Consumption of tyramine-containing foods with MAO inhibitors can precipitate which dangerous reaction?

• A. Hypotension
• B. Hypertensive crisis
• C. Serotonin syndrome
• D. Neuroleptic malignant syndrome

Answer: (B)

Consuming tyramine-containing foods while on monoamine oxidase inhibitors can trigger a hypertensive crisis. MAO inhibitors block the normal breakdown of tyramine in the gut and liver, so tyramine enters the circulation and causes a surge of norepinephrine release from sympathetic nerve endings. This sudden flood of norepinephrine leads to intense vasoconstriction and a dramatic rise in blood pressure, which can be life-threatening and may present with severe headache, chest pain, or other signs of hypertensive emergency. The other options don’t fit this mechanism: hypotension would be a low blood pressure response, serotonin syndrome involves excessive serotonin, and neuroleptic malignant syndrome relates to dopamine blockade from antipsychotics.