Administration of supplemental L-tyrosine with phenelzine: a clinical literature review

The subject of this literature review is the alleged relationship between L-tyrosine, phenelzine, and hypertensive crisis. Phenelzine (Nardil®) prescribing information notes: “The potentiation of sympathomimetic substances and related compounds by MAO inhibitors may result in hypertensive crises (see WARNINGS). Therefore, patients being treated with NARDIL should not take […] L-tyrosine […]”. Interest in the scientific foundation of this claim was generated during routine patient care. A comprehensive literature search of Google Scholar and PubMed revealed no reported cases of hypertensive crisis associated with concomitant administration of L-tyrosine and phenelzine. Review of current US Food and Drug Administration nutritional guidelines relating to ongoing phenelzine studies reveals no mention and requires no consideration of L-tyrosine ingestion in combination with phenelzine. This paper is intended to provide an objective review of the science to then allow the reader to formulate the final opinion.

[1]  M. Hinz,et al.  5-HTP efficacy and contraindications , 2012, Neuropsychiatric disease and treatment.

[2]  M. Hinz,et al.  Relative nutritional deficiencies associated with centrally acting monoamines , 2012, International journal of general medicine.

[3]  M. Hinz,et al.  The discrediting of the monoamine hypothesis , 2012, International journal of general medicine.

[4]  M. Hinz,et al.  Monoamine depletion by reuptake inhibitors , 2011, Drug, healthcare and patient safety.

[5]  M. Hinz,et al.  APRESS: apical regulatory super system, serotonin, and dopamine interaction , 2011, Neuropsychiatric Disease and Treatment.

[6]  M. Hinz,et al.  Validity of urinary monoamine assay sales under the “spot baseline urinary neurotransmitter testing marketing model” , 2011, International journal of nephrology and renovascular disease.

[7]  M. Hinz,et al.  Amino acid management of Parkinson’s disease: a case study , 2011, International journal of general medicine.

[8]  M. Hinz,et al.  Urinary neurotransmitter testing: considerations of spot baseline norepinephrine and epinephrine , 2011, Open access journal of urology.

[9]  R. Weinberg,et al.  Treatment of attention deficit hyperactivity disorder with monoamine amino acid precursors and organic cation transporter assay interpretation , 2011, Neuropsychiatric disease and treatment.

[10]  M. Hinz,et al.  Amino acid-responsive Crohn’s disease: a case study , 2010, Clinical and experimental gastroenterology.

[11]  M. Hinz,et al.  A pilot study differentiating recurrent major depression from bipolar disorder cycling on the depressive pole , 2010, Neuropsychiatric disease and treatment.

[12]  G. Trachte,et al.  Neurotransmitter testing of the urine: a comprehensive analysis , 2010, Open access journal of urology.

[13]  M. Hinz,et al.  The dual-gate lumen model of renal monoamine transport , 2010, Neuropsychiatric disease and treatment.

[14]  J. Driskell Food and Nutrients in Disease Management , 2009 .

[15]  G. Trachte,et al.  Both stimulatory and inhibitory effects of dietary 5-hydroxytryptophan and tyrosine are found on urinary excretion of serotonin and dopamine in a large human population , 2009, Neuropsychiatric disease and treatment.

[16]  C. Wientjes,et al.  Tyrosine improves cognitive performance and reduces blood pressure in cadets after one week of a combat training course , 1999, Brain Research Bulletin.

[17]  Harris R. Lieberman,et al.  l-Tyrosine ameliorates some effects of lower body negative pressure stress , 1995, Physiology & Behavior.

[18]  J. Deijen,et al.  Effect of tyrosine on cognitive function and blood pressure under stress , 1994, Brain Research Bulletin.

[19]  K. Shulman,et al.  Dietary Restriction, Tyramine, and the Use of Monoamine Oxidase Inhibitors , 1989, Journal of clinical psychopharmacology.

[20]  S. Ekholm,et al.  Cardiovascular effects of L-tyrosine in normotensive and hypertensive rats. , 1987, European journal of pharmacology.

[21]  H. Gavras,et al.  Blood Pressure Response to Central and /or Peripheral Inhibition of Phenylethanolamine N‐Methyltransferase in Normotensive and Hypertensive Rats , 1981, Circulation research.

[22]  Y. Yamori,et al.  The hypotensive effect of centrally administered tyrosine. , 1980, European journal of pharmacology.

[23]  J. Growdon,et al.  Elevation of plasma tyrosine after a single oral dose of L-tyrosine. , 1979, Life sciences.

[24]  R. Wurtman,et al.  Tyrosine administration reduces blood pressure and enhances brain norepinephrine release in spontaneously hypertensive rats. , 1979, Proceedings of the National Academy of Sciences of the United States of America.

[25]  A. Boulton,et al.  Hypertensive crisis in a patient on MAOI antidepressants following a meal of beef liver. , 1970, Canadian Medical Association journal.

[26]  W. Lovenberg,et al.  Monoamine Oxidase Inhibitors, Tyramine, and Cheese , 1964 .

[27]  N. Kline,et al.  Clinical results with phenelzine. , 1959, American Journal of Psychiatry.