Skip to main content
Log in

Tyramine infusions and selective monoamine oxidase inhibitor treatment

I. Changes in pressor sensitivity

  • Original Investigations
  • Published:
Psychopharmacology Aims and scope Submit manuscript

Abstract

The enhanced sensitivity to the pressor effects of tyramine, an indirect-acting sympathomimetic found abundantly in the diet, is a well-known potentially dangerous side effect occurring during treatment with commonly used nonselective monoamine oxidase (MAO) inhibitors. The effects of treatment with the selective MAO-A inhibitor clorgyline and the partially selective MAO-B inhibitors pargyline and deprenyl on tyramine's pressor effects were studied in depressed patients using an IV steady-state tyramine infusion technique. After 4 weeks of treatment, clorgyline produced a significantly greater increase in tyramine sensitivity in comparison to a medication-free baseline (29-fold) than did pargyline (12-fold) or deprenyl (1.7-fold). The pressor effects of tyramine were significantly prolonged after cessation of infusion during both clorgyline and pargyline, but not deprenyl treatment. These data from IV tyramine administrations suggest that intestinal MAO inhibition is not the major determinant of the enhanced tyramine pressor sensitivity produced by clorgyline and pargyline.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Blackwell B (1963) Hypertensive crisis due to monoamine oxidase inhibitors. Lancet II:849–851

    Google Scholar 

  • Byck R (1975) Drugs and the treatment of psychiatric disorders. In: Goodman LS, Gilman A (eds) The pharmacological basis of therapeutics. McMillan, New York, pp 152–200

    Google Scholar 

  • Elis J, Laurence DR, Madie H, Prichard BN (1967) Modification by monoamine oxidase inhibitors of the effects of some sympathomimetics on blood pressure. Br Med J 2:75–78

    Google Scholar 

  • Elsworth JD, Glover V, Reynolds GP, Sandler M, Lees AJ, Phuapradt P, Shaw KM, Stern GM, Kumar P (1978) Deprenyl administration in man: A selective monoamine oxidase-B inhibitor without the “cheese effect”. Psychopharmacology 57:33–38

    Google Scholar 

  • Fuentes JA, Neff NH (1975) Selective monoamine oxidase inhibitor drugs as aids in evaluating the role of type-A and B enzymes. Neuropharmacology 14:819–825

    Google Scholar 

  • Horwitz D, Lovenberg W, Engleman K, Sjoerdsma A (1964) Monoamine oxidase inhibitors, tyramine and cheese. JAMA 190:1108–1110

    Google Scholar 

  • Houslay MD, Tipton KF, Youdim MBH (1976) Multiple forms of monoamine oxidase, fact and artifact. Life Sci 19:467–478

    Google Scholar 

  • Innes RI, Nickerson M (1975) Norepinephrine, epinephrine and the sympathomimetic amines. In: Goodman LS, Gilman A (eds) The pharmacological basis of therapeutics. McMillan, New York, pp 514–532

    Google Scholar 

  • Knoll J (1979) Structure-activity relationships of the selective inhibitors of MAO-B. In: Singer TP, Van Korff RW, Murphy DL (eds) Monoamine oxidase: Structure, function and altered functions. Academic, New York, pp 431–446

    Google Scholar 

  • Kopin IJ (1966) Biochemical aspects of release of norepinephrine and other amines from sympathetic nerve endings. Pharmacol Rev 18:784–792

    Google Scholar 

  • Kopin IJ, Gordon EF (1962) Metabolism of 3H-norepinephrine released by tyramine and reserpine. J Pharmacol Exp Ther 138:351–359

    Google Scholar 

  • Lader MA, Sakalis G, Ansella M (1970) Interaction between sympathomimetic amines and a new monoamine oxidase inhibitor. Psychopharmacology 18:118–123

    Google Scholar 

  • Lees AJ, Shaw KM, Kohout LF, Stern GM, Elsworth JD, Sandler M, Youdim MBH (1977) Deprenyl in Parkinson's disease. Lancet II:791–796

    Google Scholar 

  • Liebowitz MR, Klein DF (1979) Hysteroid dysphoria in affective disorders: Special clinical forms. In: Akisdal, S (ed) The psychiatric clinics of North America. Saunders, New York, pp 555–575

    Google Scholar 

  • Lipper S, Murphy DL, Slater S, Buchsbaum MS (1979) Comparative behavioral effects of clorgyline and pargyline in man: A preliminary report. Psychopharmacology 62:123–128

    Google Scholar 

  • Marley E, Blackwell B (1970) Interactions of monoamine oxidase inhibitors, amines and foodstuffs. Adv Pharmacol Chemother 8:186–239

    Google Scholar 

  • Murphy DL (1978) Substrate-selective monoamine oxidases: Inhibitor, tissue, species and functional differences. Biochem Pharmacol 27:1889–1893

    Google Scholar 

  • Murphy DL, Lipper S, Slater S, Shilling S (1979) Selectivity of clorgyline and pargyline as inhibitors of monoamine oxidase A and B in vivo in man. Psychopharmacology 62:129–132

    Google Scholar 

  • Neff NH, Yang HYT (1974) Another look at the monoamine oxidases and the monoamine oxidase inhibitor drugs. Life Sci 14:2061–2074

    Google Scholar 

  • Pickar D, Cohen RM, Jimerson DC, Lake CR, Murphy DL (1981) Tyramine infusions and selective MAO inhibitor treatment. II. Interrelationships among pressor sensitivity changes, platelet MAO inhibition, and plasma MHPG reduction. Psychopharmacology 74:8–12

    Google Scholar 

  • Pickar D, Cohen RM, Murphy DL (1979) Tyramine infusions in bipolar illness: Behavioral effects and longitudinal changes in pressor sensitivity. Am J Psychiatry 136:1460–1463

    Google Scholar 

  • Sanders JC (1963) Treatment of hospitalized depressed and schizophrenic patients with monoamine oxidase inhibitors including reflections on pargyline. Ann NY Acad Sci 107:1081–1089

    Google Scholar 

  • Sandler M, Glover V, Ashford A, Stern GM (1978) Absence of cheese effect during (-)deprenyl therapy: Some recent studies. J Neurol Transm 43:209–215

    Google Scholar 

  • Singer TP, Von Korff RW, Murphy DL (1979) Monoamine oxidase: Structure, function and altered function. Academic, New York

    Google Scholar 

  • Youdim MBH (1977) Tyramine and psychiatric disorders. In: Usdin E, Hamberg DA, Barchas ID (eds) Neuroregulators and psychiatric disorders. Oxford University Press, New York, pp 57–67

    Google Scholar 

  • Youdim MBH, Riederer P, Birkmayer W, Medlewicz J (1979) The functional activity of monoamine oxidase: The use of deprenyl in the treatment of Parkinson's disease and depressive illness. In: Singer TP, Van Korff RW, Murphy DL (eds) Monoamine oxidase: Structure, function and altered functions. Academic, New York, pp 477–496

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Presently with the Biological Psychiatry Branch, NIMH

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pickar, D., Cohen, R.M., Jimerson, D.C. et al. Tyramine infusions and selective monoamine oxidase inhibitor treatment. Psychopharmacology 74, 4–7 (1981). https://doi.org/10.1007/BF00431747

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00431747

Key words

Navigation