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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Ilene on January 30, 2004, at 12:24:12
I'm almost done tapering off desipramine and buspirone. Then I will have a 2-week washout period before starting an MAOI. I think I will ask for Parnate because of the SE profile. Question is, can I eat cheese, etc. during the washout period? I am the first pt. my pdoc has put on an MAOI.
Just BTW--if you experience a "cheese reaction" does it happen right away, a few hours later, or does it vary?
Thank you,
I.
Posted by gardenergirl on January 30, 2004, at 14:34:17
In reply to MAOI diet during drug washout, posted by Ilene on January 30, 2004, at 12:24:12
You do not need to follow the diet before you start the MAOI. And I'm sure you know it's not just cheese, but just checking. You do, however, need to follow the diet for 2-4 weeks AFTER going off of an MAOI, during it's washout period. Right now you can have all the cheese you want.
When I was getting ready to go on Nardil, I "practiced" the diet during my washout of Celexa and Wellbutrin to make sure that I could really do it.
Reactions usually come fairly quickly. I would say within the hour. The only one I had went away within about 1-2 hours after it started. But it likely was not a huge quantity. (Stuffing at Thanksgiving made with giblets).
Good luck and I hope the MAOI is effective for you.
gg
Posted by Ilene on January 30, 2004, at 17:03:24
In reply to Re: MAOI diet during drug washout, posted by gardenergirl on January 30, 2004, at 14:34:17
> You do not need to follow the diet before you start the MAOI. And I'm sure you know it's not just cheese, but just checking. You do, however, need to follow the diet for 2-4 weeks AFTER going off of an MAOI, during it's washout period. Right now you can have all the cheese you want.
>
> When I was getting ready to go on Nardil, I "practiced" the diet during my washout of Celexa and Wellbutrin to make sure that I could really do it.
>
> Reactions usually come fairly quickly. I would say within the hour. The only one I had went away within about 1-2 hours after it started. But it likely was not a huge quantity. (Stuffing at Thanksgiving made with giblets).
>
> Good luck and I hope the MAOI is effective for you.
>
> ggYou seem very knowledgeable. It didn't occur to me that I would have to keep off the cheese (and other aged protein) *after* I stopped taking the MAOI. I hope it's going to work for me and there will be no after, though. (I've been on approximately a dozen meds, and this feels like my last chance, so I'm quite anxious for it to work.)
You seem so blase about the reaction. Did you go to the hospital, or just wait for it to go away?
Thanks,
I.
Posted by gardenergirl on January 30, 2004, at 17:16:12
In reply to Re: MAOI diet during drug washout » gardenergirl, posted by Ilene on January 30, 2004, at 17:03:24
I hope it works for you, too as it seems like a miracle drug for me.
Here's the story about my reaction. I had some major dental work done just before Thanksgiving. I looked over all of the food and scanned for cheese and other no-no's, but I was mostly looking at the texture for soft stuff as I was still in some pain. It never occured to me that my aunt would use giblets in the stuffing as my mother never used to, but I realize now that is really naive. I just wasn't thinking and was also on Vicuprofen, so...not my sharpest. Anyway, not long after dinner I developed a terrible headache. I attributed it to referred tooth pain and took another Vicuprofen when it was time. I have had migraines in the past, so the headache, although awful, did not scare me. (Incidentally, not a single migraine since I started the Nardil. Used to also take tylenol daily for tension headaches, but none of those, either!)
I later realized that I must be having a reaction, as the Vicuprofen didn't really help, but it was fading with time, which a migraine does not usually do with me. By the time I got back home, about 2 hours or so after it started, my BP was normal and my head felt much better. I am betting if I could have checked it during the headache it would have been elevated.
There are others who have gone to the hospital and/or who carry emergency medication to deal with hypertensive crises. The jury is still out according to research as to whether these emergency meds (Procardia is one, can't think of the other)are effective or safe, so I have never asked my doc. for one. If I were to have another attack, I likely would go to the hospital if only to get faster relief from the pain. I'm sure my husband would insist, as he is quite cautious.
But there are also posts on here that talk about bad experiences going to the hospital. If you are on an MAOI, you may want to consider getting a med alert bracelet (I still haven't done that, but I intend to.)
Incidentally, there is a great deal of information in the archives of this site about MAOI's. It's here that I learned so much. I learned that I can safely eat mozzarella and provolone cheese as these are not aged and research failed to detect a significant amount of tyramine in them. Pizza, YES! This is good to know, but I also recommend that when you first start out you follow the recommendations very closely until you know how you react to the med. Everyone reacts differently to the med and to the diet, so what's good for one is not necessarily okay for someone else.
Good luck and if I can help more, please let me know,
gg
Posted by Ilene on January 30, 2004, at 18:58:00
In reply to Re: MAOI diet during drug washout, posted by gardenergirl on January 30, 2004, at 17:16:12
That's an interesting story.
is Vicoprofen like Vicodin? Does it have a narcotic in it? I think Vicodin contains oxycodone. Narcotics are supposed to be MAOI no-no's, which will be a problem for me because I take Ultracet for the pain I get from chronic fatigue syndrome. (Ultracet contains tramodol. It's the only thing that works. OTC pain meds don't do squat, and Vicodin is too strong.)
My mother suffered from migraines, which were brought on by stress/anxiety. ( In retrospect, I think she had an anxiety disorder. I don't know if she had full-bore clinical depression, but I've figured out that mental illness runs in my family). If Nardil is effective against anxiety, and if your migraines are triggered by anxiety, then bingo! no more migraines.
By the way, there's a link between migraine and bipolar disorder.
I will be getting a medical alert bracelet and I think the pdoc will prescribe some magic antidote pills. I might invest in a bp cuff, too. (My bp is wierd anyway.)
I eat a lot of cheese and Asian food (soy sauce) but I don't like most pizza. (I hate oregano. I'm also a food snob.) Ironically, I'm moving to San Francisco, famous for Chinese and Italian restaurants.
Yes, I searched the archives and got a lot of useful info. on diet.
Thanks again,
I.
Posted by gardenergirl on January 30, 2004, at 20:24:08
In reply to Re: MAOI diet during drug washout » gardenergirl, posted by Ilene on January 30, 2004, at 18:58:00
Vicoprofen is like Vicodin but it contains ibuprofen instead of acetominophin. According to a software program I have that can check drug interactions, Nardil and Vicoprofen are not a complete no-no. Caution is advised as combo may increase risk of hypotension, CNS depression. My dentist checked and felt that this would be okay for me. I didn't have to take them for more then a few days.
I also bought an automatic BP cuff. I'm glad your pdoc is on the ball with the MAOI. I have to admit, my scrip is from my primary care physician. I requested the Nardil and had done a lot of research beforehand. I actually knew (probably still do) more than he does about it, and I feel pretty confident about my judgement in this. But it's really unusual for a GP to prescribe an MAOI. Many pdocs won't even touch them.
It is SO nice not to get headaches or migraines anymore! Perhaps it was anxiety. I am finding, through psychotherapy, that I did and do have more anxiety than I was aware of. In addition, Nardil gave me an immediate boost of confidence, which also helped me realize I was anxious.
I ran Ultracet and Nardil and no interactions were found. So you should be okay with that.
I feel for you about the cheese and asian food. It is really difficult in restaurants, trying to order. Some places are more accomodating than others in going over ingredients. I am thinking I might print out a card with a list of the no-no's on it. Then I can just hand it to the server to give to the chef and ask what they recommend or ask them to check on a specific dish or two. Visiting friends or family is tough too. I feel really high maintenance. And there is always the question of why you have this diet. Sometimes it is easier, particulary in restaurants, to describe it more as an allergy.
Take care,
gg
Posted by Ilene on January 31, 2004, at 8:36:24
In reply to Re: MAOI diet during drug washout » Ilene, posted by gardenergirl on January 30, 2004, at 20:24:08
> Vicoprofen is like Vicodin but it contains ibuprofen instead of acetominophin. According to a software program I have that can check drug interactions, Nardil and Vicoprofen are not a complete no-no. Caution is advised as combo may increase risk of hypotension, CNS depression. My dentist checked and felt that this would be okay for me. I didn't have to take them for more then a few days.
>
What's the software program called? More important, what sources does it cite for the information?> I also bought an automatic BP cuff. I'm glad your pdoc is on the ball with the MAOI. I have to admit, my scrip is from my primary care physician. I requested the Nardil and had done a lot of research beforehand. I actually knew (probably still do) more than he does about it, and I feel pretty confident about my judgement in this. But it's really unusual for a GP to prescribe an MAOI. Many pdocs won't even touch them.
>
Oh yes. I don't think my pdoc wants to admit how much she *doesn't* know.> It is SO nice not to get headaches or migraines anymore! Perhaps it was anxiety. I am finding, through psychotherapy, that I did and do have more anxiety than I was aware of. In addition, Nardil gave me an immediate boost of confidence, which also helped me realize I was anxious.
>
It was *years* before I realized I was abnormally anxious. Only after I read a non-US definition of GAD.> I ran Ultracet and Nardil and no interactions were found. So you should be okay with that.
I still need to convince the docs. They are ultra-cautious.
>
> I feel for you about the cheese and asian food. It is really difficult in restaurants, trying to order. Some places are more accomodating than others in going over ingredients. I am thinking I might print out a card with a list of the no-no's on it. Then I can just hand it to the server to give to the chef and ask what they recommend or ask them to check on a specific dish or two. Visiting friends or family is tough too. I feel really high maintenance. And there is always the question of why you have this diet. Sometimes it is easier, particulary in restaurants, to describe it more as an allergy.
>
> Take care,
> ggI'm glad (envious, actually) that you are doing so well. I'm not going to have the eating-in-restaurant or visiting-friends-or-family problem for a few months. I have no social life right now, and there is no family to visit.
I.
Posted by gardenergirl on January 31, 2004, at 8:59:37
In reply to Re: MAOI diet during drug washout » gardenergirl, posted by Ilene on January 31, 2004, at 8:36:24
> >
> What's the software program called? More important, what sources does it cite for the information?The program is called ePocrates and I downloaded it for my Palm. It updates each time I hotsync.
As far as sources for information, it is edited by a large group of MD's and pharmacologists. The format and content is very similar to the PDR, although it does not give much info. about the chemical structure. It does give adult and ped dosing, contraindications, adverse reactions, drug interactions, cost based on what formulary you select, basic mechanism of action, metabolism, and pregnancy warnings. I find it useful, but they do offer a disclaimer that they are not responsible for typographical errors or use of the information they present.
>
> I still need to convince the docs. They are ultra-cautious.
The information that comes with the medication from the pharmacy is also overly cautious and likely based on outdated research. The funniest, or perhaps saddest part of that is it says to get a full dietary restriction list from your doc or the pharmacy. I asked. You guessed it, they don't have anything. My doc never even went over the precautions when he initially prescribed it. It's a good thing I knew what I was asking for as he could have given me a stroke. He also named a bunch of tricyclics when I first asked for an MAOI and had to look it up in front of me to convince himself that I was right and he was wrong about what an MAOI was. Yikes! I would never recommend to anyone else to do what I did (use a GP for getting a scrip), but I had the recommendation of my T and I had really researched it before hand.
> >
> I'm glad (envious, actually) that you are doing so well. I'm not going to have the eating-in-restaurant or visiting-friends-or-family problem for a few months. I have no social life right now, and there is no family to visit.Ilene, I so hope that you have a similar result as I did. You deserve it!
Take care, and keep my posted,
gg
Posted by Ilene on January 31, 2004, at 9:44:17
In reply to Re: MAOI diet during drug washout » Ilene, posted by gardenergirl on January 31, 2004, at 8:59:37
Posted by jerrympls on February 2, 2004, at 22:39:42
In reply to Re: MAOI diet during drug washout » gardenergirl, posted by Ilene on January 30, 2004, at 18:58:00
> That's an interesting story.
>
> is Vicoprofen like Vicodin? Does it have a narcotic in it? I think Vicodin contains oxycodone. Narcotics are supposed to be MAOI no-no's, which will be a problem for me because I take Ultracet for the pain I get from chronic fatigue syndrome. (Ultracet contains tramodol. It's the only thing that works. OTC pain meds don't do squat, and Vicodin is too strong.)
>
> My mother suffered from migraines, which were brought on by stress/anxiety. ( In retrospect, I think she had an anxiety disorder. I don't know if she had full-bore clinical depression, but I've figured out that mental illness runs in my family). If Nardil is effective against anxiety, and if your migraines are triggered by anxiety, then bingo! no more migraines.
>
> By the way, there's a link between migraine and bipolar disorder.
>
> I will be getting a medical alert bracelet and I think the pdoc will prescribe some magic antidote pills. I might invest in a bp cuff, too. (My bp is wierd anyway.)
>
> I eat a lot of cheese and Asian food (soy sauce) but I don't like most pizza. (I hate oregano. I'm also a food snob.) Ironically, I'm moving to San Francisco, famous for Chinese and Italian restaurants.
>
> Yes, I searched the archives and got a lot of useful info. on diet.
>
> Thanks again,
>
> I.
I was on Nardil and while I was on it, I was in the hospital two times - once for encephalitis and once to remove the VNS implant - both times I was treated with strong narcotics - Dilauded and then Percocet when I went home and then Vicoden. Of course - the heavy narcotics were while I was in the hospital and so I was checked on, etc. But I never had ANY problems with Vicodin (hydrocodone) or Percocet (oxycontin). My pdoc even put me on Vicodin - 4 tabs/day while I was tapering OFF the Nardil (for various reasons). It seems the interaction between narcotics and MAOI's it blown a bit out of proportion - EXCEPT for DEMEROL - one shot of that and you're dead. That's why my doc made me wear a medic alert bracelet.Just my experiences....
Jerry
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