title: Tap (draft) beer and monoamine oxidase inhibitor dietary restrictions.
abstract: OBJECTIVE
  Traditional monoamine oxidase inhibitors (MAOIs) continue to play an important role in the management of a wide variety of clinical conditions. Accordingly, a practical and safe approach to MAOI dietary restrictions remains an essential component of patient management.
  
  
  METHODS
  In an effort to refine MAOI dietary recommendations, we report a case of hypertensive crisis following the consumption of a modest amount of tap beer.
  
  
  RESULTS
  A well-documented case report involving tap (draft) beer consumed while on an MAOI supports an earlier study, which recommended that all tap beers be restricted on MAOI diets. The 2 cases were remarkably similar in terms of the offending substance, quantity consumed, and subsequent reaction.
  
  
  CONCLUSIONS
  As a result of recent tyramine analyses and 2 well-documented case reports, all tap (draft) beers should now be absolutely restricted on MAOI diets because they represent a very significant risk at modest levels of consumption.
authors.affiliation: Department of Psychiatry, University of Toronto, Ontario.
authors.forename: K I
authors.initials: KI
authors.lastname: Shulman
authors.forename: S A
authors.initials: SA
authors.lastname: Tailor
authors.forename: S E
authors.initials: SE
authors.lastname: Walker
authors.forename: D M
authors.initials: DM
authors.lastname: Gardner
mesh_terms: D000328:Adult; D001515:Beer / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000188:drug therapy*; D000075202:Contraindications; D003866:Depressive Disorder / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D006974:Hypertension, Malignant / Q000139:chemically induced* / Q000517:prevention & control; D008297:Male; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D010624:Phenelzine / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D008996:Monoamine Oxidase Inhibitors; D010624:Phenelzine