Abstract
The consumption of tyramine-containing foods is contraindicated in patients on classic monoamine oxidase (MAO) inhibitors. We report successful therapeutic use of moclobemide (a MAO-A selective inhibitor) plus controlled amounts of Bovril (a tyramine-rich yeast-extract available as a food) in a patient with pure central autonomic failure who was rendered bed-bound by severe postural hypotension. Standing blood pressure is now at least 90/45 mm Hg. The selectivity of moclobemide allows about a tenth of ingested tyramine to reach nerve endings and thus the modest hypertensive effect of this combination re-established day-to-day function by restoring normotension.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Activities of Daily Living
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Autonomic Nervous System Diseases / complications
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Autonomic Nervous System Diseases / diagnosis
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Autonomic Nervous System Diseases / drug therapy*
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Benzamides / pharmacology
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Benzamides / therapeutic use*
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Blood Pressure / drug effects
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Blood Pressure Monitoring, Ambulatory
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Drug Therapy, Combination
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Female
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Heart Rate / drug effects
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Humans
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Hypotension, Orthostatic / diagnosis
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Hypotension, Orthostatic / etiology*
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Hypotension, Orthostatic / physiopathology
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Middle Aged
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Moclobemide
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Monoamine Oxidase Inhibitors / pharmacology
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Monoamine Oxidase Inhibitors / therapeutic use*
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Treatment Outcome
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Tyramine / pharmacology
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Tyramine / therapeutic use*
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Yeast, Dried / pharmacology
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Yeast, Dried / therapeutic use*
Substances
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Benzamides
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Monoamine Oxidase Inhibitors
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marmite
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Moclobemide
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Tyramine