Q&A: Are There Food Combinations That Can Cause Death?

29 Jul

Q: In my story, somebody wants to kill a man by sneaking something into his food. The rest of the family ate the same food, but nobody else became ill. What combination of foods could he have eaten or could the family have eaten to change the outcome. He has no known allergies, but the person who wanted to make him suffer winds up tried for murder.

Diana Huston

A: There are no foods that will protect someone from the effect of other foods or toxins so that won’t work. And since you’ve ruled out a food allergy and a bacterial agent or toxic poison added to the food wouldn’t fit since it would effect everyone who consumed the food. To varying degrees, but still everyone would be effected in some way. Your best bet is to set up a situation where relatively common foods would harm an otherwise normal appearing person.

I would suggest having your character be on one of the Monoamine Oxidase Inhibitor (MAOI) drugs since these medications can have deadly reactions if certain foods are consumed. These meds are classified as psychotropic drugs (effect the psyche) and are typically used to treat depression. If your character had some degree of depression, his MD could prescribe one of these drugs and he could take it daily. The MAOIs tend to lessen depression and elevate the person’s mood. So far so good.

MAOIs alter the chemistry of the brain by blocking the enzyme monoamine oxidase, which normally breaks down norepinephrine and other neurotransmitters in the brain. Complex biochemistry and it’s not necessary to explain it. Just know that a person on a MAOI must not take certain other meds and must avoid certain foods. If not a Hypertensive Crises could ensue. In this situation the blood pressure (BP) abruptly shoots up and the person can suffer a stroke, heart attack, or sudden death.

Common MAOIs are: Nardil, Pamate, and Marplan.

Drugs that can cause a Hypertensive Reaction when taken in conjunction with one if these MAOIs include:

Diet Pills of all types
Many High Blood Pressure meds
Flexeril (Cyclobenzaprine)
Prozac (Fluoxetine)
Paxil (Paroxetine)
Zoloft (Sertraline)
Demerol (Meperidine)
Any Tricyclate Antidepressant such as: Elavil (amitriptyline), Sinequan (doxepin), and Tofranil (imipramine)
The list is very long but the above are a few common ones.

Foods to avoid are those that are high in the amino acid tyramine such as: certain cheeses, fava beans, smoked or pickled meats, fermented sausages (bologna, pepperoni, salami, and summer sausage), alcohol, and caffeinated drinks such as coffee, tea, colas, and chocolate. Again, the list is much longer but this gives you the idea and some choices.

If your character was taking one of the MAOIs for some mild depression, your villain could then slip him an amphetamine or a diet pill or a couple of Paxil tabs and wait.

In the food arena he could feed him one of the above foods or even more diabolical could make a caffeine broth, which he could slip into a bowl of spicy soup. This would be easy in the serving process. Finely ground coffee could be simmered for a while to leach all the caffeine out, the liquid could be boiled down to concentrate it, and then it could be strained. A couple of tablespoons of this potent liquid could easily be added to his bowl of soup—a spicy or very flavorful one to mask the bitter taste of the caffeine—and the killer could sit back and wait.

In a few minutes the reaction would occur. The victim’s blood pressure would shoot up, he would develop a severe headache, blurred vision, shortness of breath, and then collapse. He could or could not have a seizure with this. The elevated BP damages the brain and may even cause bleeding into the brain.

Or he could become short of breath and sweaty, perhaps clutch his chest and complain of chest pain, and collapse. This would look very much like a heart attack and indeed such elevated BP could precipitate a heart attack.

Of course, the ME would find caffeine in his system but if this occurred at a party where coffee and caffeinated soft drinks were available, he might assume that the victim drank some those and this in combination with his prescription medication did him in.

A similar scenario would work if he was unknowingly fed sausage or cheese. These could easily be added to some flavorful food so that he wouldn’t know he was consuming them.


13 responses to “Q&A: Are There Food Combinations That Can Cause Death?

  1. Sarah G

    July 29, 2010 at 10:37 am

    Just curious…. Could you do this in reverse? Could a killer slip the MAOI drug into something the victim consumes, then give them a gift package from The Swiss Colony? Would the victim need to take the drug in repeated doses, or would a time lapse be necessary to achieve the full lethal effect?



    • D.P. Lyle, MD

      July 29, 2010 at 10:45 am

      In fact, that’s how it has to work. The victim must already have the MAOI in his system before taking one of the other meds or eating the food. Best if he has been on the MAOI for at least a few days but even a single dose a few hours ahead of time could work.


    • cmartin

      January 7, 2013 at 12:17 am

      their is a type of mushroom that is considered a delicacy that can be fatal when mixed with alcohol


      • D.P. Lyle, MD

        January 7, 2013 at 7:39 am

        Both psilocybin (Magic) mushrooms and the very dangerous Amanita family (Death Cap) etc. mushrooms can kill even without alcohol. WIth the later, by the time symptoms appear hours or even a couple of days later the liver damage is well advanced. This happens frequently when folks wander into the woods and pick their own mushrooms and don’t know which ones to avoid.


  2. Emily R

    July 29, 2010 at 2:00 pm

    You need to proofread. Your paragraph about the caffeine broth starts out fine but then ends with you referring to nicotine.


    • D.P. Lyle, MD

      July 29, 2010 at 4:54 pm

      Don’t we all need proofreaders? Thanks for catching it. I hate it when the brain does register what the eyes see.


  3. Beth

    July 29, 2010 at 3:21 pm

    Those are great ideas! Here are some more…….
    Torsades de pointes, dysrythmias, SA & AV node conduction, dissociations and tachycardias (severe) are the fatal cardiac problems listed here.
    abrupt increase in blood pressure (can cause an aneurysm rupture – astroke if in the brain)
    Respiratory depression (stop breathing)
    CNS (Brain) depression, if not very severe, would cause somebody to have a car accident (fatal) anyway, or fall, or stop breathing

    and then from:
    Case #5: Food-drug and herb-drug interactions
    A 45-year-old woman is brought to the emergency department after being found unconscious in her bedroom. She is bradycardic, comatose, and hypotensive. While she is being resuscitated, her husband tells you that she has been on the same dose of felodipine, a calcium channel blocker, for hypertension for more than five years and that this is the only drug she takes. On further questioning, the husband states that the patient is in excellent health and has not overdosed on her medications. As you question him further, the husband recalls that the patient recently began drinking grapefruit juice every morning as part of a new dietary regimen. Luckily, her bradycardia and hypotension improve with aggressive resuscitation and supportive care, but they were probably due to the interaction between grapefruit juice and the felodipine.


  4. Carol Kilgore

    July 30, 2010 at 7:33 am

    All of this is great information, not just for writing research but also just to know in the event we or someone we love is ever on any of these meds. Thanks.


  5. Twist

    July 30, 2010 at 7:57 am

    I am so never eating dinner at your house.


  6. Richard JP Le Guen

    August 16, 2010 at 1:03 pm

    “The rest of the family ate the same food, but nobody else became ill.”

    I don’t know if it helps, but the opposite occurs in the story “The Herb of Death” from Agatha Christie’s work “The Thirteen Problems / The Tuesday Night Club” except ** Spoiler Alert ** instead everyone eats contaminated food and everyone gets sick, but only one person get sick enough to die. In the story the victim had simply been given a little more poison/contaminated food than everyone else, before hand.



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