Posted by Elizabeth on June 4, 2001, at 16:55:38
In reply to Re: MAOIs » Elizabeth, posted by SLS on June 4, 2001, at 9:58:36
> > * Parnate potentiates tyramine at clinically used doses to a much greater degree than other MAOIs, and 60 mg is a fairly high dose.
>
> Why do you suppose that is? Are Parnate or its metabolites amphetamine-like? Are they catecholamine releasers?Parnate itself is *most* amphetamine-like. (If it hadn't been grandfathered out, Parnate would definitely be a Schedule II Controlled Substance under the Analogue Act.)
As for metabolites -- nobody knows. It was hypothesised at one point that Parnate was metabolised into amphetamine or methamphetamine, but this has pretty much been disproven. We are left with the possibility that Parnate has catecholamine-releasing activity (or has a metabolite with such activity). Unfortunately nobody is interested in doing new research on old drugs.
> I am not sure if I am a rapid-metabolizer of desipramine or not. When I was being treated by W. Harrison and F. Quitkin at Columbia in 1982, they had me take 450mg of imipramine, claiming that my blood work indicated that this was necessary to achieve a therapeutic level. However, my blood level of nortriptyline is towards the upper end of its therapeutic level when taking a modest dosage of 100mg. I guess the two tricyclics follow different routes of elimination, or perhaps the assays used in 1982 were unreliable.
I'm guessing it's the second one. Both are secondary amine TCAs, and they have similar metabolic pathways.
> I have taken a combination of Parnate 150mg and desipramine 300mg (along with Lamictal). I ate plenty of pizza during this period of time. In fact, I had no problem with pizza when I was taking Parnate 120mg + desipramine 200mg + Dexedrine 15mg + Synthroid.
Pepperoni, or just plain? Plain cheese pizza is pretty certain to be harmless, as long as it's mozzarella and not some weird cheese like feta. (Sprinkles of parmesan, BTW, are probably ok simply because the amount is so small.)
> > Different people have different levels of sensitivity to BP elevation.
>
> I guess you are a good example of that.I dunno. I am pretty good at guessing what my blood pressure is at any given moment, but that's most likely a result of practise. I don't think that I feel worse when my BP is too high than others do. The one time I had a serious reaction (pulmonary hemorrhage, max BP measured 240/140), I definitely had a bad headache, but it wasn't so bad that I felt a need for treatment for the pain itself. (Treatment for the hypertension would have been nice, but there's the MIT medical centre for you.)
> You'll have to forgive my fuzzy memory, but I think I encountered something that indicated that the pounding headache produced during the MAOI-food reaction is not exclusive or dependant upon a significant rise in blood pressure.
I'm not in any position to be criticising people for fuzzy memory. But anyway, I don't recall reading anything like that. It is true that people who are already mildly hypertensive or hypotensive may respond differentaly to elevated BPs than normotensive people. (Clumsy sentence -- hope it made sense anyway.)
> I don't know. I would think that for me it was, given that the magnitude of the throbbing pain changed with posture.
Postural changes in BP are normal for people on MAOIs, especially high-dose MAOIs.
> Well, I don't know. I did see red when I became angry at myself for being so careless.
< g >
> That explains it. I am surely brain-dead.
That's nothing. I'm drain-bead!
-elizabeth
poster:Elizabeth
thread:64764
URL: http://www.dr-bob.org/babble/20010530/msgs/65387.html