Panic Disorder and MAO Inhibitors

Introduction

  MAO inhibitors have been used in the treatment of panic disorder, but not without problems. Unfortunately these drugs require a special diet. Also certain medications must be avoided including ephedrine, L-dopa, methyldopa, stimulants, cold tablets, meperidien, etc. Otherwise an interaction may occur causing hypertensive crisis.

The Diet

  The diet avoids foods that have amines in them. These include beer, wine, cheese, smoked or pickled fish, herring, beef or chicken liver, summer (dry) sausage, fava or broad beans, brewer's yeast, etc.

  Certain other foods have lesser amounts of amines. These include ripe avocado, ripe fresh bananas, sour cream, soy sauce, yogurt, chocolate, figs, meat tenderizers, raisins, yeast breads, coffee, tea, caffeine, etc.

  This information is from Mc Cabe and Tsuang (1982) published in Journal of Clinical Psychiatry.

  These bad foods are mostly fermented (e.g., beer, wine, cheese, etc.).

Psychotherapy

  Psychotherapy is a safer treatment for panic disorder. The problem with these drugs is that they interact with tyramine in foods.

Conclusions

  Further research is needed. A lot of drugs have been prescribed, but they all have bad side effects, unfortunately. MAO inhibitors can cause hypertensive reaction, insomnia, tachycardia, edema, etc. A hypertensive reaction can present as a severe, crushing headache with sweating.

  Rainey et al (1985) found abnormal lactate metabolism in panic disorder. I favor orthomolecular treatment.

Reference

1. Rainey, J. M.; Frohman, C. E.; Warner, K. et al. Panic anxiety and lactate metabolism. Psychopharmacology Bulletin 21:434-437, 1985.