Posted by ed_uk2010 on November 30, 2013, at 6:16:23
In reply to Re: nardil and heart, posted by stargazer2 on November 29, 2013, at 8:18:06
Like Stargazer said, Nardil tends to reduce blood pressure (BP), provided that you stick to the correct diet of course. This could theoretically have some benefits for your heart and cardiovascular system.
An MAOI called pargyline was once used for patients with high blood pressure (mainly in the 1960s I believe). Of course, it was awkward to use due to the diet etc and was replaced by newer BP meds with milder side effects.
Nardil reduces blood pressure with little change in heart rate. It does not cause abnormal heart rhythms, unlike some antidepressants. Provided you educate yourself fully about the diet, you should be fine. Do take care as you increase the dose because drops in BP on standing up can cause dizziness and faintness eg. when getting out of bed. Always best to get up slowly rather that jumping out of bed/out of your chair/or whatever.
Do not buy any medicines to take while on Nardil without consulting the pharmacist, and do not take any additional prescribed medicines without double checking for interactions. A lot of cold/flu/cough meds interact seriously, as do most other antidepressants and some painkillers (eg. tramadol, meperidine). If you have any interacting meds around the house, it may be a good idea to get rid of them. Dietary and med restrictions must be continued for 2 weeks after stopping Nardil, if you do need to stop.
I hope this makes you feel a bit better. Nardil is a very effective medication, but education is key to its safe use. For further information on the diet, search the Dr. Bob archives for MAOI or Nardil, diet and Elizabeth. The former poster Elizabeth did a lot of great posts about the MAOI diet. Obviously, eating out can be awkward if you don't know what's gone into the food, especially the sauces. This is particular true of Chinese food due to Soy sauce.
There are various diet sheets online:
http://www.upmc.com/patients-visitors/education/nutrition/pages/maoi-diet-facts.aspx
Some points are a little controversial, for example, most patients on MAOIs do seem to tolerate caffeine. I would avoid it during initial treatment though, especially after noon, since Nardil can cause insomnia. Similarly, most people seem to tolerate chocolate. If you wish to introduce any new food on the 'limit' list, do so very gradually. The severity of the food interactions in highly dependent on how much you ate. With respect to things like cheese, tyramine content is very variable to it's best to avoid all except cottage cheese and highly processed American 'hamburger' cheese, which is barely even cheese! Tyramine content also varies between batches, which is why the 'limit' list exists.
Tyramine is a breakdown product of protein. Foods with little or no protein will not contain tyramine eg. most fruits.
With respect to meds...
Meds you CAN take with Nardil:
Acetaminophen aka. paracetamol (on its OWN - some tablets contain a variety of other drugs, some of which are not safe at all).
Ibuprofen - on its own. Check the box.
Non-sedating antihistamines, on their own (some contain decongestants). Safe antihistamines include cetirizine and loratadine.
All common over-the-counter laxatives. Nardil can cause constipation. MiraLax is a good choice in the US, Movicol if you're in the UK.
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Meds to AVOID in all cases:
All types of decongestants for nose/sinuses etc. Contained in many cold/flu treatments. Best to avoid decongestant nasal sprays too. If you have allergies, you can use a steroid nasal spray safely. Banned decongestants to look out for include pseudoephedrine (eg. Sudafed) and phenylephrine.
Certain painkillers: eg. tramadol (Ultram), meperidine (pethidine/Demerol). Check with the pharmacist for the safety of other prescription analgesics.
Some OTC cough meds: Dextromethorphan (eg. Robitussin Dry Cough and many other dry cough brands).
Most antidepressants: SSRIs and related (Paxil, Zoloft, Prozac, Celexa, Lexapro, Effexor, Cymbalta etc react extremely severely with Nardil). Remove them from your house. Some older ADs eg. clomipramine (Anafranil) and imipramine also react very badly.
If in doubt, check with a professional, and take care :) Nardil can be very safe in the right hands, and can work when nothing else has.
poster:ed_uk2010
thread:1055032
URL: http://www.dr-bob.org/babble/20131115/msgs/1055086.html