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

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Sir: Music aficionados will, no doubt, recognize the parodyon 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, whyfava beans have attained the reputation of being one of those"tyramine-rich foods . . . to avoid" in the presence of monoamineoxidase inhibitors (MAOIs). The product package insertsfor EMSAM (selegiline transdermal system) and Azilect(rasagiline) contain warnings against ingesting tyramine-richfoods including "broad bean pods (fava bean pods)."’ ‹