Psycho-Babble Medication Thread 3352

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Re: Annie - weight gain

Posted by Dwight on May 26, 1999, at 6:39:41

In reply to Re: Annie - weight gain, posted by Elizabeth on May 14, 1999, at 10:43:11

> Right, that's what I was curious about. It seems that some people who *gain* weight while depressed may lose weight on Nardil because it treats the depression.
>
> Also, of course, the "weight gain" side effect doesn't happen to everybody (though it's extremely common).

I've been taking Nardil off an on for several years. Most of you sound like you take for depression, but it also works very well for social anxiety. I have the same problem with weight gain. I'm thinking about trying this new drug Celexa or maybe Remeron. I can't imagine any drug causes as much weight gain as Nardil. I only wish something else worked as well on my social anxiety.

 

Nardil - Dwight

Posted by Elizabeth on May 27, 1999, at 4:46:24

In reply to Re: Annie - weight gain, posted by Dwight on May 26, 1999, at 6:39:41

> I've been taking Nardil off an on for several years. Most of you sound like you take for depression, but it also works very well for social anxiety. I have the same problem with weight gain. I'm thinking about trying this new drug Celexa or maybe Remeron. I can't imagine any drug causes as much weight gain as Nardil. I only wish something else worked as well on my social anxiety.

Hi Dwight. I take Parnate, but it doesn't seem to be as good for anxiety (in general, or social) as Nardil was. I wonder if Marplan - apparently this has become available in the U.S. again lately - would be a nice happy medium.

I have trouble imagining anything causing as much weight gain as Nardil either. :-}

 

Re: nardil - Elizabeth

Posted by Dwight on May 27, 1999, at 12:18:05

In reply to Nardil - Dwight, posted by Elizabeth on May 27, 1999, at 4:46:24

> > I've been taking Nardil off an on for several years. Most of you sound like you take for depression, but it also works very well for social anxiety. I have the same problem with weight gain. I'm thinking about trying this new drug Celexa or maybe Remeron. I can't imagine any drug causes as much weight gain as Nardil. I only wish something else worked as well on my social anxiety.
>
> Hi Dwight. I take Parnate, but it doesn't seem to be as good for anxiety (in general, or social) as Nardil was. I wonder if Marplan - apparently this has become available in the U.S. again lately - would be a nice happy medium.
>
> I have trouble imagining anything causing as much weight gain as Nardil either. :-}


--Thanks for the response, Elizabeth. I'll look into Marplan. I tried Parnate one time, but it seemed to make me more anxious. Sometimes I use the herb Kava Kava for anxiety - it works almost as well as the benzodiazapines, like Klonipan, but it doesn't make you spacey for forgetful. Ginseng is good for energy.

 

Re: MAOI Diet

Posted by Erin on May 28, 1999, at 2:10:00

In reply to Re: MAOI Diet, posted by Elizabeth on March 26, 1999, at 3:06:14

I'm starting MAOI Parnate on Monday and have heard that chicken is on the restricted list- is this true? Also, what are "aged" meat and cheeses (as opposed to "regular" meat and cheeses? Thanks, Erin

 

Re: MAOI Diet

Posted by dwight on May 28, 1999, at 3:01:12

In reply to Re: MAOI Diet, posted by Erin on May 28, 1999, at 2:10:00

> I'm starting MAOI Parnate on Monday and have heard that chicken is on the restricted list- is this true? Also, what are "aged" meat and cheeses (as opposed to "regular" meat and cheeses? Thanks, Erin


I've been taking high doses of Nardil (another MAOI) for a several years, and I have never had any problem with the diet. Chicken is absolutely fine. Red wine and many over-the-counter cold medications are the real dangers. Coffee, chocolate, fine. I have never had a problem with cheese.

 

Re: MAOI Diet

Posted by dwight on May 28, 1999, at 3:03:54

In reply to Re: MAOI Diet, posted by Erin on May 28, 1999, at 2:10:00

> I'm starting MAOI Parnate on Monday and have heard that chicken is on the restricted list- is this true? Also, what are "aged" meat and cheeses (as opposed to "regular" meat and cheeses? Thanks, Erin

Erin, aged meat and cheeses. Smoked salmon, for instance. Anything "smoked" probably isn't very good. Although I have never had a problem with cheddar cheese, e.g. pizza, you might want to be careful. Especially if you take the meds at the same time.

 

Re: MAOI Diet

Posted by Elizabeth on May 28, 1999, at 15:14:32

In reply to Re: MAOI Diet, posted by dwight on May 28, 1999, at 3:03:54

Actually there has never been a documented interaction with red wine, nor has any researcher ever found a significant amount of dangerous stuff (tyramine or related amines) in a red wine.

Most pizza doesn't have cheddar cheese - it's made with mozzarella, which is much milder.
Best to be careful when dealing with "gourmet" pizza, ask the waiter or consult the ingredients list.

Chicken, as long as it's been stored properly and hasn't been contaminated, is just fine. Maybe it was chicken *liver* that you were told not to eat - liver seems to be especially prone to bacterial contamination.

 

Re: MAOI Diet

Posted by Erin on May 28, 1999, at 17:34:44

In reply to Re: MAOI Diet, posted by dwight on May 28, 1999, at 3:03:54

Thanks Dwight and Elizabeth for your replies- Is all cheddar cheese off limits or is it just smoked cheddar cheese (I'm lactose intolerant so I don't eat cheese all that often but like to indulge on occasion? Also, I've seen beer listed on one of the many MAOI restricted diet lists I've read. I rarely drink but am wondering if you know more about this? Thanks again, Erin

 

Re: MAOI Diet - Erin

Posted by Elizabeth on May 29, 1999, at 0:29:25

In reply to Re: MAOI Diet, posted by Erin on May 28, 1999, at 17:34:44

There are some researchers - Kenneth Shulman and colleagues - at the U of Toronto who have been looking into the MAOI diet for about the last decade. They've found a lot of the restrictions to be unnecessary. Most recently, they did a study of (get this) pizza and found it to be safe. They've also looked at a number of different American and Canadian bottled beers.

Tap or draft beer may not be okay, however.

Cheddar cheese is one of the more aged cheeses, and you pretty much need to stay away from it. The less aged the cheese, the more you can eat, although you still should limit cheese consumption to small amounts (15g in a sitting).

Ricotta, cream, cottage, and American cheeses are all just fine - they're not aged. In general, the more aged a cheese is, the more dangerous it is likely to be.

 

Re: MAOI Diet

Posted by Gretchen on May 29, 1999, at 9:22:07

In reply to Re: nardil - Elizabeth, posted by Dwight on May 27, 1999, at 12:18:05

Help Please! This is a long post -- I apologize, but I am so scared.

I would never have even read MAOI diet posts before because I never had a problem with this aspect. I follow the diet rather strictly and always have -- anything is better than how I feel not on a MAOI (and I have tried full trials of over fifteen other anti-depressants.)

I have taken both Nardil and Parnate a number of times (side effects mainly having to do with my already low blood pressure and increases in the meds have necessitated "breaks".)

I started Parnate again after yet another "break" -- about two years of misery trying other anti-depressants. I feel a million times better emotionally and I can actually get myself to do things during the day. I plan things and complete them - a miracle.

Then suddenly -- in one month -- I have had two tyramine reactions to "safe" food. This has never happened in the probably four years (adding together the separate trials) that I have been on Parnate or Nardil.

Both times I had chicken that was cooked and ready to eat from a grocery store (two reputable chains.) _I can not understand it._

The pain of the reactions is so intense that I am ready to break down and give up MAOI's (and be suicidal) for the rest of my life. I also feel so guilty, like I don't deserve to take Parnate if I can't take it responsibly. I hate ER's and I have a horrible problem with doctors in general (childhood trauma stuff.) Having to go to the ER is a nightmare.

Neither reaction was "classic" and so it was hours the first time and one hour the second time before the ER doc broke down and treated the reaction like a tyramine problem. Once I was given anti-hypertensives, the pain magically dissolved, in both cases.

Parnate makes life bearable. I drink a lot of caffeine (6-8 dt. Mountain Dews a day)with the OK of my doctor because it acts as a pressor agent to increase my blood pressure and I don't have so many dizzy, tunnel vision to complete loss of vision, fainting spells.

Yes, the side effects are major. My psychiatrist doesn't really want me taking Parnate either to add to the problem. Luckily, I am married now and my husband can provide her with a very definite, to her a more objective opinion of how much Parnate helps me emotionally. In fact, that was the only reason I was able to keep taking it after the first reaction.

I feel terrible. It's like she thinks I did it on purpose or at least was horribly negligent. Both times though, Craig was with me and could vouch for exactly what I ate.

But I am ready to give up. I am scared -- chicken is supposed to be safe. I eat McDonalds Chicken McNuggets without a problem. I don't understand.

Sorry this is so long, but I guess these are my questions:

If anyone has had more than one trial on an MAOI, did you ever find that you suddenly became super-sensitive? All of my side-effects are worse and I am taking a relatively low dose for me (40mg vs. 50mg or 60mg at other times.)

I don't want to give grocery store ready-made chicken a bad name, but it is the only linking food. Has anyone ever heard of something that is in ready-to-eat supermarket chicken -- preservatives, etc???

Finally, the only other factor that is different this time, is instead of taking Ortho Cyclen birth control, I am trying the Depo Provera. One shot lasts three months, so it is in my system one more month like it or not. My regular doctor, concerned about my depression also and knowing some types of birth control cause depression more than others, was trying to help me out with that angle. Has anyone heard any type of caution regarding mixing these two meds?

Any advice would be appreciated. I dread telling my psychiatrist about last night's reaction. MAOI's are the _only_ meds that have ever, ever helped me.

Finally, to try and be a little helpful, I did read all of your posts. To share my experience, if you think Nardil causes weight gain and carbo cravings -- for me, Remeron was much worse. It has a 27% chance of weight gain and a greater incidence of carbo cravings. My Mom, who is a RN at a nursing home, says that they don't give Remeron to patients for depression, but to those who won't eat. **However, I have a history of eating disorders, so perhaps that made me more vulnerable to that particular side-effect. Also, I did not complete a three month trial, because I was binging so badly, the threat of full blown Bulimia episode became too dangerous.**

Everyone reacts differently though, if I have learned anything in the past eleven years it is that.

If anyone has read this far thank you for listening. I feel very alone and confused. Why is this happening with the only meds that work? WHY?


> > > I've been taking Nardil off an on for several years. Most of you sound like you take for depression, but it also works very well for social anxiety. I have the same problem with weight gain. I'm thinking about trying this new drug Celexa or maybe Remeron. I can't imagine any drug causes as much weight gain as Nardil. I only wish something else worked as well on my social anxiety.
> >
> > Hi Dwight. I take Parnate, but it doesn't seem to be as good for anxiety (in general, or social) as Nardil was. I wonder if Marplan - apparently this has become available in the U.S. again lately - would be a nice happy medium.
> >
> > I have trouble imagining anything causing as much weight gain as Nardil either. :-}
>
>
> --Thanks for the response, Elizabeth. I'll look into Marplan. I tried Parnate one time, but it seemed to make me more anxious. Sometimes I use the herb Kava Kava for anxiety - it works almost as well as the benzodiazapines, like Klonipan, but it doesn't make you spacey for forgetful. Ginseng is good for energy.

 

Re: MAOI Diet & hypertensive chicken

Posted by JD on May 29, 1999, at 10:47:18

In reply to Re: MAOI Diet , posted by Gretchen on May 29, 1999, at 9:22:07

Hi Gretchen,

I'm going to take a wild stab at a hypothesis here...I could be totally off base. Is it possible that the cooking procedures and especially the marinades used in making certain kinds of store-bought chicken cause sufficient changes to cause a tyramine reaction in some people (as with aged foods)? This comes to mind because I remember the brief health flare-up (bad pun, I know) last year about the effects of chargrilling food -- A couple studies found that such high-temperature grilling of foods including chicken could create low levels of some not-so-healthful chemcials (i.e., potential carcinogens), but were also surprised that meat that had been marinated in advance seemed to have a very different chemical "profile." If I remember correctly, both of these effects were attributed to the breakdown of certain proteins, so there's at least a *possible* connection.

Are there ever warnings in MAOI diets about marinated food? High-temperature grilled food? Just what kind of chicken was it that caused the problem in the first place? Whatever you end up deciding, I hope you can find a way to live with the hypertensive wiles of Parnate one way or another--though note the recent interest on this board over the reintroduction of Marplan too...

Best,
JD


 

Re: MAOI Diet

Posted by Elizabeth on May 29, 1999, at 11:31:59

In reply to Re: MAOI Diet , posted by Gretchen on May 29, 1999, at 9:22:07

Hi Gretchen.

With regard to the chicken, it doesn't really matter if it was cooked properly or not; it might have been contaminated (by bacteria that break down tyrosine into tyramine). I find myself wondering if the two portions originated from the same source and might have been "a bad batch" so to speak.

Had you eaten anything else either time?

How high was your blood pressure each of these times?

You might think about lowering the dose of Parnate for a while, or even switching to Marplan (which is probably less tyramine-potentiating than Parnate) or selegiline (which definitely is). The other thing is, you should definitely get your doctor to prescribe you a little bit of nifedipine, a fast-acting calcium channel blocker. (It comes in 10mg gelcaps, you bite them in half and then swallow to make them work faster.) There has been some controversy about this in the past but it seems that the only risk is if you have some kinds of preexisting heart disease.

Anyway I'm sorry to hear this is going on. I hope it gets better. For whatever it's worth, I was very sensitive to Parnate the first time I took it (had spontaneous htn, had to quit the drug) but adjusted to it, so it might just be that you need to readjust. Good luck.

 

biogenic amines in food

Posted by Elizabeth on May 29, 1999, at 11:42:29

In reply to Re: MAOI Diet & hypertensive chicken, posted by JD on May 29, 1999, at 10:47:18

JD,

That's an interesting idea. The amines that cause food-MAOI interactions are generally formed by the breakdown of proteins. (A few foods, like banana peels and broad bean pods, contain the amines even though they're not so high in protein. I don't know *what* the deal is with tap beer - probably has something to do with yeast.) I don't know if cooking things in particular ways would make this more likely - as I said, it's been known to happen with bacteria that come with aging and/or contamination.

I don't know anything about cooking! What are marinated foods generally marinated *in*?

 

Re: MAO diet / biogenic amines in food

Posted by JD on June 1, 1999, at 6:33:55

In reply to biogenic amines in food, posted by Elizabeth on May 29, 1999, at 11:42:29

Perhaps there could be something to my flame-broiling/marination MAOI-interaction theory--maybe I'll hunt around the periodical databases and see what I find on the "health scare" I mentioned. I'm pretty positive that the articles I saw this spring (in the LA Times--the land of healthy eating) mentioned that the concerns had to do with the behavior of proteins when cooking over intense open flame. Marination usually involves tenderizing and flavoring foods beforehand with acidic preparations (vinegar-, citrus-based, etc.)--I wouldn't be surprised if this actually involves some weird protein chemistry capable of leading to higher tyramine content too...But file under speculation for the time being!
--JD


> JD,
>
> That's an interesting idea. The amines that cause food-MAOI interactions are generally formed by the breakdown of proteins. (A few foods, like banana peels and broad bean pods, contain the amines even though they're not so high in protein. I don't know *what* the deal is with tap beer - probably has something to do with yeast.) I don't know if cooking things in particular ways would make this more likely - as I said, it's been known to happen with bacteria that come with aging and/or contamination.
>
> I don't know anything about cooking! What are marinated foods generally marinated *in*?

 

Re: MAO diet / biogenic amines in food

Posted by Annie on June 1, 1999, at 14:45:53

In reply to Re: MAO diet / biogenic amines in food, posted by JD on June 1, 1999, at 6:33:55

My Pdoc told me to avoid any agent or additive that causes protein to break down in foods. He specifically included meat tenderizers. Since one of the purposes of marinating meat is to tenderize it, marinade was out. Soy products(primarily soy sauce) and yeast were also on my "to be avoided list" , and they are very frequently ingredients in commercial marinades.
Annie

> Perhaps there could be something to my flame-broiling/marination MAOI-interaction theory--maybe I'll hunt around the periodical databases and see what I find on the "health scare" I mentioned. I'm pretty positive that the articles I saw this spring (in the LA Times--the land of healthy eating) mentioned that the concerns had to do with the behavior of proteins when cooking over intense open flame. Marination usually involves tenderizing and flavoring foods beforehand with acidic preparations (vinegar-, citrus-based, etc.)--I wouldn't be surprised if this actually involves some weird protein chemistry capable of leading to higher tyramine content too...But file under speculation for the time being!
> --JD
>
>
> > JD,
> >
> > That's an interesting idea. The amines that cause food-MAOI interactions are generally formed by the breakdown of proteins. (A few foods, like banana peels and broad bean pods, contain the amines even though they're not so high in protein. I don't know *what* the deal is with tap beer - probably has something to do with yeast.) I don't know if cooking things in particular ways would make this more likely - as I said, it's been known to happen with bacteria that come with aging and/or contamination.
> >
> > I don't know anything about cooking! What are marinated foods generally marinated *in*?

 

Re: MAO diet / biogenic amines in food

Posted by JD on June 3, 1999, at 5:47:49

In reply to Re: MAO diet / biogenic amines in food, posted by Annie on June 1, 1999, at 14:45:53

Well, there's some confirmation of what I naively thought was just my own weird idea--never having dealt up-close with an MAOI diet, I wasn't aware that marination was already recognized as potentially causing tyramine problems. Is this something commonly told to people on MAOIs? I had almost mentioned meat tenderizers in my post too, since--as you say--their basic *job* is to break down proteins... All very interesting, but hopefully not too confusing for people trying to follow a reasonably safe MAOI diet! I wonder if this helps to solve the riddle of the hypertensive chicken?
--JD

> My Pdoc told me to avoid any agent or additive that causes protein to break down in foods. He specifically included meat tenderizers. Since one of the purposes of marinating meat is to tenderize it, marinade was out. Soy products(primarily soy sauce) and yeast were also on my "to be avoided list" , and they are very frequently ingredients in commercial marinades.
> Annie
>
> > Perhaps there could be something to my flame-broiling/marination MAOI-interaction theory--maybe I'll hunt around the periodical databases and see what I find on the "health scare" I mentioned. I'm pretty positive that the articles I saw this spring (in the LA Times--the land of healthy eating) mentioned that the concerns had to do with the behavior of proteins when cooking over intense open flame. Marination usually involves tenderizing and flavoring foods beforehand with acidic preparations (vinegar-, citrus-based, etc.)--I wouldn't be surprised if this actually involves some weird protein chemistry capable of leading to higher tyramine content too...But file under speculation for the time being!
> > --JD
> >
> >
> > > JD,
> > >
> > > That's an interesting idea. The amines that cause food-MAOI interactions are generally formed by the breakdown of proteins. (A few foods, like banana peels and broad bean pods, contain the amines even though they're not so high in protein. I don't know *what* the deal is with tap beer - probably has something to do with yeast.) I don't know if cooking things in particular ways would make this more likely - as I said, it's been known to happen with bacteria that come with aging and/or contamination.
> > >
> > > I don't know anything about cooking! What are marinated foods generally marinated *in*?

 

Re: MAOIs & hypertensive chicken

Posted by JD on June 3, 1999, at 10:25:11

In reply to Re: MAO diet / biogenic amines in food, posted by JD on June 3, 1999, at 5:47:49

The possible reasons for a reaction to store-bought chicken get even simpler... Check out the comprehensive (and not always conclusive!) info under the "MAOI Diet" link listed on the main page of Dr. Bob's "Tips" One MD writes:

>>> The hardest thing to get patients to understand is that any protein containing food if refrigerated poorly or too long becomes dangerous. I specifically warn people about open cans of tuna or salmon and about left-over poultry.

 

Re: MAOIs & hypertensive chicken

Posted by Gretchen on June 3, 1999, at 23:08:10

In reply to Re: MAOIs & hypertensive chicken, posted by JD on June 3, 1999, at 10:25:11

Sorry it has taken me so long to reply. I haven't been on the computer for a while.

Your ideas are great! I really appreciate all of the information and support.

I had never heard anything about being careful regarding things cooked at very high temperatures, but it will be something I can keep in mind.

I guess I wasn't considering protein breakdown on a wide enough scale. For instance, I have marinated things before, but I have checked to make sure the marinade only had "safe" foods in it (I considered fruit based marinades OK.) I didn't think to consider this a meat tenderizing method, but that makes perfect sense.

I had considered the possiblity that both times the chicken was badly refrigerated or in some way contaminated, but it seemed like too much of a coincidence. I have never heard one needed to be especially careful with chicken.

Since I never had problems with the MAOI diet before and I have a problem with low blood pressure, I have never carried anything to help in case of a tyramine reaction. I will talk to my doctor (who thankfully is letting me continue taking Parnate even after I told her about the second incident) about carrying nifedipine. I know that would make my husband feel better.

Thanks so much for all this information. I might be able to eat something besides bagels and milk again finally! I have been too scared to eat anything else -- intense pain, having to go to the ER and the possibility of the MAO being taken away -- quite the aversive stimulus.


> The possible reasons for a reaction to store-bought chicken get even simpler... Check out the comprehensive (and not always conclusive!) info under the "MAOI Diet" link listed on the main page of Dr. Bob's "Tips" One MD writes:
>
> >>> The hardest thing to get patients to understand is that any protein containing food if refrigerated poorly or too long becomes dangerous. I specifically warn people about open cans of tuna or salmon and about left-over poultry.

 

Parnate and insomnia

Posted by Carlene on June 9, 1999, at 7:48:24

In reply to Re: MAOIs & hypertensive chicken, posted by Gretchen on June 3, 1999, at 23:08:10

A couple of people have mentioned some trouble with insomnia on parnate. I'm finding it difficult to fall asleep--mind racing for at least an hour every night--which isn't characteristic of me. When I'm not on parnate and depressed, I'm sometimes an early morning insomniac (wake at 3:30 or 4 and can't go back to sleep) but being unable to sleep for sometimes two or three hours is very unusual for me. Any other experience with this? Anything that helps?

 

Re: Parnate and insomnia

Posted by Judy on June 9, 1999, at 18:46:27

In reply to Parnate and insomnia, posted by Carlene on June 9, 1999, at 7:48:24

Carlene,

I take Nardil (another MAOI) and am also too hyper to fall asleep at night. My doctor prescribed 1 mg Xanax which I take about a half hour before I'm ready to go to bed, and I go out like a light! Since Xanax is a fast-in/fast-out drug, I have no problem with grogginess in the morning. It's been a great help.

How long have you been taking Parnate? I've taken Nardil before, and I found that after awhile I didn't need medicinal help to fall asleep, though I can't promise that will happen for you (or for me this time - it's always a wait-and-see.)

Good luck...I know how awful it is to be awake at night when the rest of the world is asleep.

Judy

 

Re: Parnate and insomnia

Posted by Gretchen on June 10, 1999, at 2:20:01

In reply to Parnate and insomnia, posted by Carlene on June 9, 1999, at 7:48:24

When I re-started Parnate this time (third trial,) my sleep did get considerably worse for about the first two months. However, it is now better than it has been in a very long time because I am actually _doing_ things during the day.

I take klonipin (2mg) at night when I am having a really hard time getting to sleep.

Are you taking the Parnate early in the day? For instance, the second dose (if you take two,) at least six hours before bed time?

(I have been getting a really strong anxiety reaction consistently about two to three hours after I take my meds. It can last up to three hours. (It feels like a panic attack, but there is no focus to it because I know it's the meds -- weird.) In any case, perhaps you are having a variation of the same type of side-effect? That is the time line basis for the "six hours" which was suggested above.)

Hope things get better for you,
Gretchen

> A couple of people have mentioned some trouble with insomnia on parnate. I'm finding it difficult to fall asleep--mind racing for at least an hour every night--which isn't characteristic of me. When I'm not on parnate and depressed, I'm sometimes an early morning insomniac (wake at 3:30 or 4 and can't go back to sleep) but being unable to sleep for sometimes two or three hours is very unusual for me. Any other experience with this? Anything that helps?

 

Re: Parnate and insomnia

Posted by Carlene on June 11, 1999, at 22:56:00

In reply to Re: Parnate and insomnia, posted by Gretchen on June 10, 1999, at 2:20:01

Thanks to both Gretchen and Judy for the encouragement! I found the information about controlling dosage before bedtime on another page and realized that shortly before I'd begun having the sleep problems, my job had become so busy that I'd been taking my 2 p.m. dose at 6 p.m. So that was exactly the problem. By the next day, I was back to myself again -- what a relief. I'm on a 3x/day schedule, so I had been taking my meds at 6 a.m., 2 p.m., and 10 p.m., which had worked fine for me (no insomnia related to the last daily dose). Now, to control the 2 p.m. slippage I'm doing them 3x/day at mealtimes, which are pretty well defined for me.

Again, thank you both for the encouragement. May God strengthen you, too, as you continue learning to walk with this challenge.

> When I re-started Parnate this time (third trial,) my sleep did get considerably worse for about the first two months. However, it is now better than it has been in a very long time because I am actually _doing_ things during the day.
>
> I take klonipin (2mg) at night when I am having a really hard time getting to sleep.
>
> Are you taking the Parnate early in the day? For instance, the second dose (if you take two,) at least six hours before bed time?
>
> (I have been getting a really strong anxiety reaction consistently about two to three hours after I take my meds. It can last up to three hours. (It feels like a panic attack, but there is no focus to it because I know it's the meds -- weird.) In any case, perhaps you are having a variation of the same type of side-effect? That is the time line basis for the "six hours" which was suggested above.)
>
> Hope things get better for you,
> Gretchen
>
>
>
>
> > A couple of people have mentioned some trouble with insomnia on parnate. I'm finding it difficult to fall asleep--mind racing for at least an hour every night--which isn't characteristic of me. When I'm not on parnate and depressed, I'm sometimes an early morning insomniac (wake at 3:30 or 4 and can't go back to sleep) but being unable to sleep for sometimes two or three hours is very unusual for me. Any other experience with this? Anything that helps?

 

Re: MAOI Diet

Posted by Jubee on June 24, 1999, at 8:36:01

In reply to Re: MAOI Diet, posted by Dr. Bob on March 24, 1999, at 22:10:14

> > I hope everyone is aware that many of the "MAOI diets" that are floating around are overly restrictive - that is, they list as "restricted" foods that are just fine.
>
> But remember that what's "just fine" for one person could be a real problem for someone else...
>
> Bob

Bob, where can a more realistic diet listing be found? Also, I take a daily dose of 30mg Nardil, 40-60mg methylphenidate, 150mg Lamictal, .125mg Synthroid, 1mg Estrace. Do I need to be even more careful than someone on a MAOI alone. This combo is the first to really work for me after years of trying everything on the market.

 

Re: MAOI Diet

Posted by Elizabeth on June 24, 1999, at 10:49:08

In reply to Re: MAOI Diet, posted by Jubee on June 24, 1999, at 8:36:01

Hi there. I only restrict foods on two bases:
(1) reliably measured tyramine (or other amine that has been shown to be dangerous, e.g. dopamine) levels;
(2) well-documented case reports.

Most of the recent research has come from a group at the U of Toronto. Here are some relevant references.

Folks DG. Monoamine oxidase inhibitors: reappraisal of dietary considerations. J Clin Psychopharmacol. 1983 Aug;3(4):249-52.

Sullivan EA, Shulman KI. Diet and monoamine oxidase inhibitors: a re-examination. Can J Psychiatry. 1984 Dec;29(8):707-11.

Cooper AJ. Tyramine and irreversible monoamine oxidase inhibitors in clinical practice. Br J Psychiatry Suppl. 1989 Oct;(6):38-45.

Shulman KI, et al. Dietary restriction, tyramine, and the use of monoamine oxidase inhibitors. J Clin Psychopharmacol. 1989 Dec;9(6):397-402.

Da Prada M, Zurcher G. Tyramine content of preserved and fermented foods or condiments of Far Eastern cuisine. Psychopharmacology (Berl). 1992;106 Suppl:S32-4.

Gardner DM, et al. The making of a user friendly MAOI diet. J Clin Psychiatry. 1996 Mar;57(3):99-104.

Walker SE, et al. Tyramine content of previously restricted foods in monoamine oxidase inhibitor diets. J Clin Psychopharmacol. 1996 Oct;16(5):383-8.

Shulman KI, et al. Tap (draft) beer and monoamine oxidase inhibitor dietary restrictions. Can J Psychiatry. 1997 Apr;42(3):310-2.

Shulman KI, Walker SE. Refining the MAOI diet: tyramine content of pizzas and soy products.
J Clin Psychiatry. 1999 Mar;60(3):191-3.

(If you do decide to take a look at these, read the whole article, not just the abstract. Some of them even have lists of measured tyramine content of various foods.)

I think that you may need to be a little extra careful because of the Ritalin, but you are also on a very low dose of Nardil. So, it's hard to say. In my mind, everybody should be careful, of course!

 

Re: Annie - weight gain

Posted by Rick on June 27, 1999, at 13:31:40

In reply to Re: Annie - weight gain, posted by Annie on May 12, 1999, at 14:40:11

> > > Having been on just about every AD and gaining weight on most of them, I find it interesting that I lost 45 pounds on Nardil! My appetite totally disappeared. I became obsessive about losing weight. Interesting fact, if I ate more than 600 calories a day, I would gain weight. So possibly the obsessiveness caused by the drug counteracted its weight gain potential.
> >
> > I take it that you were using it for depression, so this makes me wonder: what kind of appetite changes, if any, did you have associated with the depression?
> >
> > (I've heard of people losing weight on Nardil who been gaining weight while depressed.)
>
> I am not certain I understand your question. Yes, I am diagnosed with uni-polar depression. I have not presented any obssessive behavior prior to or subsequent to my use of Nardil(my fifth drug trial). I did experience some increase in appetite and signicant weight gain with the onset of depression and prior to any drug treatment. If I had eaten my pre-depression healthy diet while on Nardil, I still would have gained weight. The effect of the drug on my depression was not dramatic.

--------
I've been taking Nardil for two months for social phobia. I do not have depression or other mental illnesses (that I know of, anyways). Having heard the weight gain horror stories, I was quite concerned, because for health reasons I was embarking on my first diet in 30 years concurrently with starting the medication! To my pleasant surprise, I've been consistently dropping 1-3 pounds a week, and it has actually been *easier* than I expected (I eat a lot healthier during the week, but still indulge my appetite with pretty much whatever I want on weekends).

Unfortunately, some of Nardil's other side effects hit me big-time! For example, I was mild-to-moderately hypertensive before starting Nardil, and remained that way after 4-5 weeks on the drug. But then, as dosage reached 75mg the hypotensive effect hit like a bolt, and my blood pressure became way too LOW most of the time (70/50 is common...I use to be more like 145/93). Postural hypotension and dizziness got so bad that I fell down 3 times, once in public, and had several episodes of staggering as if I were stone drunk (actually kind of fun in a weird way). Constipation, inorgasmia (sp?), dry mouth, tinnitus, and twitching have also been problems. But worst of all, the Nardil, which had been showing great promise after about two weeks, just pooped out for me a couple weeks ago. I've been off it for five days, and the side effects are slowly abating, but this former hypertensive is still getting readings of 70/50 - 100/70 (amazing...there sure aren't any blood pressure meds that work that well!).

Does anyone know if another MAO has the potential to help with Social Phobia after "gold standard" Nardil failed (after a promising start)? Or how about Klonopin?


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