Hypertensive Episode Associated with Phenelzine and Tap Beer???A Reanalysis of the Role of Pressor Amines in Beer

The Microbiology of Malting and Brewing

“…These compounds are found in a wide range of foods and beverages, including fish, meat, cheese, and wine, and are formed by microbial decarboxylation of amino acids (245,246). BAs pose a health hazard to sensitive individuals, resulting in allergy-like reactions (247), migraine (248), and/or toxic reactions with monoamine oxidase inhibitor drugs (249,250). BAs in beer are formed primarily during fermentation but can also be produced by microbes in barley, malt, wort, and hops (251,252).…”

“…Beer experiences a certain residence time in this unrefrigerated environment before it is dispensed to the next customer. During this time, cells may multiply in the beer trapped in the lines, causing spoilage through haze, off-flavors, and even BA production (250). A study of draft and bottled beers in Canada found that of all beers tested (n ϭ 98), only the draft beers (4 of 49 beers) contained dangerous concentrations of BAs (Ͼ10 mg/liter)-implying postpackaging microbial growth-and these investigators suggested that draft beers should be avoided by BA-sensitive individuals (250).…”

“…During this time, cells may multiply in the beer trapped in the lines, causing spoilage through haze, off-flavors, and even BA production (250). A study of draft and bottled beers in Canada found that of all beers tested (n ϭ 98), only the draft beers (4 of 49 beers) contained dangerous concentrations of BAs (Ͼ10 mg/liter)-implying postpackaging microbial growth-and these investigators suggested that draft beers should be avoided by BA-sensitive individuals (250). The best means of controlling draft contamination is through observation of proper hygienic practices, including cleaning and sanitization of all equipment prior to connection to a keg, replacement of all lines at regular intervals, and proper storage conditions.…”

A Review of Biogenic Amines and Polyamines in Beer

“…Hypertensive crises have been observed in patients treated with drugs inhibiting monoamine oxidase (used mainly in psychiatry) after beer consumption 31,35,40,44 . The adverse effects were observed from both draft and nonalcoholic beers and were attributed to TY.…”

“…The adverse effects were observed from both draft and nonalcoholic beers and were attributed to TY. TY intake as low as 6 mg within a 4-hour period or beers with TY content over 10 mg/L were considered as dangerous for these particular patients 44 . Alcohol and probably some other BAs present in beer can potentiate TY effects.…”