Posted by King Vultan on November 20, 2004, at 11:01:15
In reply to Re: more MAOI diet questions, posted by KaraS on November 20, 2004, at 3:11:20
> Also, re: nifedipine, I hadn't heard any controversy about it's use for hypertensive crises. Has anyone of you ever taken it before? If so, how did it work? I read that reboxetine is actually good for countering this problem but I don't know if it's good after-the-fact or just prophylactically.
Yes, there are different schools of thought on nifedipine and MAOIs. My GP does not think it's a very good idea, and I know that one of this specialities is blood pressure meds, and he probably does have legitimate reason for concern. My pdoc--from whom I got the prescription--seems to be less concerned, but he said that ideally, the prudent thing to do is to visit a hospital emergency room if a hypertensive crisis occurs. The problem with that is the anecdotes I've read from people who have done this and suffered horribly because the people at the hospital were ignorant and/or did not take their symptoms seriously, and the patients did not receive proper (or any) treatment.
The authors (Perry and Lund) of a paper on MAOI adverse effects I have posted links to in the past also wind up discouraging the use of nifedipine. This is inspite of the fact that they state that "In all 29 cases of hypertensive crisis, the nifedipine was rapidly effective and no ADRs (adverse reactions) were noted even when the nifedipine was taken for the wrong reasons. No patient noted a rapid remission of the headache unless and until the nifedipine was taken." It should be noted that they seem to be referring to nifedipine taken sublingually (under the tongue); I have read other views elsewhere that the nifedipine pill should be crushed between the teeth and swallowed. I guess it's the latter method I would tend to use myself if I were in a situation where I was forced to use the nifedipine. However, I am not expecting to have to actually use it, given that I seem to be relatively careful and conscientious about the dietary and drug restrictions.