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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by J Kelly on April 29, 2016, at 14:02:05
Nardil is a strange beast.
I did two weeks at 45mg with no side effects or benefit. Which was fine. Almost a week ago I went up to 60mg and that's when things got strange.
Day one on 60mg I felt drugged.
Day two I woke up to extreme anxiety. I almost ditched the trial. Instead I took .5mg Klonopin twice along with 2.5 mg Zyprexa. The anxiety disappeared and I felt okay. No anxiety.
Day three non-eventful.
Day four woke up to two hours of feeling noticeably better (blip?). Then two episodes of pretty severe hypotension. Stayed seated and drank lots of water. Hypotension abated. Couple hours later hypertension episode 156/96. Might have been tyrosine induced. I accidentally ate yogurt.
Day five (today) back to baseline no s/e's.
Crossing my fingers. Trying to be a patient patient :)
Jade
Ps- Pdoc has said no to the following: Lamictal, Nifedipine, Metformin. He said no to switching Klonopin to Xanax, and Zyprexa to another AP. He and my therapist have said "stay the course". I guess at this point I agree.
Posted by baseball55 on April 29, 2016, at 21:16:30
In reply to Nardil Experience so Far, posted by J Kelly on April 29, 2016, at 14:02:05
Yogurt is not contra-indicated and does not contain tyramine. BP rises and falls during the day, with or without Nardil of other drugs.
Posted by Horse on April 29, 2016, at 21:34:37
In reply to Re: Nardil Experience so Far » J Kelly, posted by baseball55 on April 29, 2016, at 21:16:30
Staying the course sounds like good advice. I think Nardil takes time to settle into but I haven't taken it myself.
I think some kefir is contraindicated. I recall something about that when I was at upper doses of emsam.
Be well :)
Posted by J Kelly on April 30, 2016, at 6:26:44
In reply to Re: Nardil Experience so Far » J Kelly, posted by baseball55 on April 29, 2016, at 21:16:30
> Yogurt is not contra-indicated and does not contain tyramine. BP rises and falls during the day, with or without Nardil of other drugs.
That's what I thought. But I've since found many sources saying yogurt IS contraindicated. So I might have to experiment with small amounts. I'd hate to have to give it up.
My BP was too high to be a natural rise. I'm suspecting yogurt, lunch meat (ham), or Wendy's chili to be the culprit. Any ideas?
Jade
Posted by J Kelly on April 30, 2016, at 6:34:56
In reply to Re: Nardil Experience so Far, posted by Horse on April 29, 2016, at 21:34:37
> Staying the course sounds like good advice. I think Nardil takes time to settle into but I haven't taken it myself.
>
> I think some kefir is contraindicated. I recall something about that when I was at upper doses of emsam.
>
> Be well :)Thanks Horse,
The MAOI diet seems to change each time I find a new source. I think some things I may choose to experiment with small amounts. Others I'm just gonna give up if its not a staple in my current diet.
Jade
Posted by J Kelly on April 30, 2016, at 8:51:20
In reply to Nardil Experience so Far, posted by J Kelly on April 29, 2016, at 14:02:05
Update. Day 6 (today) having another "blip". Not manic/euphoric, not full remission, but feeling noticeably better. I wish this feeling wasn't so transient but maybe its a sign of things to come. Thoughts?
Jade :)
Posted by SLS on April 30, 2016, at 9:51:10
In reply to Re: Nardil Experience so Far, posted by J Kelly on April 30, 2016, at 8:51:20
> Update. Day 6 (today) having another "blip". Not manic/euphoric, not full remission, but feeling noticeably better. I wish this feeling wasn't so transient but maybe its a sign of things to come. Thoughts?
>
> Jade :):-)
I think you are on your way!
Do not "experiment" too much with foods. Yogurt is generally fine. If in doubt, choose the Dannon brand.
Do not eat blue cheese!
Inexpensive processed cheeses are okay, but it would be wise to experiment with very small amounts. Mozzarella and Ricotta cheeses are okay, but Romano and Provalone are not.
Aged or cured meats are a no-no. Could the ham you ate be considered aged or cured?
What foods are you concerned about?
http://www.dr-bob.org/babble/20010814/msgs/75408.html
- Scott
Posted by J Kelly on April 30, 2016, at 13:13:28
In reply to Re: Nardil Experience so Far » J Kelly, posted by SLS on April 30, 2016, at 9:51:10
>
> :-)
>
> I think you are on your way!
>
> Do not "experiment" too much with foods. Yogurt is generally fine. If in doubt, choose the Dannon brand.
>
> Do not eat blue cheese!
>
> Inexpensive processed cheeses are okay, but it would be wise to experiment with very small amounts. Mozzarella and Ricotta cheeses are okay, but Romano and Provalone are not.
>
> Aged or cured meats are a no-no. Could the ham you ate be considered aged or cured?
>
> What foods are you concerned about?Well this BP issue is messing with my blip :(
Here's what I'm concerned about:
-Oscar Meyer Honey Ham, sandwich slices. In tiny print on the back it says it contains soy lecithin and soy. I don't know if its smoked, aged or cured. It doesn't say. I called customer service but they are closed.
-Grocery bought American "pasteurized process cheese food" says "may contain traces of soy.
-Chobani Greek Yogurt. Nothing about soy on the box.
-Skippy crunchy peanut butter. Contains soybean oil.
-Bigelow brand tea. Contains soy lecithin.
-Crystal Light lemonade. Contains soy lecithin and soy.
I have had all of these today except the ham and cheese. My BP is moderately elevated and I have a headache.
Also, what is the difference between soy lecithin and soy? Is the former okay?
I have put my self on a diet that I feel good about but if you could comment on these items that would be awesome. Thanks!
>
> http://www.dr-bob.org/babble/20010814/msgs/75408.html
>
> https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=14&ved=0ahUKEwifvtH2yrbMAhWJZj4KHSx3CtkQFghiMA0&url=http%3A%2F%2Fwww.psychotropical.com%2Fimages%2Fpdf-downloads%2Fmaois_diet_SO_short.pdf&usg=AFQjCNGZm-tGt4p8RcCQrv2QsqawKS64tQ&sig2=hhXIRAbd8asgjNw1Wi3Azg&cad=rja
>
>I actually used Elizabeth's list when I took Parnate. I passed it on to other posters as well :)
Jade
Posted by baseball55 on April 30, 2016, at 21:02:31
In reply to Re: Nardil Experience so Far » SLS, posted by J Kelly on April 30, 2016, at 13:13:28
People worry way to much about food interactions from MAOIs.
There is nothing wrong with soy - just soy sauce. I had given up sushi because I thought soy sauce was an absolute no-no. But I read that up to 1/4 cup is fine and I generally won't use more than a tablespoon or two when I get sushi.
Deli meats - ham, turkey, roast beef - are fine. Just avoid aged meats like salami and pepperoni Any aged meat, including spoiled meat should be avoided. (But, of course, spoiled meats should always be avoided). Any aged cheese should be avoided. This means American and mozzarella are OK.
Chianti and draft beer have been know to cause problems, but white wines and bottled beer are fine in moderation.
Don't go searching all over the web for contra-indicated foods. I've seen sites that say don't eat oranges, dried fruit, most nuts, eggplant, on and on and on.
Years ago, I posted an article which had a reasonable and evidence-based list. I can't remember where it came from now, but you may find it in the archives.
And BP can vary a lot. I've been in the hospital where they take BP every few hours and seen it go from 100/60 to 160/100. Take your BP once a day at the same time, preferably when you wake up in the morning. Unless you have an occipital headache after eating a contra-indicated food (and not in trace amounts), spikes in your BP can easily occur simply because you're anxious about spikes in your BP.
> > :-)
> >
> > I think you are on your way!
> >
> > Do not "experiment" too much with foods. Yogurt is generally fine. If in doubt, choose the Dannon brand.
> >
> > Do not eat blue cheese!
> >
> > Inexpensive processed cheeses are okay, but it would be wise to experiment with very small amounts. Mozzarella and Ricotta cheeses are okay, but Romano and Provalone are not.
> >
> > Aged or cured meats are a no-no. Could the ham you ate be considered aged or cured?
> >
> > What foods are you concerned about?
>
> Well this BP issue is messing with my blip :(
>
> Here's what I'm concerned about:
>
> -Oscar Meyer Honey Ham, sandwich slices. In tiny print on the back it says it contains soy lecithin and soy. I don't know if its smoked, aged or cured. It doesn't say. I called customer service but they are closed.
>
> -Grocery bought American "pasteurized process cheese food" says "may contain traces of soy.
>
> -Chobani Greek Yogurt. Nothing about soy on the box.
>
> -Skippy crunchy peanut butter. Contains soybean oil.
>
> -Bigelow brand tea. Contains soy lecithin.
>
> -Crystal Light lemonade. Contains soy lecithin and soy.
>
> I have had all of these today except the ham and cheese. My BP is moderately elevated and I have a headache.
>
> Also, what is the difference between soy lecithin and soy? Is the former okay?
>
> I have put my self on a diet that I feel good about but if you could comment on these items that would be awesome. Thanks!
>
>
> >
> > http://www.dr-bob.org/babble/20010814/msgs/75408.html
> >
> > https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=14&ved=0ahUKEwifvtH2yrbMAhWJZj4KHSx3CtkQFghiMA0&url=http%3A%2F%2Fwww.psychotropical.com%2Fimages%2Fpdf-downloads%2Fmaois_diet_SO_short.pdf&usg=AFQjCNGZm-tGt4p8RcCQrv2QsqawKS64tQ&sig2=hhXIRAbd8asgjNw1Wi3Azg&cad=rja
> >
> >
>
> I actually used Elizabeth's list when I took Parnate. I passed it on to other posters as well :)
>
> Jade
>
>
> >
> > :-)
> >
> > I think you are on your way!
> >
> > Do not "experiment" too much with foods. Yogurt is generally fine. If in doubt, choose the Dannon brand.
> >
> > Do not eat blue cheese!
> >
> > Inexpensive processed cheeses are okay, but it would be wise to experiment with very small amounts. Mozzarella and Ricotta cheeses are okay, but Romano and Provalone are not.
> >
> > Aged or cured meats are a no-no. Could the ham you ate be considered aged or cured?
> >
> > What foods are you concerned about?
>
> Well this BP issue is messing with my blip :(
>
> Here's what I'm concerned about:
>
> -Oscar Meyer Honey Ham, sandwich slices. In tiny print on the back it says it contains soy lecithin and soy. I don't know if its smoked, aged or cured. It doesn't say. I called customer service but they are closed.
>
> -Grocery bought American "pasteurized process cheese food" says "may contain traces of soy.
>
> -Chobani Greek Yogurt. Nothing about soy on the box.
>
> -Skippy crunchy peanut butter. Contains soybean oil.
>
> -Bigelow brand tea. Contains soy lecithin.
>
> -Crystal Light lemonade. Contains soy lecithin and soy.
>
> I have had all of these today except the ham and cheese. My BP is moderately elevated and I have a headache.
>
> Also, what is the difference between soy lecithin and soy? Is the former okay?
>
> I have put my self on a diet that I feel good about but if you could comment on these items that would be awesome. Thanks!
>
>
> >
> > http://www.dr-bob.org/babble/20010814/msgs/75408.html
> >
> > https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=14&ved=0ahUKEwifvtH2yrbMAhWJZj4KHSx3CtkQFghiMA0&url=http%3A%2F%2Fwww.psychotropical.com%2Fimages%2Fpdf-downloads%2Fmaois_diet_SO_short.pdf&usg=AFQjCNGZm-tGt4p8RcCQrv2QsqawKS64tQ&sig2=hhXIRAbd8asgjNw1Wi3Azg&cad=rja
> >
> >
>
> I actually used Elizabeth's list when I took Parnate. I passed it on to other posters as well :)
>
> Jade
>
>
Posted by Horse on April 30, 2016, at 23:40:58
In reply to Re: Nardil Experience so Far » Horse, posted by J Kelly on April 30, 2016, at 6:34:56
Hi Jade, what I've read about yogurt and kefir is to limit to 4 oz. Some kefir and yogurt have more tyramine, and some only have a trace. I can't comment on the list you've posted. My experience with kefir was drinking it daily and in larger portions than 4 oz. I recall once feeling 'funny' after some kefir.
Here's a thread about kefir http://www.dr-bob.org/babble/alter/20111229/msgs/1012242.html
I think Scott's recommendation of Dannon or another mainstream yogurt is a good one. Be careful and knowledgable, but don't stress.
Have you tried DBT? Some skills there might help with mood swings. Just a thought. Best to you.
> > Staying the course sounds like good advice. I think Nardil takes time to settle into but I haven't taken it myself.
> >
> > I think some kefir is contraindicated. I recall something about that when I was at upper doses of emsam.
> >
> > Be well :)
>
> Thanks Horse,
>
> The MAOI diet seems to change each time I find a new source. I think some things I may choose to experiment with small amounts. Others I'm just gonna give up if its not a staple in my current diet.
>
> Jade
>
>
Posted by Lamdage22 on May 1, 2016, at 3:56:18
In reply to Re: Nardil Experience so Far » J Kelly, posted by baseball55 on April 30, 2016, at 21:02:31
Carry some emergency nifedipine with you. 5mg is sufficient for weak hypertensive crises. 10mg only for strong ones.
Posted by J Kelly on May 1, 2016, at 7:05:04
In reply to Re: Nardil Experience so Far » J Kelly, posted by baseball55 on April 30, 2016, at 21:02:31
> People worry way to much about food interactions from MAOIs.
>I'm not too worried about food interactions, only in that I'd like to avoid the symptomology that arises from BP variations. I'm experiencing unpleasant symptoms from both low and high BP. I'm hoping its as simple as excluding a few things from my current diet.
Jade :)
Posted by J Kelly on May 1, 2016, at 7:27:14
In reply to Re: Nardil Experience so Far » J Kelly, posted by Horse on April 30, 2016, at 23:40:58
> Hi Jade, what I've read about yogurt and kefir is to limit to 4 oz. Some kefir and yogurt have more tyramine, and some only have a trace. I can't comment on the list you've posted. My experience with kefir was drinking it daily and in larger portions than 4 oz. I recall once feeling 'funny' after some kefir.
>
> Here's a thread about kefir http://www.dr-bob.org/babble/alter/20111229/msgs/1012242.html
>
> I think Scott's recommendation of Dannon or another mainstream yogurt is a good one. Be careful and knowledgable, but don't stress.Hello again,
I've never tried kefir. Thanks for the link :)
I'm really addicted to Chobani Greek Yogurt so I'm hoping I wont have to give that up. I believe its a well known brand. I'm actually not too stressed about the diet but I'd like to reduce the bp symptomology I've been experiencing.
>
> Have you tried DBT? Some skills there might help with mood swings. Just a thought. Best to you.
>I've recently started therapy and I'm not sure whether its CBT or DBT. I think its one or the other though. She lent me David Burns Feel Good book and I'm gonna order a copy.
Thanks,
Jade
Posted by J Kelly on May 1, 2016, at 7:34:05
In reply to Re: Nardil Experience so Far, posted by Lamdage22 on May 1, 2016, at 3:56:18
> Carry some emergency nifedipine with you. 5mg is sufficient for weak hypertensive crises. 10mg only for strong ones.
>
>I asked my pdoc for some but he won't prescribe it. In looking at some old threads it seems that Nifedipine can lower bp too much. One poster said even in the hospital they just did a watch and wait. This same thing happened to me once while on Parnate.
Jade
Posted by rose45 on May 14, 2016, at 3:40:36
In reply to Re: Nardil Experience so Far » Horse, posted by J Kelly on May 1, 2016, at 7:27:14
fwiw, I was originally put on Nardil in hospital at the Maudsley Hospital in London.The first 6 weeks on 60 mg were hell. I could barely function. They refused to give me sleeping medication, or any other medication because they said it is better to stick to one medication, to see how it works. I began to feel the benefit after 6 weeks on 60 mg. I began to feel slightly happy, and then more and more positive, and I began to sleep. I always found Nardil tricky when changing the dosage.Nardil stopped working after 20 years and I am now on Parnate, and the dose changes are easier to handle, not so many side effects, but it doesnt give the euphoria that Nardil does. I found that I need to be stricter with the diet on Parnate than I did on Nardil. Goat's cheese is ok.
Posted by J Kelly on May 14, 2016, at 4:49:01
In reply to Re: Nardil Experience so Far, posted by rose45 on May 14, 2016, at 3:40:36
> fwiw, I was originally put on Nardil in hospital at the Maudsley Hospital in London.The first 6 weeks on 60 mg were hell. I could barely function.
Wow I've got the opposite going on. Other than the first few days I've had almost zero side effects on Nardil. Maybe slight fatigue but that could be a result of coming off of Ritalin. I had a lot of side effects on Parnate.
They refused to give me sleeping medication, or any other medication because they said it is better to stick to one medication, to see how it works. I began to feel the benefit after 6 weeks on 60 mg. I began to feel slightly happy, and then more and more positive, and I began to sleep. I always found Nardil tricky when changing the dosage.Nardil stopped working after 20 years and I am now on Parnate, and the dose changes are easier to handle, not so many side effects, but it doesnt give the euphoria that Nardil does. I found that I need to be stricter with the diet on Parnate than I did on Nardil. Goat's cheese is ok.
20 years? I would love 20 years of this. Did you ever go higher than 60mg? I'm wondering if 75mg would take care of that last bit of depression/fatigue. But I'm certainly not complaining! I'll ask my pdoc and see what he wants to do.
Thanks,
Jade :)
This is the end of the thread.
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