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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by dbc on December 8, 2006, at 23:04:14
On 4 different boards today i've had to answer questions that could potentially be life threatening to someone because they want to combine their MAOIs with other meds.
The Remeron post on here was the most sane of them all. Although the fact that we really dont understand why Remeron potenates serotonin drugs might make you want to stay far away. . I realize someone will probably find a study showing its method of action but theres been multiple studies that dont agree on how remeron works.
People really need to be educated on MAOI safety and the fact that they may very well die if they screw around. I dont mean the people on this board as most of all of you have a bit of common sense and experience.
Posted by Maxime on December 8, 2006, at 23:17:34
In reply to Why Are People Suddenly Getting Silly With MAOIs?, posted by dbc on December 8, 2006, at 23:04:14
I take 2 grams of Trytophan with Nardil and haven't had any problems.
I know the threat is there, but not as bad as people think. At one time the dietary restriction were MUCH MORE strict. Then they found out that you could eat certain foods.
I do believe there is danger, but sometimes I think it blown out of proportion.
Maxome
> On 4 different boards today i've had to answer questions that could potentially be life threatening to someone because they want to combine their MAOIs with other meds.
>
> The Remeron post on here was the most sane of them all. Although the fact that we really dont understand why Remeron potenates serotonin drugs might make you want to stay far away. . I realize someone will probably find a study showing its method of action but theres been multiple studies that dont agree on how remeron works.
>
> People really need to be educated on MAOI safety and the fact that they may very well die if they screw around. I dont mean the people on this board as most of all of you have a bit of common sense and experience.
Posted by backclass on December 9, 2006, at 5:43:00
In reply to Why Are People Suddenly Getting Silly With MAOIs?, posted by dbc on December 8, 2006, at 23:04:14
What is the deal with soy products? I got a food chart for EMSAM and at the highest dose is says you can't eat tofu, but you can drink soymilk. I don't understand this, but this is OK, but I am wondering about all the soy products, which I eat a lot of, like meat alternatives (boca burgers), soy ice cream and the million of other soy products. Also, I really need to know if it is OK to consume Soy Protien? This is what I am concerned about: http://www.nowfoods.com/?action=itemdetail&item_id=14706
Posted by Maxime on December 9, 2006, at 11:11:57
In reply to MAOI Diet Question, posted by backclass on December 9, 2006, at 5:43:00
You can eat soy products EXCEPT fermented soy such as Miso or soy sauce.
I ate tofu on Parnate and have had some on Nardil ... no problem. Accidently has soy sauce and had a very bad reaction.
With the exception of things like fava beans and chocolate, just remember to stay away from things that have been aged (cheese, red wine, cured meat). Even fruit that has gone soft (and fermented a little), you should stay away from. Anyhow, that makes it easier to remember.
Maxime
> What is the deal with soy products? I got a food chart for EMSAM and at the highest dose is says you can't eat tofu, but you can drink soymilk. I don't understand this, but this is OK, but I am wondering about all the soy products, which I eat a lot of, like meat alternatives (boca burgers), soy ice cream and the million of other soy products. Also, I really need to know if it is OK to consume Soy Protien? This is what I am concerned about: http://www.nowfoods.com/?action=itemdetail&item_id=14706
Posted by madeline on December 9, 2006, at 16:24:55
In reply to MAOI Diet Question, posted by backclass on December 9, 2006, at 5:43:00
I would ask your doctor. It is different for some people.
Good luck with EMSAM, I hope you have success with it.
Posted by Maxime on December 9, 2006, at 18:53:44
In reply to MAOI Diet Question, posted by backclass on December 9, 2006, at 5:43:00
You can freely eat Tofu. No miso and no tempeh. Tofu is fine. This is according to the psychopharmacologist I saw and the fact that myself and others have consumed LARGE quantities of Tofu while on an MAOI and are still alive (sadly in my case) to talk about it.
Maxime
Posted by backclass on December 9, 2006, at 19:27:38
In reply to Re: MAOI Diet Question, posted by madeline on December 9, 2006, at 16:24:55
> I would ask your doctor. It is different for some people.
>
> Good luck with EMSAM, I hope you have success with it.HA! You think my doctor would have a clue? The answer is NO.
Posted by Maxime on December 9, 2006, at 21:48:57
In reply to Re: MAOI Diet Question » madeline, posted by backclass on December 9, 2006, at 19:27:38
Ask your pharmacist?
MAxime
> > I would ask your doctor. It is different for some people.
> >
> > Good luck with EMSAM, I hope you have success with it.
>
> HA! You think my doctor would have a clue? The answer is NO.
>
Posted by backclass on December 10, 2006, at 6:13:20
In reply to Re: MAOI Diet Question » backclass, posted by Maxime on December 9, 2006, at 21:48:57
Posted by stargazer on December 10, 2006, at 15:23:12
In reply to Why Are People Suddenly Getting Silly With MAOIs?, posted by dbc on December 8, 2006, at 23:04:14
I'm feeling like when I read some of the posts, there are alot of mixing of medications and taking meds when side effects and medical conditions would make treatment with many medications contrainidcated.
Like taking many meds I was told are contrainidcated with Maos's...
Like SE's of peripheral edema, which is an indication of congestive heart failure and can lead to heart attacks....
Like, many other things I am reading today here.
Has all caution been thrown to the wind?
I understand that docs (?) have approved some of these combinations... but there are always docs who will prescribe things that are not optimal treatments...medical malpractice is still alive and well...
I am not comfortable with some of the combinations being prescribed. You can't tell what's causing what side effects as you combine more and more drugs that are obviously interacting with one another.
Then when I read about heart attacks when the biggest side effect with the MAo's is hypertension, I almost have a heart attack.
It seems as though concerns expressed for others when things like this are pointed out are ignored or minimized. It gets really hard trying to be supportive when there seems to be no precautions being taken and it's hard to tell who's dropping the ball, the docs or the patients.
I certainly would never take some of those risks myself and it's not because I am not really depressed or I'm not as depressed as others. That's not the argument.
I am just too afraid of causing more problems for myself than depression, which is bad enough.
I am afraid of what these drugs are doing to many of you who are ignoring the risks of taking these drugs.I am on EMsam now and I have taken Nardil, Parnate and Marplan and I religiously followed the dietary and drug restrictions given to me. When I asked my pdoc about some of the things that others are doing today, based on what I have read here, he is amazed with the current cavalier attitude which now exists.
I believe that taking these risks now will ultimately cause more harm than good in the long run.
AD's are usually used as temporary fixes, but heart attacks and liver failure are life sentences.
You be the judge but do your research and get a second opinion if your treatment is leading you to have more and more side effects. Not all docs are as careful as others.
SG
Posted by gardenergirl on December 10, 2006, at 19:59:23
In reply to same feeling as dbc...risk taking w MAO's, posted by stargazer on December 10, 2006, at 15:23:12
> I'm feeling like when I read some of the posts, there are alot of mixing of medications and taking meds when side effects and medical conditions would make treatment with many medications contrainidcated.
>
> Like taking many meds I was told are contrainidcated with Maos's...
>
> Like SE's of peripheral edema, which is an indication of congestive heart failure and can lead to heart attacks....So when I get edema during my period, I'm going into CHF? In my case, it's about fluid retention, not CHF. Your limbs can show edema without there be being a build up of fluid in the cardiopulmonary system. Ask any woman who experiences water weight gain before and during menstruation.
>
> Like, many other things I am reading today here.
>
> Has all caution been thrown to the wind?I would say no. Again in my case, I research drug interactions and discuss the potential risks and benefits with my doctor before adding any medication at all, even non psychotropics. Any foods I eat which are on the traditional "no-no" list are ones which have been tested for tyramine levels and found to have very small levels. I don't just wake up one day and say, "Today I'm going to eat _____". Also, I start with small quantities and check my BP after ingesting a small bit. And I'm a real pain in restaurants, at receptions or banquets, and when eating at anyone's home since I have to know what's in everything before I can eat it. But that's what I have to do, so I do it.
Am I throwing caution thrown to the wind? I think not. I can't speak for everyone else here who are on MAOI's, but I certainly have read posts where folks were seeking information in order to weigh the risks and benefits before making a change.
> I am not comfortable with some of the combinations being prescribed. You can't tell what's causing what side effects as you combine more and more drugs that are obviously interacting with one another.
Everyone's comfort level is their own. I would assume if you are not comfortable with what's being prescribed for you, you would discuss that with your doc. If you're not comfortable with what a doc is prescribing for anyone else, well...not sure what I can say about that.
>> It seems as though concerns expressed for others when things like this are pointed out are ignored or minimized. It gets really hard trying to be supportive when there seems to be no precautions being taken and it's hard to tell who's dropping the ball, the docs or the patients.
How would you like to see concerns responded to? What would help you feel more able to be supportive? I agree it's hard to be supportive when you feel like the person is not hearing and/or not taking your advice. It's hard to separate out our own feelings of concern from the other person's behavior. But they are separate and individual.
>
> I certainly would never take some of those risks myself and it's not because I am not really depressed or I'm not as depressed as others. That's not the argument.
>
> I am just too afraid of causing more problems for myself than depression, which is bad enough.
> I am afraid of what these drugs are doing to many of you who are ignoring the risks of taking these drugs.I believe you're sincere in this concern, and I'm sorry if it's upsetting or frustrating (or whatever word you would use) for you. I think it's hard, too, because we only get pieces of information from folks. We don't get to see their entire thought process, feelings, and/or behaviors. So I'm not sure it's fair to say that risks are being ignored. Sure, in some cases that's probably happenening. It's always going to happen. All we can do is try to be supportive and to inform when we can, but ultimately, the individual's behavior is up to them.
>
> I am on EMsam now and I have taken Nardil, Parnate and Marplan and I religiously followed the dietary and drug restrictions given to me. When I asked my pdoc about some of the things that others are doing today, based on what I have read here, he is amazed with the current cavalier attitude which now exists.Sounds like you have a good working relationship with your doc. I'm glad. And it's good that you know what you will and won't risk in order to be well. That's often a difficult issue.
>
> I believe that taking these risks now will ultimately cause more harm than good in the long run.
>
> AD's are usually used as temporary fixes, but heart attacks and liver failure are life sentences.Then it's important to work towards good physical health as well as mental health, I would think. And please keep in mind that these are rare occurrences. And there are often co-morbid issues which contribute to someone having a heart attack or liver failure.
>
> You be the judge but do your research and get a second opinion if your treatment is leading you to have more and more side effects. Not all docs are as careful as others.That's a good thing to keep in mind. I think it can be easy to get sort of myopic about health care providers, and it's important to do a reality-check from time to time to make sure they really are effective, etc. It took me too long to realize my last pdoc was, um, an uncivil word. I'm glad I finally did, but the signs were there from the beginning. I just didn't pay enough attention to them. Actually, I suppose I also didn't trust my own reactions, but that's a separate issue.
Take care and thanks for expressing your concerns.
gg
Posted by madeline on December 11, 2006, at 6:16:47
In reply to Re: same feeling as dbc...risk taking w MAO's » stargazer, posted by gardenergirl on December 10, 2006, at 19:59:23
Perhaps I can clear this up.
Look, everyone swells up every now and then. After I eat chinese food I puff up like a blow fish.
The signs of congestive heart failure are:
1. Shortness of breath.
2. Persistent pitting edema in the arms or legs (especially around the wrists and ankles). Edema is "pitting" when you press the tissue and it doesn't immediately spring back to it original shape - it leaves a pit.
3. Reduced urine output.If you have these symptoms, it's time for a trip to the doc.
Posted by Maxime on December 11, 2006, at 15:41:23
In reply to Re: same feeling as dbc...risk taking w MAO's » stargazer, posted by gardenergirl on December 10, 2006, at 19:59:23
I really agree with GG. Couldn't have said it better myself (or been has diplomatic).
When I was on the Parnate, my pdoc told me try some of the "no-no" foods in small quantities to see if I would react.
Yup, I agree with GG 100%!
Maxime
> > I'm feeling like when I read some of the posts, there are alot of mixing of medications and taking meds when side effects and medical conditions would make treatment with many medications contrainidcated.
> >
> > Like taking many meds I was told are contrainidcated with Maos's...
> >
> > Like SE's of peripheral edema, which is an indication of congestive heart failure and can lead to heart attacks....
>
> So when I get edema during my period, I'm going into CHF? In my case, it's about fluid retention, not CHF. Your limbs can show edema without there be being a build up of fluid in the cardiopulmonary system. Ask any woman who experiences water weight gain before and during menstruation.
> >
> > Like, many other things I am reading today here.
> >
> > Has all caution been thrown to the wind?
>
> I would say no. Again in my case, I research drug interactions and discuss the potential risks and benefits with my doctor before adding any medication at all, even non psychotropics. Any foods I eat which are on the traditional "no-no" list are ones which have been tested for tyramine levels and found to have very small levels. I don't just wake up one day and say, "Today I'm going to eat _____". Also, I start with small quantities and check my BP after ingesting a small bit. And I'm a real pain in restaurants, at receptions or banquets, and when eating at anyone's home since I have to know what's in everything before I can eat it. But that's what I have to do, so I do it.
>
> Am I throwing caution thrown to the wind? I think not. I can't speak for everyone else here who are on MAOI's, but I certainly have read posts where folks were seeking information in order to weigh the risks and benefits before making a change.
>
> > I am not comfortable with some of the combinations being prescribed. You can't tell what's causing what side effects as you combine more and more drugs that are obviously interacting with one another.
>
> Everyone's comfort level is their own. I would assume if you are not comfortable with what's being prescribed for you, you would discuss that with your doc. If you're not comfortable with what a doc is prescribing for anyone else, well...not sure what I can say about that.
> >
>
> > It seems as though concerns expressed for others when things like this are pointed out are ignored or minimized. It gets really hard trying to be supportive when there seems to be no precautions being taken and it's hard to tell who's dropping the ball, the docs or the patients.
>
> How would you like to see concerns responded to? What would help you feel more able to be supportive? I agree it's hard to be supportive when you feel like the person is not hearing and/or not taking your advice. It's hard to separate out our own feelings of concern from the other person's behavior. But they are separate and individual.
> >
> > I certainly would never take some of those risks myself and it's not because I am not really depressed or I'm not as depressed as others. That's not the argument.
> >
> > I am just too afraid of causing more problems for myself than depression, which is bad enough.
> > I am afraid of what these drugs are doing to many of you who are ignoring the risks of taking these drugs.
>
> I believe you're sincere in this concern, and I'm sorry if it's upsetting or frustrating (or whatever word you would use) for you. I think it's hard, too, because we only get pieces of information from folks. We don't get to see their entire thought process, feelings, and/or behaviors. So I'm not sure it's fair to say that risks are being ignored. Sure, in some cases that's probably happenening. It's always going to happen. All we can do is try to be supportive and to inform when we can, but ultimately, the individual's behavior is up to them.
> >
> > I am on EMsam now and I have taken Nardil, Parnate and Marplan and I religiously followed the dietary and drug restrictions given to me. When I asked my pdoc about some of the things that others are doing today, based on what I have read here, he is amazed with the current cavalier attitude which now exists.
>
> Sounds like you have a good working relationship with your doc. I'm glad. And it's good that you know what you will and won't risk in order to be well. That's often a difficult issue.
> >
> > I believe that taking these risks now will ultimately cause more harm than good in the long run.
> >
> > AD's are usually used as temporary fixes, but heart attacks and liver failure are life sentences.
>
> Then it's important to work towards good physical health as well as mental health, I would think. And please keep in mind that these are rare occurrences. And there are often co-morbid issues which contribute to someone having a heart attack or liver failure.
> >
> > You be the judge but do your research and get a second opinion if your treatment is leading you to have more and more side effects. Not all docs are as careful as others.
>
> That's a good thing to keep in mind. I think it can be easy to get sort of myopic about health care providers, and it's important to do a reality-check from time to time to make sure they really are effective, etc. It took me too long to realize my last pdoc was, um, an uncivil word. I'm glad I finally did, but the signs were there from the beginning. I just didn't pay enough attention to them. Actually, I suppose I also didn't trust my own reactions, but that's a separate issue.
>
> Take care and thanks for expressing your concerns.
>
> gg
This is the end of the thread.
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