Psycho-Babble Medication Thread 75408

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Re: Dr. Bob : as Dr. your MAOI vs SSRI?

Posted by polarbear206 on October 5, 2002, at 16:09:54

In reply to Dr. Bob : as Dr. your MAOI vs SSRI?, posted by chad_3 on October 5, 2002, at 14:09:51

> I return only for this post ...
>
> Was curious Dr. Bob how often your prescribe MAOI's. As you know, expert psychiatrists consider these considerably underutilized. And latest consenses is that MAOI's have less sexual side effects than SSRI's in general.
>
> I personally feel the post was not offensive - I felt she spoke honestly and sounded compassionate and caring...
>
> My input,
>
> Chad
> http://www.socialfear.com/
>
>
>
> > > i just wanted to say "why the f*** don't doctors prescribe MAOI's anymore!!?"
> >
> > I understand it's frustrating, but please don't use language that could offend others:
> >
> > http://www.dr-bob.org/babble/faq.html#civil
> >
> > Thanks,
> >
> > Bob
> >
> > PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.
>
>


In my own opinion and from my experience, the older drugs (MAOI'S and Tricyclics) are far more
superior to the newer generation of antidepressants. Esp. for those with atypical/vegitated and more severe forms of endogenous dperessions. They are refered by many p-doc's as "OLD FAITHFULS".

Laura.

 

Re: Follow-ups regarding posting policies

Posted by Dr. Bob on October 6, 2002, at 11:55:29

In reply to Re: please be civil » katie tkm, posted by Dr. Bob on October 5, 2002, at 13:18:29

> PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.

Here's a link:

http://www.dr-bob.org/babble/admin/20020918/msgs/7669.html

Sorry, but some discussion about medication got moved along with that about posting policies...

Bob

 

Re: Back to MAOIs

Posted by jsarirose on October 6, 2002, at 17:20:31

In reply to Re: Follow-ups regarding posting policies, posted by Dr. Bob on October 6, 2002, at 11:55:29

(I'll skip the posting issue.)

Katie - I kind of understand why MAOI's are a later, not first choice, but I totally agree that they shouldn't wait so long to try them. I've been through so many years of depression and failed drug attempts (legal) and Parnate is the first thing in ages to help me. I felt/feel like you! I'm so excited to actually have some relief and perhaps start thinking about a future again. It's a little scary to trust it, but I, too, am just going slowly and trying to enjoy.

Regarding the MAOI diet lists on the site I mentioned (http://www.vh.org/Providers/Conferences/CPS/19.html), they actually aren't completely inconsistent. For the yeast extract it lists specifically Marmite as having a very high tyramine count, and later it mentions that yeast extract is okay except for Marmite. The herring it first states has a level of 2.45 per serving which is within aceptable levels unless a great amount is eaten. Then later it lists it as an acceptable food. I agree that it is a bit contradictory about whether it is unlimited or not. My take is that based on the tyramine level listed, it's okay in limited amounts. Completely my opinion though!

Let me know if you are still confused! (It's not easy...) And I also agree that this site is great. I've learned so much from everyone here.

-Jessica

 

Re: please be civil » Dr. Bob

Posted by katie tkm on October 6, 2002, at 21:11:55

In reply to Re: please be civil » katie tkm, posted by Dr. Bob on October 5, 2002, at 13:18:29

dear dr bob,

i sincerely apologise to you and to anyone who was offended by my comment.

this board has been an invaluable support to me.

the word is in common usage, but i understand how not commenting on one instance could lead to a storm of even worse language on the board.

i'm not a big swearer in general - i wanted to emphasize a point and unfortunately f*** clearly expressed the depth of my emotion!!!

next time i will just have to use many exclamation points.

thank you to other postings for understanding why i expressed myself as i did.

apologies
katie

p.s. do you check these postings personally dr bob? or do graduate students? it seems like a large job for one person.


> > i just wanted to say "why the f*** don't doctors prescribe MAOI's anymore!!?"
>
> I understand it's frustrating, but please don't use language that could offend others:
>
> http://www.dr-bob.org/babble/faq.html#civil
>
> Thanks,
>
> Bob
>
> PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.

 

accumulating tyramine » jsarirose

Posted by katie tkm on October 6, 2002, at 22:14:25

In reply to Re: Back to MAOIs, posted by jsarirose on October 6, 2002, at 17:20:31

dear jess,

thanks for your post and understanding. please read my previous email for apology for any offense i may have caused.

i'm trying to find a post i thought you wrote a while ago (i could have been mistaken thinking i'd seen your name). i've found negotiating all the threads a bit difficult and confusing at times. i've also read so much it gets mixed up in my overloaded brain! but i'm sure i came across a post you wrote about research into how long tyramine stays in the body. i just can't find it again.

did you write it? could i please get the link off you again?

thanks
katie

p.s. i'm really glad MAOI's are giving you some relief too.

 

Re: accumulating tyramine

Posted by jsarirose on October 7, 2002, at 13:45:42

In reply to accumulating tyramine » jsarirose, posted by katie tkm on October 6, 2002, at 22:14:25

> dear jess,
>
> thanks for your post and understanding. please read my previous email for apology for any offense i may have caused.
>
> i'm trying to find a post i thought you wrote a while ago (i could have been mistaken thinking i'd seen your name). i've found negotiating all the threads a bit difficult and confusing at times. i've also read so much it gets mixed up in my overloaded brain! but i'm sure i came across a post you wrote about research into how long tyramine stays in the body. i just can't find it again.
>

I can't recall where I found the information, but I can tell you what I remember. When I have more time later I'll see if I can find it again. Basically it fades from your body and by 12 hours is gone. So if you have 6 shots of espresso at once it's going to be more harmful than one shot every two hours for 12 hours. I don't think I found an exact formula - but I'll check on it.

-Jessica
ps - I was not offended in the least by your post, but I understand the need for rules. (The part of my last post pertaining to the posting issue was removed because the whole message seemed to be blocked if I included it.)

 

Re: thanks for understanding (nm) » katie tkm

Posted by Dr. Bob on October 7, 2002, at 17:52:28

In reply to Re: please be civil » Dr. Bob, posted by katie tkm on October 6, 2002, at 21:11:55

 

New to MAOIs

Posted by eln on October 11, 2002, at 16:40:23

In reply to Re: thanks for understanding (nm) » katie tkm, posted by Dr. Bob on October 7, 2002, at 17:52:28

Hi all-
I have been reading through your correspondence on this thread, and have found the suggestions very helpful. Currently, I am on a 10-day tapering off period for my antidepressants. In about 3 weeks, I will be starting on Parnate.

I have a few questions about the diet, drug restrictions, and such. I have a pshychiatrist who is pretty good, but a little ill-informed about the more recent discoveries about "safe" foods and hypertensive crisis medications.

1. He suggested that I get a medic alert-type bracelet. I want to get a remotely fashionable one, so I need to get it inscribed with a short description rather than a phone number to call.
What should I have engraved on it? (I have 36 characters)

2. There are a few foods which I am not sure are "safe" at all or not:
- pickles (Kosher dill)
- Campbell's soup
- Malt beverages (like Skyy Blue, Smirnoff Ice)
- Thai food (curries)
- Aspartame (like in Diet Coke)
- Vegetarian frozen products (Morningstar Farms products)

3. Which "emergency" medication/s should I ask for? Should I also ask for pain medication in case of a severe migraine?


Thanks in advance,
E


 

Re: New to MAOIs

Posted by jsarirose on October 11, 2002, at 19:12:09

In reply to New to MAOIs, posted by eln on October 11, 2002, at 16:40:23

> 1. He suggested that I get a medic alert-type bracelet. I want to get a remotely fashionable one, so I need to get it inscribed with a short description rather than a phone number to call.
> What should I have engraved on it? (I have 36 characters)
>
> 2. There are a few foods which I am not sure are "safe" at all or not:
> - pickles (Kosher dill)
> - Campbell's soup
> - Malt beverages (like Skyy Blue, Smirnoff Ice)
> - Thai food (curries)
> - Aspartame (like in Diet Coke)
> - Vegetarian frozen products (Morningstar Farms products)
>
> 3. Which "emergency" medication/s should I ask for? Should I also ask for pain medication in case of a severe migraine?
>
>
> Thanks in advance,
> E
>
Okay - I'll go first. : )

1. I don't know. I keep a slip of paper in my wallet on the hunch that if I'm in an accident and can't communicate they'll check for ID and find the paper. It lists all my current meds, the dosage, which pills I will have taken in a hypertensive crisis, and my psychiatrist's phone number.

2.
Pickles - just fine (& yummy!)

Campbell's Soup - depends, check for autolyzed yeast in the ingredients and any obvious taboo's (cheese, etc.)

Bottled (as opposed to tap) malt beverages - Fine. You may want to stick to larger companies (like those you mentioned) and not tiny local breweries. Also, it is considered a moderate item, meaning I wouldn't recommend a whole ton of beer or malt beverage. Although several people on this list have had a fair amount with no ill effects (including me). Parnate tends to make me more sensitive to alcohol as well. I get much more of an effect from less alcohol, so be careful the first time you drink. I don't know if other people have had the same tolerance reaction.

Thai Food - be careful, make sure you know what's in it, or at least ask about the amount of soy sauce, whether it contains fermented soy or tempeh, and if it contains any fish or shrimp paste. I eat Asian foods, but try to stick to more obvious items unless the waitperson has a good grasp of English and I can ask them about ingredients. Curry itself is just fine if you're talking about cumin & coriander, which are the main ingredients. You may want to pick up a bottle at the store and check the ingredients, I would guess it's just fine.

Aspartame - no problem

Vegetarian Frozen Products - again, you need to check for autolyzed yeast, marmite, or any obvious taboo foods. I've had better luck with the vegetarian, organic, or more natural foods. The general ones such as Budget Gourmet, etc. tend to contain autolyzed yeast.

And a final point about autolyzed yeast. It's listed as not allowable, but I have eaten some products that contain it with no adverse effects. My guess is the amount is so tiny that it's okay - but I don't eat it any more because I really don't want to trigger an episode. So I stick to the list (newer).

3. There are many pills that people use. My personal favorite is the one my doctor gave me because it is safe to take even if your blood pressure isn't spiking. It's not always possible to take your blood pressure when you're in the middle of an attack. I take Chlorpromazine (Thorazine). It will bring down my blood pressure if it's elevated, but if it's not elevated it still helps alleviate my migraine. It does make you tired for a day or two. And I also tend to feel dizzy for a day or two. I'm not sure if those symptoms are from the Thorazine or the crisis though. I only have to take one pill. I keep one with me in my wallet, one in my car, and a few at home. I also take 1/2 to a whole Oxycodone. I have these left over from surgery though, I don't know if my doctor would prescribe some or not. The pain of migraine is so intense that the Oxycodone really helps. I've had three attacks so far in about a year. The first two were early on due to eating mistakes. I don't think my blood pressure elevated but I did get an intense migraine. The third was recent (and totally my fault, I had beer on tap knowing better), my blood pressure definitely spiked as I became sweaty, nauseas and dizzy. I took my pill immediately as I recognized the onset of symptoms and it was my most mild migraine. Then I'm just left with being tired, dizzy, and mildly headachy.

I don't want to scare you with my descriptions of the attacks - if you're careful you should be able to avoid them. And if you make a mistake, it won't last forever. I never had to go to the hospital, I never saw my doctor, I just took my emergency pill and rested at home. Some of the other pills are more serious and are only okay if your blood pressure is spiking. Also some require you to go to the hospital. I think this is unnecessary.

Well, good luck. Feel free to email if you need moral support or have more questions.

-Jessica (jsarirose@attbi.com)

 

Re: New to MAOIs

Posted by cybercafe on October 13, 2002, at 11:46:34

In reply to Re: New to MAOIs, posted by jsarirose on October 11, 2002, at 19:12:09


Hey jess I just paid another visit to sunnybrook and they have quite a stash of psychiatric journals... "Tyramine content of preserved and fermented foods or condiments of Far Eastern Cuisine" is my latest find .... apparently the author found a portion of malaysian curry to have 2.88 mg of tyramine .... fried noodles to have 2.12 .... and chicken/coconut sauce to have 6.31 ... thai sausages 2.03 ... chicken bamboo curry 1.69 ... glass noodles with mushrooms 3.36 ... sweet and sour beef 2.18 ...and korean beer was a real killer, at 13.97

so it's all quite complicated... like, if you are in the east, and go to a small restaurant, and eat a big portion you could be headed for trouble..... but otherwise you're probably safe??

 

maoi and tyrosine

Posted by Ted Abel on October 13, 2002, at 11:50:21

In reply to Re: New to MAOIs, posted by jsarirose on October 11, 2002, at 19:12:09

I have been on nardil for almost seven years. At first it was wonderful; literally saving my life, or atleast starting it again.I am starting to get a decreased benefit. Due to side-effects, I can't increase the dose.
I heard that tyrosine acts as a precursor to the necessary neurotransmitters, especially dopamine. But I also heard this otc can cause problems. Any comments.

 

Tyrosine and Tyramine Different

Posted by linkadge on October 13, 2002, at 18:30:10

In reply to Re: New to MAOIs, posted by cybercafe on October 13, 2002, at 11:46:34

Tyrosine is an amino acid precursor to
Dopamine and norepinephrine (indirectly).
From what I've heard, it can help in some
cases in combo with certain drugs, but
its not very relyable. Personally I would
add Folic acid and Vitamin B12, to try and
boost an MAOI's effectivness.


Tyramine is a food substance that
is metabolised my MAO.


Linkadge

 

Vitamin B6 and Nardil » Bobbiedobbs

Posted by katie tkm on October 13, 2002, at 22:34:33

In reply to Re: side effects of MAOI's, posted by Bobbiedobbs on October 4, 2002, at 0:30:34

dear phil,

thanks for telling me about your experiences. it was good to know.

i think the nardil is really working for me - i just can't help wondering if parnate might have less side effects. i guess i can't exactly predict my response from other people's side effects because we/they're all so different.

i'm on week 6 and hanging in there with fatigue, constipation,insomnia and sexual disturbances. it's not too bad. so many other side effects have faded i hope that these will go too - and not in 4 months as some articles suggest!

i've read about taking vitamin B6 with nardil because it can cause a depletion. SOMEWHERE i read that it might be a good idea to separate the B6 and nardil dose to increase the vitamin absorption (because nardil blocks B6 absorption mostly at the same time when it is being absorbed??). like so many of the snippets i remember from hours of reading on the net i can't find the info again!!!

do you know anything about this separating when you take B6 and nardil issue?

anyway i hope you are doing ok.
best wishes
katie

 

Success with Marplan? » cybercafe

Posted by ZeeZee on October 14, 2002, at 9:42:35

In reply to Re: New to MAOIs, posted by cybercafe on October 13, 2002, at 11:46:34

Has anyone used with success Marplan? If so, how do the side effects differ from Nardil and Parnate? Was it as effective? I used Nardil in the past, switched to Parnate because of s/e and it was very helpful. Recently re-tried Parnate but couldn't handle some very weird s/e that I never had before. Am considering trying a MAOI again, since they've been the only AD to work and not increase my problem with anxiety/panic. Any experiences with Marplan would be appreciated.
Thanks,
Lisa

 

Re: Vitamin B6 and Nardil

Posted by Bobbiedobbs on October 14, 2002, at 14:23:35

In reply to Vitamin B6 and Nardil » Bobbiedobbs, posted by katie tkm on October 13, 2002, at 22:34:33

Katie: I honestly don't know anything about Vitamin B-6 and its interplay with Nardil; hopefully others here will. My advice on the Nardil is to stick with it at least for awhile longer because its benefits are hard to replicate. You might consider tapering the doseage to see if you can retain the benefits but mitigate the adverse effects. It's certainly an imperfect science. You sound like you have approximately the same stew of s/e that I did, except for the fatigue, which I now have on Parnate.
As for me, the Parnate is keeping the anxiety and social phobia somewhat at bay but I have the blahs and it doesn't do dogpile for OCD. I've become almost totally reclusive except for work, and even there I'm pretty avoidant. I'm going to try the Parnate up to a higher dose (say, 60 mg from 40) to see if that makes a difference, even if I don't go to the bathroom for the next month or so.
BTW, I'm curious as to the "third" of the MAO trilogy -Marplan - which another poster has asked about. I have had a hard time finding much about it. It only recently began being resold after being taken off the market. Hopes this helps; good luck to both (all) of us! Phil

 

Re: Success with Marplan?

Posted by Chocoholic on October 14, 2002, at 18:37:39

In reply to Success with Marplan? » cybercafe, posted by ZeeZee on October 14, 2002, at 9:42:35

I just quit Marplan last week after a seven week trial. I had high hopes for it because an international authority recommended it for me at a consult. I was very disappointed:it was so toxic for me that I looked really bad and my colleagues held an "intervention" and insisted I go see a doctor. My husband even had to come pick me up from work because I couldn't drive home. The side effects included rapid cycling, urinary hesitancy, constipation, dizziness and very low blood pressure. Oh, and one EPS episode.

But don't let me dissuade you--aparently they use it at Stanford with many treatment resistant patients with great success.

I actually found moclobemide, a reversible MAOI, much more effective for me. I took it for 3 years.

Good luck!

Chocoholic

 

Re: New to MAOIs

Posted by eln on October 29, 2002, at 15:23:58

In reply to New to MAOIs, posted by eln on October 11, 2002, at 16:40:23

Its almost time- I start on Thursday, and will be going to see my psychiatrist in an hour to get the prescription for Parnate. The washout period has been difficult, as I have had to have my mom come to stay with me and have had to "play sick" to get away with the minimum amount of work and social interaction while I have tapered off my SSRIs for 2 weeks and spent 2 disturbing weeks off all medications.
Thank all of you who have posted on here- I am in the process of educating my psychiatrist, who considers himself to be knowledgeable on the subject of MAOIs (as he has prescribed them to many patients successfully) yet works from a diet list created in the late 70's.
I got my Medic Alert bracelet, an automatic wrist blood pressure monitor, purse to carry my emergency meds and cell phone in, and a very detailed wallet medication card.
I will let you all know how its going. Meanwhile, I have been fattening myself up by gorging myself on all the cheeses, foreign chocolates, aged meats, and chiantis that I will no longer be able to eat.

I had a question about one more thing for now: is Tequila (major brand like Jose Cuervo) OK?

Thanks, E

 

Re: New to MAOIs » eln

Posted by jsarirose on October 29, 2002, at 16:10:51

In reply to Re: New to MAOIs, posted by eln on October 29, 2002, at 15:23:58

> Its almost time- I start on Thursday, and will be going to see my psychiatrist in an hour to get the prescription for Parnate. The washout period has been difficult, as I have had to have my mom come to stay with me and have had to "play sick" to get away with the minimum amount of work and social interaction while I have tapered off my SSRIs for 2 weeks and spent 2 disturbing weeks off all medications.
> Thank all of you who have posted on here- I am in the process of educating my psychiatrist, who considers himself to be knowledgeable on the subject of MAOIs (as he has prescribed them to many patients successfully) yet works from a diet list created in the late 70's.
> I got my Medic Alert bracelet, an automatic wrist blood pressure monitor, purse to carry my emergency meds and cell phone in, and a very detailed wallet medication card.
> I will let you all know how its going. Meanwhile, I have been fattening myself up by gorging myself on all the cheeses, foreign chocolates, aged meats, and chiantis that I will no longer be able to eat.
>
> I had a question about one more thing for now: is Tequila (major brand like Jose Cuervo) OK?
>
> Thanks, E
>

Oh yes, you can have wine. You don't want to over do it, but several glasses is just fine. I would avoid home made wine though. Tequila is just fine too. The lists usually recommend moderation with alcohol, but the "newer" liquors are just fine. If you're drinking aged scotch or something, you might want to be a bit more careful. Beer is fine too, but make sure it's bottled beer (a larger brewery) and not tap.

The lists aren't as restrictive as previously thought. There are actually quite a few cheese options (my big weakness): mozzarella, parmesan (in moderation), Swiss Gruyere, Canadian Muenster, feta, ricotta, cream cheese, even brie if you make sure it's just the inside and no rind. I've personally had all of the above cheeses with no ill effects, and they are all on one of the more recent lists.

Check out:
http://www.vh.org/Providers/Conferences/CPS/19.html

If you page down you'll get actual tyramine contents and some good info. Usually 1-4mg is fine, 4 or 5 to 7 is okay in moderation, and over that is not allowed.

Keep posting your questions! There is a lot of expert info on this list about the diet restrictions.

Oh yeah - and chocolate is fine! If you like, I can send you a file with pretty specific info about the diet. jsarirose1@attbi.com

And you're doing a great prep job. Having all your precautions in line will make you more at ease. Please don't be too nervous about the med. You'll get used to it and the diet restrictions in no time. (Don't forget about med interactions too! No decongestants!)

-Jessica

 

Re: New to MAOIs

Posted by cubbybear on October 31, 2002, at 0:48:30

In reply to Re: New to MAOIs » eln, posted by jsarirose on October 29, 2002, at 16:10:51

Hi,
I read about your starting up on MAOIs.Good luck!! I was taking Parnate for 18 years and considered it a life-saver. My only side effects were dry mouth (tolerable), ocassional lightheadedness (from standing up too suddenly--but don't let this scare you) and watch out--WEIGHT GAIN. So keep that in mind as a POSSIBLE side effect. Now, I want to emphasize that after perusing this website and others for countless days and nights, I have come to the conclusion that every patient reacts to every different medication in a different way. I'm telling you only about MY experience, OK? I think Parnate (is that what you're taking?) is fabulous and as long as you're careful about the foods and other meds., you shouldn't worry at all. But what I find a bit disturbing is that in someone's previous post, they said that beer and wine are OK. I was shocked because I had always thought that beer is NOT OK and onlly WHITE wine is OK. There is definitely some leeway on some foods, but you should do as much research as you can on the subject of the forbidden foods. Good luck!

 

Re: New to MAOIs

Posted by jsarirose on October 31, 2002, at 1:34:58

In reply to Re: New to MAOIs, posted by cubbybear on October 31, 2002, at 0:48:30

> Hi,
> I read about your starting up on MAOIs.Good luck!! I was taking Parnate for 18 years and considered it a life-saver. My only side effects were dry mouth (tolerable), ocassional lightheadedness (from standing up too suddenly--but don't let this scare you) and watch out--WEIGHT GAIN. So keep that in mind as a POSSIBLE side effect.

But what I find a bit disturbing is that in someone's previous post, they said that beer and wine are OK. I was shocked because I had always thought that beer is NOT OK and onlly WHITE wine is OK. There is definitely some leeway on some foods, but you should do as much research as you can on the subject of the forbidden foods. Good luck!

In general, Parnate is supposed to promote weight loss. At the very least, it's not supposed to promote weight gain like Nardil and others may. As the previous poster mentioned, 'your mileage may vary'. Side effects are different for every person. I've lost over 90lbs on Parnate (and with diet and exercise changes that were possible because of the Parnate).

Regarding the beer and wine, make sure you are looking at the most recent research. Tap beers and homemade beers and wine should be avoided. Other should be had in moderation, but really is just fine. (Check out the site I mentioned previously.)

-Jessica

 

Re: New to MAOIs

Posted by Bobbiedobbs on October 31, 2002, at 10:57:04

In reply to Re: New to MAOIs, posted by jsarirose on October 31, 2002, at 1:34:58

Regarding the food and alcohol restrictions, Id more or less concur with Jessica. I'd go slow on the wines (red or white) and alcohol while you are acclamating to the medication. But it doesn't matter what kind of alcohol it is at long as it is not a home-brew or microbrew beer. In 20 years of Nardil and Parnate I've only had 2 reactions - one to a decongestant, another to anchovy paste. and that includes alot of sausage, sauerkraut, soy sauce, pepperoni, and God knows, chocolate! Riccota/mozzerella/cream cheese/processed yogurts/are DEFINITELY no problem!!!!Phil

 

Re: New to MAOIs

Posted by jsarirose on October 31, 2002, at 15:03:48

In reply to Re: New to MAOIs, posted by Bobbiedobbs on October 31, 2002, at 10:57:04

> Regarding the food and alcohol restrictions, Id more or less concur with Jessica. I'd go slow on the wines (red or white) and alcohol while you are acclamating to the medication. But it doesn't matter what kind of alcohol it is at long as it is not a home-brew or microbrew beer. In 20 years of Nardil and Parnate I've only had 2 reactions - one to a decongestant, another to anchovy paste. and that includes alot of sausage, sauerkraut, soy sauce, pepperoni, and God knows, chocolate! Riccota/mozzerella/cream cheese/processed yogurts/are DEFINITELY no problem!!!!Phil

That's funny, one of my three reactions was to anchovy paste too! I found it's in some of the more obscure Asian foods. (For me it was Vietnamese Pho.) And I've been on a sauerkraut binge lately because a new pub serves it with brats (I don't eat the brats, just the kraut).

-Jessica

 

MAOIs and Painkillers

Posted by eln on November 14, 2002, at 15:59:22

In reply to Re: New to MAOIs, posted by eln on October 29, 2002, at 15:23:58

Thanks for all the support - I am up to my full dosage now (30 mg/day) and so far things are going fine. I am losing weight (my appetite has decreased), and my biggest problem seems to be with insomnia. I was already taking sleeping pills before, and I had to increase my dose.
I haven't tried any of the foods in dispute (like any cheeses or wines), but my doctor and I plan to do some in-office trials in the next few weeks.

I am still searching for a pain medication that would be OK to take in case of a reaction - I am unfortunately allergic to codeine, oxycodone, and hydrocodone. Darvon is supposedly unsafe, and demerol is of course out of the question. I am not an expert at this- even my doctor is stumped. Are there other medications I should look up or get in touch with the manufacturers? I know they all seem to list their products as interacting adversely in order to protect themselves legally, but they can't ALL be that bad...

Hopefully, I will never need this, but I also don't want to suffer if I do have a reaction. I don't think I will feel OK with doing food trials until I'm certain I can take care of the pain.

Thanks,
E

 

Re: MAOIs and Painkillers

Posted by jsarirose on November 14, 2002, at 16:23:42

In reply to MAOIs and Painkillers, posted by eln on November 14, 2002, at 15:59:22

> I am still searching for a pain medication that would be OK to take in case of a reaction - I am unfortunately allergic to codeine, oxycodone, and hydrocodone. Darvon is supposedly unsafe, and demerol is of course out of the question. I am not an expert at this- even my doctor is stumped. Are there other medications I should look up or get in touch with the manufacturers? I know they all seem to list their products as interacting adversely in order to protect themselves legally, but they can't ALL be that bad...
>
> Hopefully, I will never need this, but I also don't want to suffer if I do have a reaction. I don't think I will feel OK with doing food trials until I'm certain I can take care of the pain.
>
> Thanks,
> E

I'm a little confused. The pain medicine will make you feel better but it won't help with a blood pressure spike. Did your doctor prescribe an emergency pill? For example, if I start having a reaction I take Chlorpromazine (Thorazine). It will bring down my blood pressure if necessary but won't harm me if my blood pressure isn't spiking. That has nothing to do with pain control (other than shortening my reaction). It is very necessary to prohibit a heart attack or stroke though.

-Jessica

ps - most foods I know of aren't controversial if you look into the most recent tyramine levels. It's only if you're looking at an old study and a new study that there is conflict. I always go with the latest information and haven't had a single problem.

 

Re: New to MAOIs » jsarirose

Posted by Mairwen on January 4, 2003, at 17:20:53

In reply to Re: New to MAOIs » eln, posted by jsarirose on October 29, 2002, at 16:10:51

> > Its almost time- I start on Thursday, and will be going to see my psychiatrist in an hour to get the prescription for Parnate. The washout period has been difficult, as I have had to have my mom come to stay with me and have had to "play sick" to get away with the minimum amount of work and social interaction while I have tapered off my SSRIs for 2 weeks and spent 2 disturbing weeks off all medications.
> > Thank all of you who have posted on here- I am in the process of educating my psychiatrist, who considers himself to be knowledgeable on the subject of MAOIs (as he has prescribed them to many patients successfully) yet works from a diet list created in the late 70's.
> > I got my Medic Alert bracelet, an automatic wrist blood pressure monitor, purse to carry my emergency meds and cell phone in, and a very detailed wallet medication card.
> > I will let you all know how its going. Meanwhile, I have been fattening myself up by gorging myself on all the cheeses, foreign chocolates, aged meats, and chiantis that I will no longer be able to eat.
> >
> > I had a question about one more thing for now: is Tequila (major brand like Jose Cuervo) OK?
> >
> > Thanks, E
> >
>
> Oh yes, you can have wine. You don't want to over do it, but several glasses is just fine. I would avoid home made wine though. Tequila is just fine too. The lists usually recommend moderation with alcohol, but the "newer" liquors are just fine. If you're drinking aged scotch or something, you might want to be a bit more careful. Beer is fine too, but make sure it's bottled beer (a larger brewery) and not tap.
>
> The lists aren't as restrictive as previously thought. There are actually quite a few cheese options (my big weakness): mozzarella, parmesan (in moderation), Swiss Gruyere, Canadian Muenster, feta, ricotta, cream cheese, even brie if you make sure it's just the inside and no rind. I've personally had all of the above cheeses with no ill effects, and they are all on one of the more recent lists.
>
> Check out:
> http://www.vh.org/Providers/Conferences/CPS/19.html
>
> If you page down you'll get actual tyramine contents and some good info. Usually 1-4mg is fine, 4 or 5 to 7 is okay in moderation, and over that is not allowed.
>
> Keep posting your questions! There is a lot of expert info on this list about the diet restrictions.
>
> Oh yeah - and chocolate is fine! If you like, I can send you a file with pretty specific info about the diet. jsarirose1@attbi.com
>
> And you're doing a great prep job. Having all your precautions in line will make you more at ease. Please don't be too nervous about the med. You'll get used to it and the diet restrictions in no time. (Don't forget about med interactions too! No decongestants!)
>
> -Jessica

Hello
I have just started on Nardil and have no medic alert bracelet, no auto wrist blood pressure monitor, emergency meds or wallet medication card. These have not been mentioned to me. Should I be worried?
Mairwen


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