Will Cheese Make You Happy? Not if You’re Taking MAOI’s: Why Your Antidepressant May Not Be A Gouda

Serotonin aka the “happiness hormone” is a chemical messenger released by your brain that enhances your overall state of happiness and comfort.(1) It’s a stimulative neurotransmitter and vasoconstrictor that can affect blood pressure, mood and your appetite.(2) Serotonin is made from tryptophan—an essential amino acid, that tends to be plentiful in your diet.(1) When there are high levels of tryptophan in your blood, it sends a signal to the brain to create serotonin. Serotonin tends to be the target of antidepressants because of its positive effect on mood.(1) One of these antidepressants is monoamine oxidase inhibitors, or MAOI’s, which prevent the breakdown of neurotransmitters, like serotonin, in the brain.(1) They help to treat both mild and moderate symptoms of depression but there are food and drug interactions that come along with the ingestion of these antidepressants.(2) MAOI’s work by blocking monoamine oxidase (MAO), an enzyme that removes amino groups.(2) MAO breaks down serotonin and tyramine—a substance found in various dietary sources, including cheese, fish alcohol and meat, to help stop the buildup of such chemicals in the brain(2)(Figure 1)(5). So then, if you’re taking an MAOI to help with your depressive symptoms, you will be inhibiting the breakdown of serotonin in your brain, but you will also be inhibiting the breakdown of tyramine.(2)

Figure 1: MAOs work to degrade neurotransmitters like serotonin and norepinephrine to stop them from building up in the brain. (5)

An excess of tyramine in your brain can lead to headaches, high blood pressure and even stroke.(2) It then becomes important to avoid foods that are high in tyramine, like cheeses and alcohol. When taking MAOI’s tyramine build-ups can cause hypertensive crises but can easily be avoided by avoiding food high in tyramine, like aged cheese, especially which contains a considerable amount of tyramine).(3) A hypertensive crisis can occur one to two hours after ingesting tyramine and symptoms can include an increase in blood presage, heart pounding, headaches and can lead to complications including hemorrhage, cardiac failure, pulmonary edema and even death.(3) So, if you’re taking an MAOI to treat your depression, watching your diet and tyramine intake levels is key. Try to avoid foods like cheeses, meats (dry and cured meats especially), caviar, soy, fava beans, dried or overripe fruit, beer and vermouth (this is not extensive, but it is a start, so talking to your doctor or dietitian of a full list of foods to avoid will be beneficial).(4) So then, if you’re already on an MAOI to treat your depression and you think having some cheese may make you happier, don’t.

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1. Sperry L. Mental Health and Mental Disorders: an Encyclopedia of Conditions, Treatments, and Well-Being. Santa Barbara, CA: Greenwood, an imprint of ABC-CLIO, LLC; 2016.

2. Anderson O. Nitrogen-Containing Compounds. December 2018.

3. Yeragani V, Rao TS. Hypertensive crisis and cheese. Indian Journal of Psychiatry. 2009;51(1):65. doi:10.4103/0019-5545.44910.

4. Holden K. Meal Ideas and Menus: Avoiding High-Tyramine Foods Made Easy. https://www.mc.vanderbilt.edu/documents/neurology/files/Tyramine Menu Book 06227101.pdf. Published 2006. Accessed December 9, 2018.

5. Researchers uncover brain molecule regulating human emotion, mood. The strong robot with the gentle touch | RIKEN. http://www.riken.jp/en/pr/press/2013/20130807_2/. Accessed December 9, 2018.