![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Questionmark on May 24, 2003, at 0:10:53
i've been on Parnate for 2 weeks (1 wk on 20mg), and already i've had my first hypertensive reaction. Take the dietary restrictions seriously if you're on an MAOI.
i haven't been too concerned about the dietary restrictions yet since i'm on a fairly low dose and well, i just didn't wanna be. But today i was at a resturaunt and, totally forgetting about the dietary restrctions, ate a plentiful serving of mac and cheese (and some baked haddock). i went home and took my 2 Parnates for the day (as i didn't in the morning). About two hours later i started feeling like crap-- pounding heart, fatigued but really nervous, and just a general feeling of malaise. i went in my room and lied down on the floor, after 10 seconds of which i started to get a terrible pounding headache, mostly occipital. Then i realized i definitely must have eaten something wrong, and i remembered the mac and cheese. Having no nifedipine and not at all wanting to go the ER, i took 0.5mg clonazepam, 20mg propanolol, and half a pill of some phenothiazine i had gotten for nausea awhile back, and i decided to try and sleep for awhile. i thought i'd either get lucky and die, get intracranial bleeding & brain damage and have to willfully "step out" myself, or, most likely, experience about half an hour more of bad pain and discomfort until those pills counteracted the excess tyramine and i could sleep. For better or worse, the latter is what occurred. (By the way, i do NOT recommend relying on those types of drugs to relieve a hypertensive reaction, but it's all i had).
Anyway, i don't know why i wrote all this exactly, but, moral of the story: don't f**k around with the food restrictions if you're on an MAOI (at least/ especially the ones that are completely restricted).
Posted by fallsfall on May 24, 2003, at 0:44:12
In reply to Hypertensive reaction., posted by Questionmark on May 24, 2003, at 0:10:53
Please go to the Emergency Room next time! Or you will give one of us heart failure!
I was on Parnate for a couple of months a year ago. I was good except for moderate amounts of chocolate (the 5th major food group). Guess that was a good strategy.
Please be careful!
Posted by djmmm on May 24, 2003, at 10:39:19
In reply to Hypertensive reaction., posted by Questionmark on May 24, 2003, at 0:10:53
> i've been on Parnate for 2 weeks (1 wk on 20mg), and already i've had my first hypertensive reaction. Take the dietary restrictions seriously if you're on an MAOI.
> i haven't been too concerned about the dietary restrictions yet since i'm on a fairly low dose and well, i just didn't wanna be. But today i was at a resturaunt and, totally forgetting about the dietary restrctions, ate a plentiful serving of mac and cheese (and some baked haddock). i went home and took my 2 Parnates for the day (as i didn't in the morning). About two hours later i started feeling like crap-- pounding heart, fatigued but really nervous, and just a general feeling of malaise. i went in my room and lied down on the floor, after 10 seconds of which i started to get a terrible pounding headache, mostly occipital. Then i realized i definitely must have eaten something wrong, and i remembered the mac and cheese. Having no nifedipine and not at all wanting to go the ER, i took 0.5mg clonazepam, 20mg propanolol, and half a pill of some phenothiazine i had gotten for nausea awhile back, and i decided to try and sleep for awhile. i thought i'd either get lucky and die, get intracranial bleeding & brain damage and have to willfully "step out" myself, or, most likely, experience about half an hour more of bad pain and discomfort until those pills counteracted the excess tyramine and i could sleep. For better or worse, the latter is what occurred. (By the way, i do NOT recommend relying on those types of drugs to relieve a hypertensive reaction, but it's all i had).
> Anyway, i don't know why i wrote all this exactly, but, moral of the story: don't f**k around with the food restrictions if you're on an MAOI (at least/ especially the ones that are completely restricted).For what it's worth, Benzos and Inderal are often used in hospitals in cases of hypertensive reactions. The goal of medicating a hypertensive crisis is obviously lowering your blood pressure at a consistant rate, and safely. Klonopin will help by attenuating further catecholamine release, and Inderal, will selectivly compete for norepinephrine sites (via non-selective beta-adrenergic receptor blocking). I believe Inderal is such a competetive drug, it may displace norepinephrine (and epinephrine in the heart), making it a good choice for mild hypertensive episodes. Inderal is indicated for hypertension. I believe in more serious case of hypertensive "crisis" a med called Nitroprusside is used because of it's rapid rate of onset.
Posted by SLS on May 24, 2003, at 11:07:43
In reply to Hypertensive reaction., posted by Questionmark on May 24, 2003, at 0:10:53
> i went in my room and lied down on the floor, after 10 seconds of which i started to get a terrible pounding headache, mostly occipital.
I think the worst thing to do is to lie down. You are better off standing and allowing blood to drain from the head and lower intracranial pressure.
I had a similar experience with pepperoni pizza. Not paying attention, I took one bite. I only swallowed 1 1/2 pieces of thinly-cut pepperoni, but that was enough to induce the unmistakable reaction headache. I was at work at the time, and didn't want to go to the hospital, so I gambled that it would go away. I was OK so long as I remained standing. When I tried to sit down, the pounding at the back of my head would appear. It probably took 30-45 minutes for the reaction to stop to the point that I could sit down again.
I can eat all the regular pizza I want without inducing a hypertensive reaction. I stay away from pepperoni, sausage, and anchovies.
- Scott
Posted by MelD on May 24, 2003, at 11:35:10
In reply to Re: Hypertensive reaction., posted by SLS on May 24, 2003, at 11:07:43
Sorry for what you went through and so glad you came through ok. Thanks for sharing your experience - its a good "heads up' for those of us on MAOIs who might get a little lax on the diet restrictions! Melodie
Posted by TapiocaMonk on May 25, 2003, at 23:07:36
In reply to Re: Hypertensive reaction., posted by MelD on May 24, 2003, at 11:35:10
is it possible to have a hypertensive crisis w/o having a headache?
Posted by Jack Smith on May 26, 2003, at 0:48:14
In reply to Re: Hypertensive reaction. » Questionmark, posted by fallsfall on May 24, 2003, at 0:44:12
why'd you go off parnate? what is your diagnosis?
> Please go to the Emergency Room next time! Or you will give one of us heart failure!
>
> I was on Parnate for a couple of months a year ago. I was good except for moderate amounts of chocolate (the 5th major food group). Guess that was a good strategy.
>
> Please be careful!
Posted by fallsfall on May 26, 2003, at 13:08:28
In reply to Re: Hypertensive reaction. » fallsfall, posted by Jack Smith on May 26, 2003, at 0:48:14
I have severe major depression. I had crashed about 6 months before due to 3 stressors. We had tried a bunch of meds and none were working. (I had also taken a variety of meds over the previous 7 years) It was time to try an MAOI. I had taken it for a couple of months when I wound up in the hospital (not because of new stressors, but because I was still going down). We figured that Parnate wasn't doing enough if I ended up in the hospital while I was taking it. I was willing to be really good about the diet if the drug was going to work for me.
I'm now on Prozac, Lithium, Strattera and Provigil and things are a little better.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.