Psycho-Babble Medication Thread 75408

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Re: hypertensive experiences? ayrity

Posted by SLS on July 25, 2002, at 7:22:38

In reply to Re: hypertensive experiences?, posted by ayrity on July 17, 2002, at 23:55:30

Hi Ayrity.

> I have atypical depression and extreme fatigue is the prominent symptom- since Parnate has a stimulant effect we went with that first. My doc prefers Marplan (fewer side effects, though knowing me...) instead of Parnate if the stimulant effect is not required, or as second choice if the Parnate doesn't work out.

I am very interested to know why your doctor would choose Marplan over Nardil. Marplan is most definitely more mild in terms of side effects. However, the "old-timers" characterized Marplan as being a "weaker Nardil". It's non-usage probably led to the drug company to discontinue it years ago. However, there are a significant number of people who respond well to Marplan whom failed to respond to both Nardil and Parnate. I think the drug company was convince to begin selling Marplan again after they received so many requests that it be made available under a "compassionate use" protocol.

Terrence Ketter, MD at Stanford has recommended to a friend of mine that he also prefers Marplan, although I don't know all of his reasons why.

Since Nardil has been so much help to me, I would most definitely want to know why your doctor chose Marplan for you. With Nardil, the most troublesome startup side effect has been severe orthostatic hypotension. I had to literally crawl on all-fours to and from the bathroom and crawl down the stairs backwards. Surely, Nardil is not known to produce episodes of spontaneous hypertension as does Parnate. However, Marplan is probably much less offensive in this regard.

Does your doctor feel that Marplan is as efficacious as Parnate and Nardil?. How does he characterize the advantages of Marplan regarding side effects? Perhaps Marplan has been underestimated in the past such that it can now be justified as a first choice among MAOIs.

I'll say a little prayer on your behalf.

Good luck.


Sincerely,
Scott

 

To SLS

Posted by judy1 on July 25, 2002, at 11:09:35

In reply to Re: hypertensive experiences? ayrity, posted by SLS on July 25, 2002, at 7:22:38

This has nothing to do with this thread, I just wanted your attention :-). I have a thread on Psycho-Psycho Babble (my symptoms on manic psychosis) where I mention your offer to e-mail you when I was getting manic. If you remember any of that, would you mind contributing? Thanks a lot! Now back to regular programming.... Take care, judy

 

Re: hypertensive experiences? SLS SLS

Posted by jsarirose on July 25, 2002, at 13:46:50

In reply to Re: hypertensive experiences? ayrity, posted by SLS on July 25, 2002, at 7:22:38

"Surely, Nardil is not known to produce episodes of spontaneous hypertension as does Parnate. "

Did you mean to say 'not known to' ? I'm not questioning you at all, I just wasn't aware that this difference existed. I thought people on Nardil had to adhere to the same diet restrictions as those on Parnate and that the same risks were involved. How interesting.

-Jessica

 

Re: hypertensive experiences? ayrity

Posted by LLL on July 25, 2002, at 13:50:19

In reply to Re: hypertensive experiences? ayrity, posted by SLS on July 25, 2002, at 7:22:38

I'm unaware of Parnate causing "spontaneous increases in hypertentsion" without diet/drug violations. Can you please provide the source of your information?
Thanks

 

Re: hypertensive experiences? SLS SLS

Posted by cybercafe on July 26, 2002, at 0:15:21

In reply to Re: hypertensive experiences? SLS SLS, posted by jsarirose on July 25, 2002, at 13:46:50


> Did you mean to say 'not known to' ? I'm not questioning you at all, I just wasn't aware that this difference existed. I thought people on Nardil had to adhere to the same diet restrictions as those on Parnate and that the same risks were involved. How interesting.

i believe some people commented that parnate can react with it's own stimulant-type metabolites to cause a spontaneous hypertensive crisis? though i imagine this must be quite rare

 

Refining the MAOI Diet

Posted by cybercafe on July 26, 2002, at 0:21:14

In reply to Re: hypertensive experiences? ayrity, posted by LLL on July 25, 2002, at 13:50:19


well i went down to sunnybrook today and picked up a copy of "tyramine content of pizzas and soy products" ... it does list the tyramine content of 5 different soy sauces, which isn't too bad...

jess: which soy sauces have you tried in the past? ... and were they fresh, or restaurantish?

i am wondering if the "tyramine content in chinese food", Wing Y-K, Chen C-N, journal clinical psychopharmacology 1997, might have yet even more information, but i can't seem to find a copy online .........

.... it would be nice if someday soon, like everyone else, i were to educate myself in matters that actually helped to generate money :)

 

Re: Refining the MAOI Diet

Posted by jsarirose on July 26, 2002, at 1:41:09

In reply to Refining the MAOI Diet, posted by cybercafe on July 26, 2002, at 0:21:14

>
> jess: which soy sauces have you tried in the past? ... and were they fresh, or restaurantish?
>
> i am wondering if the "tyramine content in chinese food", Wing Y-K, Chen C-N, journal clinical psychopharmacology 1997, might have yet even more information, but i can't seem to find a copy online .........

I've had different types of soy sauce, from the ones in restaurants to store bought (cheap & expensive like Tamari). Haven't had a problem with any. In a restaurant if I'm eating something that has soy sauce in it I don't tend to add more - but that's more of a taste preference than being worried about tyramine.

Was there a big difference in the five soy sauces tested?

I also don't know if there could ever be a difinitive listing of tyramine content in chinese food. Restaurants vary so much as to the way they make similar dishes.

-Jessica

 

Re: Refining the MAOI Diet

Posted by LLL on July 26, 2002, at 9:04:34

In reply to Refining the MAOI Diet, posted by cybercafe on July 26, 2002, at 0:21:14

In the literature you picked up does it say anything about soy protein - like in soy burgers?

 

Re: Refining the MAOI Diet

Posted by cybercafe on July 26, 2002, at 10:43:36

In reply to Re: Refining the MAOI Diet, posted by jsarirose on July 26, 2002, at 1:41:09

>with any. In a restaurant if I'm eating something that has soy sauce in it I don't tend to add more - but that's more of a taste

oh wow i didn't know that you ate food with soy sauce already in it, .... sounds risky ... :(

... one tbsp (15mL) had results as follows
wing's 0.1483 mg tyramine
kimlan 0.5496 mg
ozeki sashimi 1.2488
pearl river bridge 3.3652
kikkoman 0.4351

so as you can see there is a lot of variability... they in fact state "We conclude that all soy sauces and indeed all soybean products should be avoided".

.... but i feel that if you can get away with 15 mL on 100 mg, i should be able to on 30 mg :)

> Was there a big difference in the five soy sauces tested?

> I also don't know if there could ever be a difinitive listing of tyramine content in chinese food. Restaurants vary so much as to the way they make similar dishes.

.... yeah... at least if you are going to risk it, you have some guidance as to which to try and which to avoid....
i mean when one brand has about 30 times the content of another, it may be quite useful to be discriminating by brand...
i'm quite happy that kikkoman is one of the better brands....

it's also interesting that different things age at a different rate in terms of tyramine production... but i'll save that for the next message

btw how are you doing jess?

>
> -Jessica

 

Re: Refining the MAOI Diet

Posted by cybercafe on July 26, 2002, at 10:50:45

In reply to Re: Refining the MAOI Diet, posted by LLL on July 26, 2002, at 9:04:34

> In the literature you picked up does it say anything about soy protein - like in soy burgers?

"vita tofu" 300 g goes from 0.2268 mg to 4.7914 mg of tyramine if stored 7 days in refrigerator (4 degrees C)...

one veggie burger after 7 days in the fridge
100 g had 0.0628 mg of tyramine, 2 days later, the level went up to 0.5983 mg of tyramine ...
so i take it freshness is quite important ...
... basically today you could eat two burgers and have no effect, the next day you could eat half of a burger and really have a lot of trouble


but they only seemed to have tested one type that i can tell.... so if i were to risk it, i would probably stick to one brand, and at first start out by eating one bite every hour or so and taking my blood pressure.... or does tyramine show an effect on bp faster than that?
then again, how relevent is it how long it has been stored in the grocery store? ....

have you guys heard anything about soy burgers?

 

Re: Refining the MAOI Diet

Posted by jsarirose on July 26, 2002, at 14:22:31

In reply to Re: Refining the MAOI Diet, posted by cybercafe on July 26, 2002, at 10:50:45

>
> have you guys heard anything about soy burgers?

Keep in mind that soy is not inherently bad, it's some forms of soy. Anything aged (soy sauce, tempeh, ...) is either not allowed or allowed in moderation (depending on item). So if you read the ingredients and it's simply soy or soy bean, etc. and it's not aged - it should be just fine. I eat a lot of soy products as I'm increasingly eating vegetarian and I've had no problems. If I'm unsure, I don't buy it and/or try to find out whether it's aged.

-Jessica

 

Re: hypertensive experiences? jsarirose

Posted by SLS on July 26, 2002, at 14:23:48

In reply to Re: hypertensive experiences? SLS SLS, posted by jsarirose on July 25, 2002, at 13:46:50

> > Surely, Nardil is not known to produce episodes of spontaneous hypertension as does Parnate. "

> Did you mean to say 'not known to' ? I'm not questioning you at all, I just wasn't aware that this difference existed. I thought people on Nardil had to adhere to the same diet restrictions as those on Parnate and that the same risks were involved. How interesting.


Hi Jessica.

First of all, it would be very silly of you not to question me. :-)

It is true that I have never been wrong, though. One time I thought I was wrong, but it turned out that I was mistaken.

There's a joke in there somewhere.

I'm glad you replied the way you did. Others may have also misinterpreted what I said, which of course is dangerous. I wish that I had the good sense to better clarify my statement.

The key word in my post is "spontaneous". For some people, Parnate can cause high blood pressure spikes all by itself. They don't have eat anything for this to happen. It is thus spontaneous. This is what was being referred to in the post I replied to. To the best of my recollection, I have never seen this happen at all with Nardil.

Of course, both of these MAOIs, along with Marplan, are capable of producing a dangerous hypertensive reaction to the foods and drugs that are to be avoided.

Is my post still confusing?


- Scott


 

Re: hypertensive experiences?

Posted by jsarirose on July 26, 2002, at 14:44:48

In reply to Re: hypertensive experiences? jsarirose, posted by SLS on July 26, 2002, at 14:23:48

> > > Surely, Nardil is not known to produce episodes of spontaneous hypertension as does Parnate. "
>
> > Did you mean to say 'not known to' ? I'm not questioning you at all, I just wasn't aware that this difference existed. I thought people on Nardil had to adhere to the same diet restrictions as those on Parnate and that the same risks were involved. How interesting.
>
>
> Hi Jessica.
>
> First of all, it would be very silly of you not to question me. :-)
>
> It is true that I have never been wrong, though. One time I thought I was wrong, but it turned out that I was mistaken.
>
> There's a joke in there somewhere.
>
> I'm glad you replied the way you did. Others may have also misinterpreted what I said, which of course is dangerous. I wish that I had the good sense to better clarify my statement.
>
> The key word in my post is "spontaneous". For some people, Parnate can cause high blood pressure spikes all by itself. They don't have eat anything for this to happen. It is thus spontaneous. This is what was being referred to in the post I replied to. To the best of my recollection, I have never seen this happen at all with Nardil.
>
> Of course, both of these MAOIs, along with Marplan, are capable of producing a dangerous hypertensive reaction to the foods and drugs that are to be avoided.
>
> Is my post still confusing?
>
>
> - Scott
>
>
Got it! Thanks for the clarification. I guess I wasn't as familiar with that side effect as I the danger of BP dipping too low.

-Jessica

 

Re: hypertensive experiences? LLL

Posted by SLS on July 26, 2002, at 15:06:21

In reply to Re: hypertensive experiences? ayrity, posted by LLL on July 25, 2002, at 13:50:19

Hi there LLL.

Here are a couple of sources.

:-)

I guess these are the most local source:

http://www.dr-bob.org/tips/split/Spontaneous-hypertensive-r.html

http://www.dr-bob.org/babble/19990301/msgs/3436.html


--------------------------------------------


http://www.mhinfosource.com/expert/exp1061900c.html

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2486182&dopt=Abstract

--------------------------------------------


- Scott

 

Re: To SLS judy1

Posted by SLS on July 26, 2002, at 15:18:48

In reply to To SLS, posted by judy1 on July 25, 2002, at 11:09:35

> This has nothing to do with this thread, I just wanted your attention :-). I have a thread on Psycho-Psycho Babble (my symptoms on manic psychosis) where I mention your offer to e-mail you when I was getting manic. If you remember any of that, would you mind contributing? Thanks a lot! Now back to regular programming.... Take care, judy


Hi Judy.

If I am reading between the lines properly, you are asking for my email address. Dear Judy, you are invited to write to me whenever.

The only thing I ask is that you don't share my email address with anyone else. I would hate to have it posted in a public forum for all to see!

;-)

sl.schofield@att.net


- Scott

 

Re: hypertensive experiences? SLS

Posted by LLL on July 26, 2002, at 15:37:50

In reply to Re: hypertensive experiences? LLL, posted by SLS on July 26, 2002, at 15:06:21

Thank you Scott, that was very informative. However, since my pulse (not b/p) is now the issue and elevated on the Parnate (117 this a.m. an hour after the first dose!), I'm afraid that my only hope is now lost! I guess I could try the Nardil again, but I recall the constant carbohydrate craving and weight gain, daytime narcolepsy attacks, anorgasmia etc. ARGGGGHHHHHHHHHH!
I don't understand why it doesn't agree with me now - it worked before and It got to where I didn't feel like I was anything!

 

Re: hypertensive experiences?

Posted by jsarirose on July 26, 2002, at 21:04:33

In reply to Re: hypertensive experiences? SLS, posted by LLL on July 26, 2002, at 15:37:50


> I don't understand why it doesn't agree with me now - it worked before and It got to where I didn't feel like I was anything!

Sorry to jump in here, but how much are you taking and do you split up the dose? I find I handle the Parnate the best when I take it three times a day. I try not to take it close to bed time so I take the first dose when I get up, the second dose around 3 hours later and the third dose three hours after that. It sounds hard, but it isn't really if you just carry a little pill box around with you. Also, except for the first dose, the other two could vary an hour or so with no ill effects. Only if I forgot the first dose and took it an hour or more late did I experience dizziness and fatigue. I'm taking 70mg now but was up to 100mg and this allowed me to handle it without getting too dizzy.

Just a thought.

-Jessica

 

Re: hypertensive experiences? jsarirose

Posted by LLL on July 26, 2002, at 21:14:33

In reply to Re: hypertensive experiences?, posted by jsarirose on July 26, 2002, at 21:04:33

I've just started and haven't gotten beyond one 10mg in the a.m and 5mg (yes, I cut that little buger in half) by 3:00 pm! This tacychardia occurs after my intial morning dose. My goal was to slowly increase to 50mg.s, however my heart will explode first! I skipped the afternoon dose today and do not plan to continue. I have an appt. with a new doc early next week. I'm very disheartened because this was so helpful in the past and now I'm sunk! I guess I could go back on Nardil, but I recall so many side effects and who knows, maybe I'll have the same reaction!
Any luck out there for panic disorder/agoraphobia with Selegilene or the reversible MAOI's?
My choice of drugs I can use are getting smaller and smaller and I'm getting more desperate!

 

Re: hypertensive experiences?

Posted by jsarirose on July 26, 2002, at 21:28:55

In reply to Re: hypertensive experiences? jsarirose, posted by LLL on July 26, 2002, at 21:14:33

> Any luck out there for panic disorder/agoraphobia with Selegilene or the reversible MAOI's?

Wow - that's an amazing reaction. I guess I didn't have that at all. I ramped up to 60mg pretty quickly.

Unfortunately that's the only MAOI I've tried and never tried Selegilene. (Gee, and I thought I'd tried EVERYTHING!)

Sorry I can't be more of a help.
Good luck,
Jessica

 

Re: hypertensive experiences?

Posted by ayrity on July 26, 2002, at 23:06:13

In reply to Re: hypertensive experiences? ayrity, posted by LLL on July 25, 2002, at 13:50:19

> I'm unaware of Parnate causing "spontaneous increases in hypertentsion" without diet/drug violations. Can you please provide the source of your information?
> Thanks

There are quite a few articles in the medical literature describing spontaneous hypertensive reactions on parnate; this doesn't seem to occur (or not as often) with other MAOI. I don't have access to it right now, but a medline search will bring up those articles (you might want to try PubMed- you can probably find a link by searching Google).

 

Re: hypertensive experiences?

Posted by ayrity on July 26, 2002, at 23:14:20

In reply to Re: hypertensive experiences? SLS SLS, posted by cybercafe on July 26, 2002, at 0:15:21

> i believe some people commented that parnate >can react with it's own stimulant-type metabolites to cause a spontaneous hypertensive crisis? though i imagine this must be quite rare
>

Yes, this is quite rare- lucky me! As I've written before, I seem to get all the side effects of meds and little benefit.

Update- I'm still on the Parnate 30 daily- instead of taking 20 mg in the AM/10 in the PM I'm spreading the dose evenly throughout the day. My blood pressure *still* spikes after each dose, but not quite as high before and I might be adapting to it. We're giving it another few weeks; if no change then off with the Parnate. Since 30 mg doesn't seem to do much for my mood and energy (in fact I feel worse, more withdrawn, irritable and tired), there's no sense in continuing it if we can't up the dose without causing more BP problems.

In answer to someone's previous question, yes my doc's MAOI of choice is Marplan- he feels it's equally effective and has fewer side effects, though he does prescribe Nardil as well (I guess it depends on the case; knowing all the bad side effects I'm prone to, maybe he feels Marplan is a better choice).

 

Re: Refining the MAOI Diet/ Chinese Restaurants

Posted by KellyM on July 27, 2002, at 8:41:30

In reply to Re: Refining the MAOI Diet, posted by jsarirose on July 26, 2002, at 1:41:09

> >
> > jess: which soy sauces have you tried in the past? ... and were they fresh, or restaurantish?
> >
> > i am wondering if the "tyramine content in chinese food", Wing Y-K, Chen C-N, journal clinical psychopharmacology 1997, might have yet even more information, but i can't seem to find a copy online .........
>
> I've had different types of soy sauce, from the ones in restaurants to store bought (cheap & expensive like Tamari). Haven't had a problem with any. In a restaurant if I'm eating something that has soy sauce in it I don't tend to add more - but that's more of a taste preference than being worried about tyramine.
>
> Was there a big difference in the five soy sauces tested?
>
> I also don't know if there could ever be a difinitive listing of tyramine content in chinese food. Restaurants vary so much as to the way they make similar dishes.
>
> -Jessica

There are a couple of chinese restaurants that I have gone to with no problems. I am pretty adamant about telling them to use less sauce when preparing the dish. The food has just a slight "glistening" on it. Of course I add no extra soy sauce to it. I don't want to give anyone the impression that this would always be safe for everyone- just my experience. I might add that I'm taking 60mg Nardil, so it's not an extra high dose.

I don't notice a great deal of taste difference either. I suppose you could also add non soy based sauces also (I like chile sauce :)}

Kelly

 

hypertensive experiences - prevention?

Posted by cybercafe on July 29, 2002, at 20:57:14

In reply to Re: hypertensive experiences?, posted by ayrity on July 26, 2002, at 23:14:20


just wondering, have any of you guys ever been eating and noticed a hypertensive crisis starting before you finished eating.. and were able to stop your meal and only get a partial migraine??

 

Re: Refining the MAOI Diet-st johns wort

Posted by felipe on July 29, 2002, at 23:35:29

In reply to Re: Refining the MAOI Diet, posted by cybercafe on July 26, 2002, at 10:50:45

does anybody know if these restrictions also apply to st john's wort,since it is supposed to be a weak maoi?im about to start taking sjw but if all this can interact i wont.however i havent read anywhere that certain foods should be avoided while taking it.if anyone knows something about this please tell me.

 

Re: Refining the MAOI Diet-st johns wort

Posted by cybercafe on July 30, 2002, at 6:45:56

In reply to Re: Refining the MAOI Diet-st johns wort, posted by felipe on July 29, 2002, at 23:35:29

> does anybody know if these restrictions also apply to st john's wort,since it is supposed to be a weak maoi?im about to start taking sjw but if all this can interact i wont.however i havent read anywhere that certain foods should be avoided while taking it.if anyone knows something about this please tell me.

my friend took it and didn't go by any diet.. but i can't say for sure you won't die if you eat the wrong thing, sorry, maybe someone else can


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