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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Annie on March 6, 1999, at 15:51:41
I've read several things here and elsewhere on Dr Bob's site about Parnate sometimes causing spontaneous hypertension. In January I started Parnate. The day prior my BP was 127/78. After three days on Parnate, my BP was 199/110. I was adhering to the strictest diet so I know it was not a tyramine reaction. I stopped Parnate. Here's the problem. My BP did not return to normal. The following week, my internist put me on Dyazide and then added Norvasc. It has dropped to 160/90. Did the BP of other people who experienced spontaneous hypertension from Parnate remain elevated? Is there a chance my BP could still return to normal or am I now stuck taking this nauseating med for life?
Posted by Elizabeth on March 9, 1999, at 23:23:23
In reply to Parnate & spontaneous hypertension, posted by Annie on March 6, 1999, at 15:51:41
I had spontaneous hypertension (240/120 I think - it was a while ago) on Parnate as well, but it went away afterwards. (With a rechallenge of the drug, the hypertension came back, and again it went away shortly after it started.) I didn't have to discontinue the drug for it to go away - it was in brief episodes similar to a tyramine reaction.
Now I'm taking a lower dose of Parnate (no antihypertensives) and doing fine (though I had to add another med because the lower dose of Parnate wasn't working very well.)
I don't know what to say about whether it will be permanent. Have you been to see a cardiologist about it (maybe in consultation with your psychiatrist)? It's a pretty weird thing to have happen, and I wonder whether it might be from something other than the Parnate.
-elizabeth
Posted by Seamus on March 14, 1999, at 9:47:15
In reply to Parnate & spontaneous hypertension, posted by Annie on March 6, 1999, at 15:51:41
> I've read several things here and elsewhere on Dr Bob's site about Parnate sometimes causing spontaneous hypertension. In January I started Parnate. The day prior my BP was 127/78. After three days on Parnate, my BP was 199/110. I was adhering to the strictest diet so I know it was not a tyramine reaction. I stopped Parnate. Here's the problem. My BP did not return to normal. The following week, my internist put me on Dyazide and then added Norvasc. It has dropped to 160/90. Did the BP of other people who experienced spontaneous hypertension from Parnate remain elevated? Is there a chance my BP could still return to normal or am I now stuck taking this nauseating med for life?
Have you been tested for pheochromocytoma?
Its a tumor of certain cells (usually in the adrenal glands) which causes them to excrete too much adrenaline.
This adrenaline, combined w/ the Parnate, could cause the hypertension you speak of.
A couple labs tests, HVA and VMA, after a washout period on the Parnate, should be able to answer the question.Regards,
S_
Posted by alli on March 19, 1999, at 19:36:59
In reply to Parnate & spontaneous hypertension, posted by Annie on March 6, 1999, at 15:51:41
I had a hypertensive episode that the ER said was due to Parnate (BP 170/100, HR 160) but I kind of doubt that Parnate was the cause. I normally have pretty low and orthostatic pressures without Parnate, and Parnate tends to put my standing systolic pressure in the 70s, even at 10mg. Because of this I was given dexedrine to raise my pressure and keep me awake. However, off all meds, when I get a migraine I sometimes get blood pressures around 154/90. I had a bad headache and low pressure for several days before I got the high pressure and heart rate. Apparently my pressure can balance all over the place without meds, so I dont think parnate and dexedrine were the cause, though they may have contributed. Now when I get a migraine I have to stop taking dexedrine and add compazine or thorazine if my pressure starts to climb (which I used to take for migraines anyhow because they treat nausea, but they always dropped my pressure so I couldnt tolerate them too well). When I had the hypertensive/tachycardia episode I was only taking 5mg Parnate (10 makes me way too hypotensive) and 10mg dexedrine, and had been on a steady dose for over a week. I have been very good about the diet and monitoring my pressure, so I didnt really see it coming. Anyhow, I'm just glad I can stick with the meds.
Posted by Elizabeth on March 20, 1999, at 12:01:11
In reply to Re: Parnate & spontaneous hypertension, posted by alli on March 19, 1999, at 19:36:59
> I had a hypertensive episode that the ER said was due to Parnate (BP 170/100, HR 160) but I kind of doubt that Parnate was the cause. I normally have pretty low and orthostatic pressures without Parnate, and Parnate tends to put my standing systolic pressure in the 70s, even at 10mg. Because of this I was given dexedrine to raise my pressure and keep me awake. However, off all meds, when I get a migraine I sometimes get blood pressures around 154/90. I had a bad headache and low pressure for several days before I got the high pressure and heart rate. Apparently my pressure can balance all over the place without meds, so I dont think parnate and dexedrine were the cause, though they may have contributed. Now when I get a migraine I have to stop taking dexedrine and add compazine or thorazine if my pressure starts to climb (which I used to take for migraines anyhow because they treat nausea, but they always dropped my pressure so I couldnt tolerate them too well). When I had the hypertensive/tachycardia episode I was only taking 5mg Parnate (10 makes me way too hypotensive) and 10mg dexedrine, and had been on a steady dose for over a week. I have been very good about the diet and monitoring my pressure, so I didnt really see it coming. Anyhow, I'm just glad I can stick with the meds.
Alli - that's interesting, I didn't know that migraines could result from high blood pressure and respond to vasodilators. I was under the impression that it was usually the worse, the vasoconstrictors (caffeine, ergot alkaloids, triptans, beta blockers, etc.) are what helps with a migraine. Can you explain this? You've got me curious now. :-)
And how did you manage to halve Parnate?
Compazine, Thorazine, etc. are great meds for nausea. Glad to hear someone else is still using them.
-elizabeth
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