Who Put the Tyramine in Mrs. Murphy's Fava Bean?

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Sir: Music aficionados will, no doubt, recognize the parody on the title of Harry “The Hipster” Gibson’s 1944 smash hit, “Who Put the Benzedrine in Mrs. Murphy’s Ovaltine.” Today, our concern is not Benzedrine and Ovaltine but, rather, why fava beans have attained the reputation of being one of those “tyramine-rich foods . . . to avoid” in the presence of monoamine oxidase inhibitors (MAOIs). The product package inserts for EMSAM (selegiline transdermal system) and Azilect (rasagiline) contain warnings against ingesting tyramine-rich foods including “broad bean pods (fava bean pods).”​

J Clin Psychiatry 2008;69(8):1336-1337