No more banana peels

Nardil has been both a blessing and a bane to my existence. I had treatment-resistant depression for longer than I care to remember, and it was the only drug that worked. But being an MAOI, it doesn’t play well with others. In addition to the foods listed below (chocolate! cofee! sourdough bread!), “a total of 924 drugs are known to interact with Nardil (phenelzine).” (from Every time I’ve had a surgery, an illness, or pain (it interacts with many pain meds), I have to warn the prescribing physician that I take phenelzine. They always look at me oddly and question why I’m taking such an antiquated medication.

This drug may rarely cause an attack of extremely high blood pressure (hypertensive crisis), which may be fatal. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas) or eating large amounts of chocolate. Foods and beverages high in tyramine should be avoided while you are taking this medication.

Foods include: aged cheeses, aged/dried/fermented/salted/smoked/ pickled/processed meats and fish (includes bacon), banana peel (is this even necessary to say?), bouillon cubes, commercial gravies, concentrated yeast extracts, fava beans, Italian green beans, broad beans, fermented bean curd, homemade yeast-leavened bread, kim chee (Korean fermented cabbage), orange pulp, overripe or spoiled fruits (again, really…is this a problem?), packaged soups, red wine, sauerkraut, sherry, snow pea pods, sourdough bread, soy sauce, soybeans, soybean paste/miso, tofu, tap beer (but canned beer is ok?) and ale, vermouth.

Moderate-to-low tyramine content foods include: alcohol-free beer, avocados, bananas, bottled beer and ale, chocolate and products made with chocolate, coffee, cola, cultured dairy products (e.g. buttermilk, yogurt, sour cream), distilled spirits, eggplant, canned figs, fish roe (caviar), green bean pods, pate, peanuts, port wine, raisins, raspberries, red plums, spinach, tomatoes, white wine.

Add to this the fact that even though it’s available as a generic, I still have to pay the full price because the insurance company doesn’t like that it’s rarely used anymore. And this year the price went up. So it’s time to play drug roulette once again. Even though I greatly fear the though of finding an alternative, I don’t see how I can continue to take this drug.

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