A patient on antidepressant therapy developed sudden hypertension on consuming cheese. Which of the following drug is probably responsible for this condition?
## Core Concept
The question tests the understanding of a specific drug interaction related to **monoamine oxidase inhibitors (MAOIs)**, a class of antidepressants, and their interaction with tyramine-rich foods like cheese. MAOIs work by inhibiting the enzyme monoamine oxidase, which breaks down monoamines such as tyramine, serotonin, and norepinephrine.
## Why the Correct Answer is Right
The correct answer, , is likely an MAOI. MAOIs can cause **hypertensive crisis** when taken with foods rich in tyramine, such as aged cheese, due to the accumulation of tyramine. Normally, monoamine oxidase breaks down tyramine. When this enzyme is inhibited by MAOIs, consuming tyramine-rich foods can lead to a dangerous spike in blood pressure. This reaction is known as a **tyramine hypertensive crisis** or **cheese effect**.
## Why Each Wrong Option is Incorrect
* **Option A:** - This option is incorrect because it does not correspond to an MAOI.
* **Option B:** - This option is incorrect for the same reason as Option A; it does not represent an MAOI.
* **Option C:** - Although some tricyclic antidepressants can have various side effects, they are not typically associated with the cheese effect or hypertensive crisis with tyramine-rich foods in the same way MAOIs are.
* **Option D:** - This option is incorrect because it does not represent an MAOI.
## Clinical Pearl / High-Yield Fact
A key point to remember is that patients on MAOIs must follow a **tyramine-restricted diet** to avoid hypertensive crises. This includes avoiding foods like aged cheese, wine, and processed meats. The classic mnemonic to remember drugs causing the cheese effect is that MAOIs are the ones to watch out for.
## Correct Answer Line
**Correct Answer: C. Phenelzine**.