Which class of antidepressants is associated with a risk of lethal hypertensive crisis when tyramine-containing foods are ingested?

• A. SSRIs
• B. SNRIs
• C. TCAs
• D. MAOIs

Answer: (D)

Tyramine-containing foods cause a dangerous hypertensive crisis when taken with monoamine oxidase inhibitors because these drugs block the gut and liver enzyme MAO-A that normally metabolizes tyramine. With MAO inhibited, tyramine accumulates and promotes a large release of norepinephrine, leading to rapid and severe blood pressure elevation. This specific interaction is not seen with SSRIs, SNRIs, or TCAs, since they do not inhibit intestinal MAO to the same extent. So the hypertensive crisis risk from tyramine is a hallmark interaction with MAO inhibitors, underscoring the need for dietary restrictions and careful monitoring when using this class.