者间变异性。当所有因素都经过权衡和平衡时，结论是MAOI饮食并不是那么困难。尽量减少少量危险食物的摄入量是所需要的。许多患者可能几乎不需要改变他们的饮食。
