Psycho-Babble Medication Thread 75408

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MAOI diet short list

Posted by Elizabeth on August 17, 2001, at 13:43:12

Hi. A couple of people have requested that I repost the dietary restrictions that I followed while taking MAOIs. Please don't take this as gospel; it's what worked for me and it's based on some fairly meticulous library research (I can provide a reading list for anyone who's interested). A lot of the "menus" that get handed out by pharmacies, hostpials, doctors, etc. are not very accurate because they are out of date and place extreme and unnecessary restrictions on what you can eat. This results in a number of problems. Many people are scared off by long, intimidating lists of restrictions. In other cases, a person will discover that s/he can "cheat" on some of the foods (the ones that really shouldn't be on the list) and will therefore take the entire list less seriously. There are some things that you definitely should avoid, but they are relatively few.

So, here it is -- a list of some things that I felt merited avoidance, and others that I felt were safe (and had no problems with, of course):

WINE is fine. Some people may get histamine-related headaches from it and think they are having a hypertensive episode when they are not.

BOTTLED BEERS are usually fine (American and Canadian ones are the best studied).

TAP BEER should be avoided.

Most AGED CHEESES are out. Of note, the mozzarella generally used on most pizzas has been found to be okay. So unless it's some weird exotic pizza with sharp cheeses (feta, cheddar, fontina) it should be okay to eat pizza. (In general, cheeses described as "sharp" are the most dangerous ones.) Ricotta cheese, cottage cheese, cream cheese, and "pasteurized process cheese food" (American cheese -- the cheesiest kind) are okay as well. In regard to the intermediately-aged cheeses, I personally had no problem with jack or brie in moderation. I would be careful if you're going to try this, though, and it's not something I'm willing to say is definitely safe.

OTHER DAIRY PRODUCTS, such as milk, yogurt, and sour cream, are generally safe as long as they are fresh.

SOY FOODS are controversial: one sample of soy sauce was reported to have quite a lot of tyramine in it, but there aren't any documented interactions. My experience has been that a little bit of soy sauce is okay. I would avoid other soy products, such as soy milk and tofu. The Taiwanese dish called "stinky tofu" is probably right out. < g >

Similarly, SAUERKRAUT has been found to contain a large amount of tyramine in some analyses, but there aren't any reactions documented that were associated with sauerkraut.

PROTEIN-CONTAINING FOODS that have passed the expiration date or that may have been stored improperly should be avoided. Fresh milk, meat, etc. are okay. One exception that I make, just because there have been so many problems reported with it, is LIVER; it seems possible that the proteins in liver are especially readily broken down to tyramine (perhaps they include more tyrosine than other proteins do, or perhaps the bacteria that turn tyrosine into tyramine are fond of liver).

Certain AGED MEATS, such as salami, bologna, and some sausages, may be problematic. Err on the side of caution. Some telltale words to look for are "aged," "smoked," "air-dried," and "fermented."

PICKLED HERRING itself isn't a problem, just don't eat the brine (yuck!).

To many people's relief, CHOCOLATE is fine. (If my experience with carb cravings on phenelzine is any indication, it's fine in *huge* amounts!)

Some miscellaneous peculiar foods, such as FAVA BEAN PODS and BANANA PEELS, also cause problems. Shouldn't be a major issue for most people. Watch out for Middle Eastern cuisine, which sometimes contains fava beans. MISO SOUP and other Oriental soup stocks have also been reported to cause problems.

I hope that people find this helpful. As I said, I can provide a list of references if anyone is interested.

-elizabeth

 

Re: MAOI diet short list

Posted by Adam on August 17, 2001, at 17:51:59

In reply to MAOI diet short list, posted by Elizabeth on August 17, 2001, at 13:43:12

Thanks, Elizabeth. No suprises. I'm still _totally_ bummed about the banana peels. Some days I just get a craving, you know?

I can second the miso soup caution: I had probably my worst "documented" (in that I recorded my b.p. some hours after eating it, and wrote it down in a log for posterity) hypertensive reaction to a food after consumption of miso: 186/104. I probably should have gone to the ER, but didn't. Anyway, I must mention that this was the first course of a large sushi and sashimi dinner, during which which a fair amount of soy sauce (well, more of a thermonuclear soy-wasabi "paste" of my own concoction that I am wont to consume) was used. However, I don't often take miso (it had been well over a year before that particular night since my last bowl), while I do often gobble sushi with the aforementioned condiments, so I atribute the reaction to the miso, at least in large part.

I have yet to have a bad reaction to a bottled beer. On a somewhat more tentative note, I have yet to have a bad reaction to a draft/tap beer, though I have not been too adventurous in this area. The only tap beers I have tried have been of the Cheap American variety (Bud, Miller, etc.), in small amounts (no more than a pint over the course of an evening - I was excoriated once for this with a "nurse it, baby!"). I did try a somewhat-less-skunky variety of tap beer once, Sam Adams, and also had no problem. After a while I decided this was a bit like playing Russian Roulette, and quit consuming tap beer. I do not recommend it. These are just my experiences.

One of the oddest reactions I have had, though, in retrospect, it shouldn't have been that suprising, was to Cliff Bars and Power Bars, those horrible, sawdust-emulsified high-energy bars outdoors buffs consume with giant volumes of water. They have soy extracts in them (as do many others of the "energy bar" variety), and I believe this was the source of the trouble. Another weird thing was a breakfast smoothie mix (the brand name escapes me, though I do remember it was strawberry-flavored) which, sure enough, had soy protein in it. This I found that out after developing a splitting headache and then running to the container to peruse the ingredients. My poor girlfriend thought she had killed me, but in the end I was OK. I pretended to have siezures for a couple days, which she did not find amusing, but no permanent damage.

In general, I might avoid all those meal-in-a-can-for-granola-heads-style "energy" foods, anything with soy or other protein extracts in them. I've had bad experiences with every one I've tried which fit the above criterion.

 

Re: MAOI diet short list

Posted by Rick on August 17, 2001, at 19:56:08

In reply to Re: MAOI diet short list, posted by Adam on August 17, 2001, at 17:51:59

> Thanks, Elizabeth. No suprises. I'm still _totally_ bummed about the banana peels. Some days I just get a craving, you know?
>
> I can second the miso soup caution: I had probably my worst "documented" (in that I recorded my b.p. some hours after eating it, and wrote it down in a log for posterity) hypertensive reaction to a food after consumption of miso: 186/104. I probably should have gone to the ER, but didn't. Anyway, I must mention that this was the first course of a large sushi and sashimi dinner, during which which a fair amount of soy sauce (well, more of a thermonuclear soy-wasabi "paste" of my own concoction that I am wont to consume) was used. However, I don't often take miso (it had been well over a year before that particular night since my last bowl), while I do often gobble sushi with the aforementioned condiments, so I atribute the reaction to the miso, at least in large part.
>
> I have yet to have a bad reaction to a bottled beer. On a somewhat more tentative note, I have yet to have a bad reaction to a draft/tap beer, though I have not been too adventurous in this area. The only tap beers I have tried have been of the Cheap American variety (Bud, Miller, etc.), in small amounts (no more than a pint over the course of an evening - I was excoriated once for this with a "nurse it, baby!"). I did try a somewhat-less-skunky variety of tap beer once, Sam Adams, and also had no problem. After a while I decided this was a bit like playing Russian Roulette, and quit consuming tap beer. I do not recommend it. These are just my experiences.
>
> One of the oddest reactions I have had, though, in retrospect, it shouldn't have been that suprising, was to Cliff Bars and Power Bars, those horrible, sawdust-emulsified high-energy bars outdoors buffs consume with giant volumes of water. They have soy extracts in them (as do many others of the "energy bar" variety), and I believe this was the source of the trouble. Another weird thing was a breakfast smoothie mix (the brand name escapes me, though I do remember it was strawberry-flavored) which, sure enough, had soy protein in it. This I found that out after developing a splitting headache and then running to the container to peruse the ingredients. My poor girlfriend thought she had killed me, but in the end I was OK. I pretended to have siezures for a couple days, which she did not find amusing, but no permanent damage.
>
> In general, I might avoid all those meal-in-a-can-for-granola-heads-style "energy" foods, anything with soy or other protein extracts in them. I've had bad experiences with every one I've tried which fit the above criterion.

My pdoc, who fancies himself a kind of MAOI historian, says that the knowledge of MAOI food interactions first came to light when Europeans taking them started inexplicably "dying", while this wasn't happening in the U.S. This pattern was eventually linked back to the inter-continental differences in dining habits, especially with regard to heavily-fermented beers and aged meats, cheeses, kraut, etc. thus uncovering the tyramine connection.

My pdoc also insists that beef liver is fine, while chicken livers are a no-no. Finally, he says that he has encountered very few hypertensive crises (among his patients that is...I don't know if he takes an MAOI himself), and that men seem particularly unlikely to encounter problems.

For the record, I should point out that my pdoc doesn't always know what he's talking about. (Uh oh, I hope he's not reading this. On second thought, maybe I hope he IS reading this.)

Adam, 186/104 is not generally an "emergency" blood pressure reading, although perhaps if you're typically on the low side a sudden rise like this could be risky...especially if you feel symptoms. (Of course, 186/104 is always quite unhealthy if it's chronic.) I have a hypertensive friend who is taking five (!) blood pressure meds and attaining quite good control...usually 110-130/70-85. (Before treatment his previous doctor gaped in disbelief at a completely asymptomatic 220/120...but no secondary causes were found.) Every week or two his generally-controlled BP asymptomatically spikes to as high as 180/105, but his doc -- a nationally-prominent hypertension specialist -- tells him not to worry about that. In fact, he recently told my friend to STOP monitoring his BP at home!

Rick

 

Re: MAOI diet short list Rick

Posted by Sunnely on August 17, 2001, at 23:15:33

In reply to Re: MAOI diet short list, posted by Rick on August 17, 2001, at 19:56:08

> My pdoc, who fancies himself a kind of MAOI historian, says that the knowledge of MAOI food interactions first came to light when Europeans taking them started inexplicably "dying", while this wasn't happening in the U.S. This pattern was eventually linked back to the inter-continental differences in dining habits, especially with regard to heavily-fermented beers and aged meats, cheeses, kraut, etc. thus uncovering the tyramine connection.


If I am not mistaken, Barry Blackwell, M.D., retired Clinical Professor of Psychiatry, University of Wisconsin-Madison, was the one credited for discovering the "cheese reaction" with MAOIs.

 

Re: MAOI diet short list Adam

Posted by Jackster on August 18, 2001, at 3:55:14

In reply to Re: MAOI diet short list, posted by Adam on August 17, 2001, at 17:51:59

Totally off tangent - thought your posting was hilarious. Nice to have a laugh amongst all the heavy stuff. :)

Jackie

(BTW - No wonder American beer is safe - it's just like that joke about having sex in a canoe.)

> Thanks, Elizabeth. No suprises. I'm still _totally_ bummed about the banana peels. Some days I just get a craving, you know?
>
> I can second the miso soup caution: I had probably my worst "documented" (in that I recorded my b.p. some hours after eating it, and wrote it down in a log for posterity) hypertensive reaction to a food after consumption of miso: 186/104. I probably should have gone to the ER, but didn't. Anyway, I must mention that this was the first course of a large sushi and sashimi dinner, during which which a fair amount of soy sauce (well, more of a thermonuclear soy-wasabi "paste" of my own concoction that I am wont to consume) was used. However, I don't often take miso (it had been well over a year before that particular night since my last bowl), while I do often gobble sushi with the aforementioned condiments, so I atribute the reaction to the miso, at least in large part.
>
> I have yet to have a bad reaction to a bottled beer. On a somewhat more tentative note, I have yet to have a bad reaction to a draft/tap beer, though I have not been too adventurous in this area. The only tap beers I have tried have been of the Cheap American variety (Bud, Miller, etc.), in small amounts (no more than a pint over the course of an evening - I was excoriated once for this with a "nurse it, baby!"). I did try a somewhat-less-skunky variety of tap beer once, Sam Adams, and also had no problem. After a while I decided this was a bit like playing Russian Roulette, and quit consuming tap beer. I do not recommend it. These are just my experiences.
>
> One of the oddest reactions I have had, though, in retrospect, it shouldn't have been that suprising, was to Cliff Bars and Power Bars, those horrible, sawdust-emulsified high-energy bars outdoors buffs consume with giant volumes of water. They have soy extracts in them (as do many others of the "energy bar" variety), and I believe this was the source of the trouble. Another weird thing was a breakfast smoothie mix (the brand name escapes me, though I do remember it was strawberry-flavored) which, sure enough, had soy protein in it. This I found that out after developing a splitting headache and then running to the container to peruse the ingredients. My poor girlfriend thought she had killed me, but in the end I was OK. I pretended to have siezures for a couple days, which she did not find amusing, but no permanent damage.
>
> In general, I might avoid all those meal-in-a-can-for-granola-heads-style "energy" foods, anything with soy or other protein extracts in them. I've had bad experiences with every one I've tried which fit the above criterion.

 

Re: MAOI diet short list Elizabeth

Posted by may_b on August 18, 2001, at 11:40:50

In reply to MAOI diet short list, posted by Elizabeth on August 17, 2001, at 13:43:12

Hi Elizabeth

Thanks so much for posting this. Because of my recent horrible experience with one bottled beer and hypertensive crisis, I wanted to comment on this:

> BOTTLED BEERS are usually fine (American and Canadian ones are the best studied).

After much rumination on the subject, I wonder if it was because that one beer was from a micro brewery (you know, one of the beers with "flavour") -- it may well have had some fermenting. It was Very Dark Lager. So maybe it would be good to avoid the micro brews, especially if they are dark.

This in hopes of sparing someone what I experienced -- some good come out of it... :)

Hope you are feeling great. I find all your posts a great help.

best, may_b

 

Cheese Reaction Discovery Sunnely

Posted by Rick on August 18, 2001, at 17:27:26

In reply to Re: MAOI diet short list Rick, posted by Sunnely on August 17, 2001, at 23:15:33

> > My pdoc, who fancies himself a kind of MAOI historian, says that the knowledge of MAOI food interactions first came to light when Europeans taking them started inexplicably "dying", while this wasn't happening in the U.S. This pattern was eventually linked back to the inter-continental differences in dining habits, especially with regard to heavily-fermented beers and aged meats, cheeses, kraut, etc. thus uncovering the tyramine connection.
>
>
> If I am not mistaken, Barry Blackwell, M.D., retired Clinical Professor of Psychiatry, University of Wisconsin-Madison, was the one credited for discovering the "cheese reaction" with MAOIs.

Sunnely -

Interesting. Do you know roughly when Dr. Blackwell discovered the cheese reaction? (I know that MAOI antidepressant effect was uncovered in the mid fifties, but have no idea when they were first marketed as antidepressants.) My pdoc is a PhD who has been practicing since '78, and I seem to recall him telling me he was very involved with studies of MAOI's. I didn't see his name anywhere in Medline, but did a Google search and found (in a third-party site) that he has an huge and impressive curriculam vitae, including stints as president of the Chicago Psychiatric Association.
And apparently he *has* written many papers and some books on medical history, so I'd be surprised (but not amazed) if his story about the European connection was competely incorrect.

Especially given that Madison isn't very far from here, perhaps my pdoc knows Dr. Blackwell personally. I'll have to ask about that.

BTW, if I hadn't made some slightly snide remarks about him, I'd mention my pdoc's name and a few interesting tidbits I found in his Vitae.

Rick

 

Re: Cheese Reaction Discovery Rick

Posted by Sunnely on August 18, 2001, at 23:21:42

In reply to Cheese Reaction Discovery Sunnely, posted by Rick on August 18, 2001, at 17:27:26

> Interesting. Do you know roughly when Dr. Blackwell discovered the cheese reaction?

I believe in the early 60s. Here's an article he published about the topic:

Blackwell B, Marley E: Interactions of cheese and of its constituents with monoamine oxidase inhibitors. Br J Pharmacol 1966 Jan;26(1):120-41.


> Especially given that Madison isn't very far from here, perhaps my pdoc knows Dr. Blackwell personally. I'll have to ask about that.

Won't be surprised. Although now retired, Dr. Blackwell continues to be active in organizations fighting for the cause of the mentally ill such as the NAMI local chapter (National Alliance for the Mentally Ill) and MHA (Mental Health Association). He currently resides in Milwaukee, WI.

 

Re: MAOI`s and Chocolate

Posted by Cecilia on August 19, 2001, at 3:13:30

In reply to MAOI diet short list, posted by Elizabeth on August 17, 2001, at 13:43:12

> Hi. A couple of people have requested that I repost the dietary restrictions that I followed while taking MAOIs. Please don't take this as gospel; it's what worked for me and it's based on some fairly meticulous library research (I can provide a reading list for anyone who's interested). A lot of the "menus" that get handed out by pharmacies, hostpials, doctors, etc. are not very accurate because they are out of date and place extreme and unnecessary restrictions on what you can eat. This results in a number of problems. Many people are scared off by long, intimidating lists of restrictions. In other cases, a person will discover that s/he can "cheat" on some of the foods (the ones that really shouldn't be on the list) and will therefore take the entire list less seriously. There are some things that you definitely should avoid, but they are relatively few.
>
> So, here it is -- a list of some things that I felt merited avoidance, and others that I felt were safe (and had no problems with, of course):
>
> WINE is fine. Some people may get histamine-related headaches from it and think they are having a hypertensive episode when they are not.
>
> BOTTLED BEERS are usually fine (American and Canadian ones are the best studied).
>
> TAP BEER should be avoided.
>
> Most AGED CHEESES are out. Of note, the mozzarella generally used on most pizzas has been found to be okay. So unless it's some weird exotic pizza with sharp cheeses (feta, cheddar, fontina) it should be okay to eat pizza. (In general, cheeses described as "sharp" are the most dangerous ones.) Ricotta cheese, cottage cheese, cream cheese, and "pasteurized process cheese food" (American cheese -- the cheesiest kind) are okay as well. In regard to the intermediately-aged cheeses, I personally had no problem with jack or brie in moderation. I would be careful if you're going to try this, though, and it's not something I'm willing to say is definitely safe.
>
> OTHER DAIRY PRODUCTS, such as milk, yogurt, and sour cream, are generally safe as long as they are fresh.
>
> SOY FOODS are controversial: one sample of soy sauce was reported to have quite a lot of tyramine in it, but there aren't any documented interactions. My experience has been that a little bit of soy sauce is okay. I would avoid other soy products, such as soy milk and tofu. The Taiwanese dish called "stinky tofu" is probably right out. < g >
>
> Similarly, SAUERKRAUT has been found to contain a large amount of tyramine in some analyses, but there aren't any reactions documented that were associated with sauerkraut.
>
> PROTEIN-CONTAINING FOODS that have passed the expiration date or that may have been stored improperly should be avoided. Fresh milk, meat, etc. are okay. One exception that I make, just because there have been so many problems reported with it, is LIVER; it seems possible that the proteins in liver are especially readily broken down to tyramine (perhaps they include more tyrosine than other proteins do, or perhaps the bacteria that turn tyrosine into tyramine are fond of liver).
>
> Certain AGED MEATS, such as salami, bologna, and some sausages, may be problematic. Err on the side of caution. Some telltale words to look for are "aged," "smoked," "air-dried," and "fermented."
>
> PICKLED HERRING itself isn't a problem, just don't eat the brine (yuck!).
>
> To many people's relief, CHOCOLATE is fine. (If my experience with carb cravings on phenelzine is any indication, it's fine in *huge* amounts!)
>
> Some miscellaneous peculiar foods, such as FAVA BEAN PODS and BANANA PEELS, also cause problems. Shouldn't be a major issue for most people. Watch out for Middle Eastern cuisine, which sometimes contains fava beans. MISO SOUP and other Oriental soup stocks have also been reported to cause problems.
>
> I hope that people find this helpful. As I said, I can provide a list of references if anyone is interested.
>
> -elizabeth

When I took Nardil around 10 years ago the package insert said chocolate was ok in "moderate" quantities. What is "moderate"? I wrote to the manufacturer to ask them and their "scientific" answer was "Ask your doctor"?! I certainly wasn`t about to do that, I figured she`d tell me not to eat it at all! I tried Parnate last year and THEIR package insert says NO chocolate. I still ate it, but didn`t enjoy it much with this anxiety added to the overwhelming Parnate induced anxiety. Of course I know the drug companies have one thing on their minds-lawsuits-but telling you to give up liver and pickled herring is one thing, but chocolate, no way!

 

Re: Cheese Reaction Discovery

Posted by djmmm on August 19, 2001, at 9:51:46

In reply to Re: Cheese Reaction Discovery Rick, posted by Sunnely on August 18, 2001, at 23:21:42

> > Interesting. Do you know roughly when Dr. Blackwell discovered the cheese reaction?
>
> I believe in the early 60s. Here's an article he published about the topic:
>
> Blackwell B, Marley E: Interactions of cheese and of its constituents with monoamine oxidase inhibitors. Br J Pharmacol 1966 Jan;26(1):120-41.
>
>
> > Especially given that Madison isn't very far from here, perhaps my pdoc knows Dr. Blackwell personally. I'll have to ask about that.
>
> Won't be surprised. Although now retired, Dr. Blackwell continues to be active in organizations fighting for the cause of the mentally ill such as the NAMI local chapter (National Alliance for the Mentally Ill) and MHA (Mental Health Association). He currently resides in Milwaukee, WI.

Here is something from May of 1965

Sem Ther 1965 May;41(5):284-7
[Monoamine oxidase inhibitors (MAOI) and food products].[Article in French]
Perrault M.
PMID: 4383266 [PubMed - indexed for MEDLINE]


 

Re: MAOI diet short list Rick

Posted by Elizabeth on August 22, 2001, at 14:16:02

In reply to Re: MAOI diet short list, posted by Rick on August 17, 2001, at 19:56:08

> Adam, 186/104 is not generally an "emergency" blood pressure reading, although perhaps if you're typically on the low side a sudden rise like this could be risky...especially if you feel symptoms.

Whenever my BP has been that high, it's been symptomatic. The time when I actually had a hemorrhage that showed up on an x-ray (and caused some nasty symptoms like coughing up blood and stuff) my BP was around 240/140 or something like that. (Normally I run about 110/70, a little lower on MAOIs.)

> I have a hypertensive friend who is taking five (!) blood pressure meds and attaining quite good control...usually 110-130/70-85.

Hypertension is very complicated to treat. When you take one med, your body makes adaptive changes and you have to have another med to counteract that, and then your body adapts to that med and so on... My father takes at least 5 meds for it that I know about.

> (Before treatment his previous doctor gaped in disbelief at a completely asymptomatic 220/120...but no secondary causes were found.)

I think, as you suggested, that paroxysmal elevations in BP in folks whose BP normally runs low or normal are more likely to cause symptoms than are sustained high BPs.

> Every week or two his generally-controlled BP asymptomatically spikes to as high as 180/105, but his doc -- a nationally-prominent hypertension specialist -- tells him not to worry about that. In fact, he recently told my friend to STOP monitoring his BP at home!

That sort of behaviour can actually lead to pretty bad hypochondriasis, yup: people become obsessed with their blood pressure from doing that. It wasn't a problem for me but I've seen it happen.

-elizabeth

 

Re: MAOI diet short list + CORRECTION re liver? Elizabeth

Posted by Rick on August 22, 2001, at 14:58:36

In reply to Re: MAOI diet short list Rick, posted by Elizabeth on August 22, 2001, at 14:16:02

All good points.

Also, I felt I should (kind of) correct something I wrote earlier.

I mentioned that a few years ago my pdoc claimed that chicken livers were verboten on MAOI's but that beef liver should be OK. Thinking it over I now realize it's POSSIBLE that I've got that backwards. I can't recall for certain that he specified chicken liver as the no-no. (He never even gave me a written list.) It would seem to me that the more important factor would be how fresh the liver is, rather than the animal who donated it. But I could be wrong. And in retrospect I'm perturbed that he didn't give me the lowdown on other species ;). Goose liver, pork liver, fish liver, Carter's Little Liver Pills??? Hey, even Americans will eat anything today.

> > Adam, 186/104 is not generally an "emergency" blood pressure reading, although perhaps if you're typically on the low side a sudden rise like this could be risky...especially if you feel symptoms.
>
> Whenever my BP has been that high, it's been symptomatic. The time when I actually had a hemorrhage that showed up on an x-ray (and caused some nasty symptoms like coughing up blood and stuff) my BP was around 240/140 or something like that. (Normally I run about 110/70, a little lower on MAOIs.)
>
> > I have a hypertensive friend who is taking five (!) blood pressure meds and attaining quite good control...usually 110-130/70-85.
>
> Hypertension is very complicated to treat. When you take one med, your body makes adaptive changes and you have to have another med to counteract that, and then your body adapts to that med and so on... My father takes at least 5 meds for it that I know about.
>
> > (Before treatment his previous doctor gaped in disbelief at a completely asymptomatic 220/120...but no secondary causes were found.)
>
> I think, as you suggested, that paroxysmal elevations in BP in folks whose BP normally runs low or normal are more likely to cause symptoms than are sustained high BPs.
>
> > Every week or two his generally-controlled BP asymptomatically spikes to as high as 180/105, but his doc -- a nationally-prominent hypertension specialist -- tells him not to worry about that. In fact, he recently told my friend to STOP monitoring his BP at home!
>
> That sort of behaviour can actually lead to pretty bad hypochondriasis, yup: people become obsessed with their blood pressure from doing that. It wasn't a problem for me but I've seen it happen.
>
> -elizabeth

 

Re: MAOI diet short list + CORRECTION re liver?

Posted by SLS on August 23, 2001, at 6:51:25

In reply to Re: MAOI diet short list + CORRECTION re liver? Elizabeth, posted by Rick on August 22, 2001, at 14:58:36

> All good points.
>
> Also, I felt I should (kind of) correct something I wrote earlier.
>
> I mentioned that a few years ago my pdoc claimed that chicken livers were verboten on MAOI's but that beef liver should be OK. Thinking it over I now realize it's POSSIBLE that I've got that backwards.


I'm pretty sure that it is chicken liver that is most dangerous.


- Scott

 

MAOIs and liver - Rick, SLS

Posted by Elizabeth on August 23, 2001, at 11:13:41

In reply to Re: MAOI diet short list + CORRECTION re liver?, posted by SLS on August 23, 2001, at 6:51:25

> I'm pretty sure that it is chicken liver that is most dangerous.

I mentioned liver because it seems to have been involved in a number of cases. I'm not enough of a gourmand to be able to distinguish among various types of liver. (Hannibal Lecter's famous meal of Chianti, fava beans, and human liver might actually have been completely safe even if he was taking Parnate or something. Question is, did he eat the liver right after killing the person, or did he age it a few days first? < g >)

-elizabeth

 

Re: MAOI diet short list

Posted by Lisa01 on January 14, 2002, at 20:46:11

In reply to MAOI diet short list, posted by Elizabeth on August 17, 2001, at 13:43:12

Elizabeth
Thank you so much for this information! I have lost several pounds since staring Parnate almost a month ago due to fear of putting anything hazardous into my mouth! I gave up red wine (my favourite), beer, pizza, nachos with cheese & sour cream... I read on one web site that wine was okay, but only quantities of 1/2 cup or less!

I'm hoping that someone can address several other MAOI issues. Regarding Parnate, I have notice an increase in anxiety/nervousness. For someone taking this for SP, this is quite unwelcome. Any idea if this will dissipate? Also, I don't feel any benefits although it's been almost a month. I'm on the min. dosage. Could it really take over a month to begin feeling benefits? Also, has anyone tried Corona, an imported beer from Mexico, on an MAOI? It's not a dark beer so I'm wondering if it might be okay.

Lisa

 

Re: MAOI diet short list

Posted by djmmm on January 15, 2002, at 2:51:46

In reply to Re: MAOI diet short list, posted by Lisa01 on January 14, 2002, at 20:46:11

> Elizabeth
> Thank you so much for this information! I have lost several pounds since staring Parnate almost a month ago due to fear of putting anything hazardous into my mouth! I gave up red wine (my favourite), beer, pizza, nachos with cheese & sour cream... I read on one web site that wine was okay, but only quantities of 1/2 cup or less!
>
> I'm hoping that someone can address several other MAOI issues. Regarding Parnate, I have notice an increase in anxiety/nervousness. For someone taking this for SP, this is quite unwelcome. Any idea if this will dissipate? Also, I don't feel any benefits although it's been almost a month. I'm on the min. dosage. Could it really take over a month to begin feeling benefits? Also, has anyone tried Corona, an imported beer from Mexico, on an MAOI? It's not a dark beer so I'm wondering if it might be okay.
>
> Lisa


Hey Lisa...

I take the MAOI Nardil for Social Anxiety, and have been for about 1.5 years, and consider myself "recovered" or at about 90%... Personally, I have NEVER had any sort of reaction to ANY food, alcohol or otherwise, including chocolate and foods containing tyramine...However, I must say that while my experience is not that uncommon, it is not typical.

as far as beer is concerned, tyramine tends to be absorbed by glass, so you may be able to drink bottled beer (like corona), but again, it depends on your own individual "chemistry"

I believe pizza considered "ok"...along with many of the original items on the "no-no" list.

If you are still having problems with Parnate, you may want to try the MAOI Nardil, It also increases GABA the(antianxiety/anticonvulsive drug Klonopin works by increasing GABA levels...and is also given for social anxiety)

http://www.biopsychiatry.com/tyramine.htm

 

Re: MAOI diet short list djmmm

Posted by spike4848 on January 15, 2002, at 7:31:57

In reply to Re: MAOI diet short list, posted by djmmm on January 15, 2002, at 2:51:46

> Hey Lisa...
>
> I take the MAOI Nardil for Social Anxiety, and have been for about 1.5 years, and consider myself "recovered" or at about 90%...

Hey djmmm,

How do you deal with the side effects of nardil....

Weight gain
Sexual dysfunction
Insomnia
Memory difficulties

Thanks

Spike

 

Re: MAOI diet short list

Posted by djmmm on January 15, 2002, at 16:23:01

In reply to Re: MAOI diet short list djmmm, posted by spike4848 on January 15, 2002, at 7:31:57

> > Hey Lisa...
> >
> > I take the MAOI Nardil for Social Anxiety, and have been for about 1.5 years, and consider myself "recovered" or at about 90%...
>
> Hey djmmm,
>
> How do you deal with the side effects of nardil....
>
> Weight gain
> Sexual dysfunction
> Insomnia
> Memory difficulties
>
> Thanks
>
> Spike

Well...actually, I had a bit of positional/orthostaic hypotension for the first few weeks, but I also started taking Inderal at the time..Inderal is a beta-blocker...no I don't have heart problems...

Im actually only 23, I have epilepsy, and Inderal helps tremendously with the mysterious tremors I have in my hand (2 neurologist's and several tests have yet to discover why I have this tremor...Im convinced it was caused by the several years I was taking SSRIs..but thats another story)...

back to the MAOI side effects... I havent gained any weight, and as far as sexual side effects, I would take Nardil over Paxil or Effexor or even Wellbutrin ANY DAY...on the SSRIs I felt like an emotion-less zombie...yeah I was no longer anxious, or depressed, but I wasn't happy either, I was lost somewhere in the middle, and very uncomfortable there.

nardil, for me, at least, has been a miracle drug, far less side effects than the SSRIs, or Effexor, Wellbutrin

I do have memory difficulties, but I can not attribute them to Nardil, I take Neurontin and Topamax for epilepsy and both of these medications have adverse effects on memory.

I take:
Nardil 60mg
Neurontin 1800mg
Topamax 200mg
Inderal 40mg

 

Re: MAOI diet short list djmmm

Posted by Rick on January 15, 2002, at 17:27:56

In reply to Re: MAOI diet short list, posted by djmmm on January 15, 2002, at 16:23:01


Great to hear that Nardil has been a miracle drug for you!

A few questions and comments:

> Well...actually, I had a bit of positional/orthostaic hypotension for the first few weeks

Nardil turned me from (untreated) hypertensive to hypotensive within days. The postural hypotension was so bad that I was falling down, including in public.

>I also started taking Inderal at the time

Do you think the Inderal adds to the anti-social-anxiety effect?

>I havent gained any weight

We both seem to be in a distinct minority on this one. I actually found it *easier* to lose weight when I was on Nardil, and I didn't really cut out many foods due to the cheese effect

>and as far as sexual side effects, I would take Nardil over Paxil or Effexor or even Wellbutrin ANY DAY

So do you/did you have any sexual dysfunction at all on Nardil? Nardil gave me such severe anorgasmia that it continued for almost four weeks after I dropped the Nardil

>on the SSRIs I felt like an emotion-less zombie...yeah I was no longer anxious, or depressed, but I wasn't happy either, I was lost somewhere in the middle, and very uncomfortable there.

I was being treated strictly for SP, not depression, but I can sure relate to your SSRI reactions based on my Celexa trial.

> nardil, for me, at least, has been a miracle drug, far less side effects than the SSRIs, or Effexor, Wellbutrin

Did either Effexor or Welbutrin help at all with the SP?

> I do have memory difficulties, but I can not attribute them to Nardil, I take Neurontin and Topamax for epilepsy and both of these medications have adverse effects on memory.

Again, I wonder if either of these, especially the Neurontin, add to the highly effective treatment of your SP?


> I take:
> Nardil 60mg
> Neurontin 1800mg
> Topamax 200mg
> Inderal 40mg

Any problems with energy or cognition (other than memory) with this combo?

 

Re: MAOI diet short list

Posted by Seamus2 on January 15, 2002, at 21:49:17

In reply to Re: MAOI diet short list djmmm, posted by spike4848 on January 15, 2002, at 7:31:57

I took Nardil solely for depression, not SP, for 5+ years before trying Parnate because of the anorgasmia Nardil caused. I really like the Parnate better, the only drawback is the increased tension and sympathomimetic agonism.

Nardil caused pronounced postural hypotension for me.

> Weight gain
If I rememeber correctly, I had carbo-cravings on Nardil, but didn't gain any weight.

> Sexual dysfunction
Complete anorgasmia at 60/mg day. No fun! :(

> Insomnia
Can't remember any.

> Memory difficulties
Can't remember any. < g > (no joke, I don't think it impaired my memory at all)

Seamus

 

Re: MAOI diet short list-Seamus2

Posted by Lisa01 on January 15, 2002, at 22:15:07

In reply to Re: MAOI diet short list, posted by Seamus2 on January 15, 2002, at 21:49:17

I thought I was well-versed in my disorder, but I've never come across the term "sympathomimetic agonism" before. Since I'm on Parnate, I'm curious to know what that is. Also, could you tell me how long you were taking it before you began to feel its benefits? I've been on it almost a month and feel the same anticipatory anxiety and physical systems as before.

Lisa

 

Re: MAOI diet short list

Posted by djmmm on January 15, 2002, at 23:04:54

In reply to Re: MAOI diet short list djmmm, posted by Rick on January 15, 2002, at 17:27:56

>
> Great to hear that Nardil has been a miracle drug for you!
>
> A few questions and comments:
>
> > Well...actually, I had a bit of positional/orthostaic hypotension for the first few weeks
>
> Nardil turned me from (untreated) hypertensive to hypotensive within days. The postural hypotension was so bad that I was falling down, including in public.
>
> >I also started taking Inderal at the time
>
> Do you think the Inderal adds to the anti-social-anxiety effect?
>
> >I havent gained any weight
>
> We both seem to be in a distinct minority on this one. I actually found it *easier* to lose weight when I was on Nardil, and I didn't really cut out many foods due to the cheese effect
>
> >and as far as sexual side effects, I would take Nardil over Paxil or Effexor or even Wellbutrin ANY DAY
>
> So do you/did you have any sexual dysfunction at all on Nardil? Nardil gave me such severe anorgasmia that it continued for almost four weeks after I dropped the Nardil
>
> >on the SSRIs I felt like an emotion-less zombie...yeah I was no longer anxious, or depressed, but I wasn't happy either, I was lost somewhere in the middle, and very uncomfortable there.
>
> I was being treated strictly for SP, not depression, but I can sure relate to your SSRI reactions based on my Celexa trial.
>
> > nardil, for me, at least, has been a miracle drug, far less side effects than the SSRIs, or Effexor, Wellbutrin
>
> Did either Effexor or Welbutrin help at all with the SP?
>
> > I do have memory difficulties, but I can not attribute them to Nardil, I take Neurontin and Topamax for epilepsy and both of these medications have adverse effects on memory.
>
> Again, I wonder if either of these, especially the Neurontin, add to the highly effective treatment of your SP?
>
>
> > I take:
> > Nardil 60mg
> > Neurontin 1800mg
> > Topamax 200mg
> > Inderal 40mg
>
> Any problems with energy or cognition (other than memory) with this combo?

To answer your questions...
the Inderal most def. helps with the "physical" aspect of social anxiety.. the increased heart rate, sweating.

I found that once my heart wasn't beating out of my chest, I wouldn't start sweating, and then I wouldn't start blushing..and this helped tremendously....but psychologically I was still having the same distorted "self-centered" social phobic thoughts.

as for sexual side-effects, rarely I have had problems with anorgasmia...maybe 10 times in the 1.5 years I have been taking the Nardil... The SSRIs destroyed my libido, and being only a teen/early 20's at the time (im 23 now) that was just unacceptable...Effexor and Wellbutrin weren't any better...

...also Effexor, surprisingly, did not work at all for me, neither did wellbutrin, and wellbutrin sr gave me hives.

I do think that the Neurontin and Topamax have contributed to my recovery...

 

Re: MAOI diet short list-Seamus2

Posted by djmmm on January 15, 2002, at 23:28:44

In reply to Re: MAOI diet short list-Seamus2, posted by Lisa01 on January 15, 2002, at 22:15:07

> I thought I was well-versed in my disorder, but I've never come across the term "sympathomimetic agonism" before. Since I'm on Parnate, I'm curious to know what that is. Also, could you tell me how long you were taking it before you began to feel its benefits? I've been on it almost a month and feel the same anticipatory anxiety and physical systems as before.
>
> Lisa

Hey Lisa
sympathomimetic is a term typically used to describe drugs that stimulate the central nervous system, like ephedrine, pseudofed,...here, he is using the term "sympathomimetic agonism", when refering to the drug Parnate.

Until recently, it was believed that the metabolites of Parnate were Amphetamine and Methamphetamine, which would fit the definition of "sympathomimetic agonists"

Most research does not support the amphetamine metabolite theory. However, there is still a lot to learn about MAOI pharmacology.

 

Re: MAOI diet short list Lisa01

Posted by Elizabeth on January 16, 2002, at 20:40:18

In reply to Re: MAOI diet short list, posted by Lisa01 on January 14, 2002, at 20:46:11

> I gave up red wine (my favourite), beer, pizza, nachos with cheese & sour cream... I read on one web site that wine was okay, but only quantities of 1/2 cup or less!

Jeez. There's no evidence that *any* wine is dangerous with MAOIs. There is one thing on your list there that you might want to be cautious about: the nachos. Sometimes restaurants use cheddar cheese, which is something you should generally avoid (while on MAOIs, that is).

> Regarding Parnate, I have notice an increase in anxiety/nervousness. For someone taking this for SP, this is quite unwelcome. Any idea if this will dissipate?

I'd expect it to, yes. You might back off to a lower dose and then increase it slower.

> Also, I don't feel any benefits although it's been almost a month. I'm on the min. dosage.

What do you mean by "the min. dosage?" I certainly think it's possible you would do well on a higher dose.

> Also, has anyone tried Corona, an imported beer from Mexico, on an MAOI? It's not a dark beer so I'm wondering if it might be okay.

I'm not sure that the color of the beer has any relationship to tyramine content. But I can't say anything about Corona specifically, sorry.

-elizabeth

 

Re: MAOI diet short list P.S. Lisa01

Posted by Elizabeth on January 16, 2002, at 20:45:23

In reply to Re: MAOI diet short list-Seamus2, posted by Lisa01 on January 15, 2002, at 22:15:07

> I thought I was well-versed in my disorder, but I've never come across the term "sympathomimetic agonism" before. Since I'm on Parnate, I'm curious to know what that is.

I think he just means that Parnate has mild amphetamine-like effects -- it enhances the activity of the sympathetic nervous system (which results in some of the "jittery" side effects like tension, increased heart and respiration rates, etc.).


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