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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Bob on January 20, 2008, at 16:53:44
I assume that olives are verboten while taking MAOIs? I love green olives, and black olives are a close second.
Posted by gardenergirl on January 20, 2008, at 17:20:25
In reply to MAOIs and olives, posted by Bob on January 20, 2008, at 16:53:44
I've never had a problem with olives, and I take Nardil. I avoid the "olive bar" set ups, though. I just stick to plain ol' black or green, and an occasional Kalamata.
gg
Posted by Bob on January 21, 2008, at 0:00:51
In reply to Re: MAOIs and olives » Bob, posted by gardenergirl on January 20, 2008, at 17:20:25
> I've never had a problem with olives, and I take Nardil. I avoid the "olive bar" set ups, though. I just stick to plain ol' black or green, and an occasional Kalamata.
>
> gg
Interesting. I just looked up an MAOI diet on the internet and olives were banned along with aged deli meats. It seems like there is so much conflicting info with these diets.
Posted by stargazer2 on January 21, 2008, at 8:50:09
In reply to Re: MAOIs and olives » gardenergirl, posted by Bob on January 21, 2008, at 0:00:51
Bob, you're right. So many of us have said the same thing over and over. As you get used to being on the 'diet' you will know what you can get away with.
When just starting a MAO, it is best to follow the diet carefully. As you continue on it, you will often try something that could be considered forbidden. I do it from time to time, but never eat more than a few bites of something on the forbidden list.
I have gotten headaches from cheese in the past but the only real serious reaction I have gotten was from combining a MAO and a stimulant, which can be very serious. At a low dose I was OK,but I pushed it farther than I should have and I paid the price.
Actually the food lists that are the best identify which the levels of tyramine and some of those so called 'forbidden' food may contain small amounts of tyramine and therefore you can eat them in samll to moderate amounts, depending of the tyramine level in the foods. I'll see if I can find one of those lists and send it to you.
Stargazer
Posted by stargazer2 on January 21, 2008, at 9:13:16
In reply to Re: MAOIs and olives/conficting diet, posted by stargazer2 on January 21, 2008, at 8:50:09
http://www.linkpharma.com.au/util/doc.jsp?i=570&f=blob6&c=20
This wasn't the exact one I was looking for but it does give you some variation on page for for foods with less risk.
Posted by Bob on January 21, 2008, at 11:32:53
In reply to Re: MAOIs and olives/conficting diet, posted by stargazer2 on January 21, 2008, at 8:50:09
> Bob, you're right. So many of us have said the same thing over and over. As you get used to being on the 'diet' you will know what you can get away with.
>
> When just starting a MAO, it is best to follow the diet carefully. As you continue on it, you will often try something that could be considered forbidden. I do it from time to time, but never eat more than a few bites of something on the forbidden list.
>
> I have gotten headaches from cheese in the past but the only real serious reaction I have gotten was from combining a MAO and a stimulant, which can be very serious. At a low dose I was OK,but I pushed it farther than I should have and I paid the price.
>
> Actually the food lists that are the best identify which the levels of tyramine and some of those so called 'forbidden' food may contain small amounts of tyramine and therefore you can eat them in samll to moderate amounts, depending of the tyramine level in the foods. I'll see if I can find one of those lists and send it to you.
>
> Stargazer
>
>
>Thanks for your help!
I've got one more question: what exactly happens when you eat too much of one of these things. How do you know when you are going down a bad road? What happened to you when you "pushed too far"?
Posted by stargazer2 on January 21, 2008, at 15:46:27
In reply to Re: MAOIs and olives/conficting diet » stargazer2, posted by Bob on January 21, 2008, at 11:32:53
Bob, if you start to have a reaction to something you ate or to a contraindicated medication, it can be very serious since the reaction is an elevated BP, which comes on rather quickly, at least it did for me.
You may start to feel flushed or just have a funny vague feeling that something is wrong, or a clearer sign like a really bad headache.
Many people would just call 911 or get to an ER for treatment but I treated myself and was OK although I wouldn't recommend it unless you know what you are doing.
I have a BP cuff and I took my BP and it was 230/130. Next I got my meds given to me by my pdoc for this purpose. The med I was given is called Nifedipine and is used to reverse
hypertension only. Some people have said it is not a good medication for this since it can bottom out your BP quickly, but I found it to work, although it took awhile. During all this, I told my husband to call 911 if I couldn't reverse the hypertension or if I became unresponsive.After an hour or so my BP was within a normal range (150/88) and I felt safe that the worse had passed without any problem.
The one thing I can say for anyone on a MAO is you should get a BP cuff and make sure you know how to use it and know what your normal BP is. If you have a reaction to a food or med, you will know it if your BP elevates significantly above your normal range. My normal BP is around 100/60 so you can see how high it went when I had the reaction.
If you have no BP cuff or meds to reverse the hypertension you will have to go to the ER and hope they know how to deal with it. Oftentimes, even hospitals are not familiar with this reaction since MAO's are not used extensively anymore, except more recently by PsychoBabblers.
Hope that answers your questions.
Stargazer
Posted by Bob on January 21, 2008, at 23:37:26
In reply to Re: MAOIs and olives/conficting diet, posted by stargazer2 on January 21, 2008, at 15:46:27
Thanks for all the info, Stargazer. Your posts are very informative and helpful. I'm actually not on an MAOI at the moment, but am evaluating possible future options.
Posted by stargazer2 on January 22, 2008, at 8:34:57
In reply to Re: MAOIs and olives/conficting diet » stargazer2, posted by Bob on January 21, 2008, at 23:37:26
Posted by Bob on January 22, 2008, at 14:22:46
In reply to You're welcome Bob, Nardil rocks despite SE's (nm), posted by stargazer2 on January 22, 2008, at 8:34:57
I was actually thinking about EMSAM, but nothing is off the table.
Posted by trx resistant on January 23, 2008, at 4:04:05
In reply to Re: MAOIs and olives/conficting diet » stargazer2, posted by Bob on January 21, 2008, at 23:37:26
Yes, try EMSAM. No restrictions @ 6mg or probably 9mg according to some becsuse it's patch.
Posted by stargazer2 on January 23, 2008, at 8:50:22
In reply to Re: MAOIs and olives/conficting diet, posted by trx resistant on January 23, 2008, at 4:04:05
Actually dietary restrictions aside, whatever med works for you is the first priority of choosing one. I tried Emsam but perhaps not long for an adequate trial.
What I'm finding with meds is the length of the trial is critical to it's success. For those of us who are advanced participants in meds, I used to not give them enough time except for the MAO's since I have had the best results with them.
The dietary issues for me are secondary to the results. I can always modify my diet if the results are worth it.
I eat more food on the really restrictive lists than I realize and never had a reaction. If uncertian, a bite or two is enough for just a taste of foods I miss, like cheese.
Stargazer
Posted by Tony P on January 24, 2008, at 11:17:23
In reply to Food restrictions are not an absolute but a guide, posted by stargazer2 on January 23, 2008, at 8:50:22
I think one issue is, how _many_ little things are you eating plus the meds you're taking that can each contribute and add up to a reaction. Most of the time my BP is about what you'd expect for an overweight sedentary guy with moderate cholesterol. But early this morning it was up in the 180/100 region. I posted details below (today's date). Reflecting, I think it was just one too many things, mostly harmless one at a time, taken all together.
I'm taking an MAOI (oral selegeline @ 10 mg/day) plus several AD meds which CAN interact with it. I've eaten blue cheese -- and olives -- before with no noticeable problems. I think what pushed me over the line into a crisis last night was likely the combined effects of insomnia, trimipramine (which I only take occasionally), and oinking out on a late-night snack of blue cheese.
Tony P
Posted by stargazer2 on January 24, 2008, at 23:26:51
In reply to Re: Food restrictions are not an absolute but a guide, posted by Tony P on January 24, 2008, at 11:17:23
I think the riskiest things are meds that should not be taken with a MAO. Did your doctor sanction all of the other meds you are taking? If not, I wouldn't play around with the chance that you may have a reaction. A few bites of a "no-no" food is one thing. Adding several potentially reactive meds to a MAO is certainly playing with fire, and then to mix in some restricted foods is certainly asking for a hypertensive reaction.
I had my one major reaction with only one med (amphetamine) that was OK'ed at 5 mg, but at 10 mg was not.
There are lists of meds which you should check against the MAO on one of those on-line med checks that others have suggested, or look in a drug book, to be sure. I'm pretty sure any meds with the suffix 'amine' are not allowed.
You sound like you know enough about what may react with a MAO, but risk it anyway. A bit of Russian routlette if you ask me.
This is one reason pdocs are not comfortable prescribing MAO's to their patients unless they feel they can follow the restrictions very carefully.
What AD's do you also take that you say CAN interact with MAO's? Why do you take them with that risk? My pdoc has only combined things that I have given him proof that they are safe with MAO's, like Nortriptylline. He would never prescribe any meds (with mAO's) without proof of their combined safety.
Is your pdoc prescribing all of the meds you are on?
Stargazer
Posted by ny2bk on January 26, 2008, at 17:27:39
In reply to No-No foods +No-No meds = hypertensive reaction, posted by stargazer2 on January 24, 2008, at 23:26:51
You mention russian roulette which may be true but a bit intense.
However you also mention how Noritriplyine spelling excluded lol is ok and showed prove.Well the proof can only exsist even with theory but trying it,so someone tried it,now under what circimstances they did,i.e docs direct consultation so on might differ,however most known maoi combos that are now considered semi safe,as thats all they can be period since some individuals are simply extremly maoi sensative and some are totaly not,are considered safe only because someone played russian roulette.
To me long term untreated clinical depression is russian roulette itself,its a demon u fight,its a relentless non stop war,and some have more to loose,family,career etc, then others,and for some the pain is just so severe they are willing to risk a LOT to introduce a new weapon to a war they are loosing,a new weapon to a war they have gone no where with for decades,so i understand risks maoi users such as myself take,im about to to turn 30 and have fought this illness with my soul since 20,and looking ahead i simply cant see myself at 35,36,37 etc a agiging man living like this,so i am always willing,with dont get me wrong much care,to step to the front of the battle line,if im gonna go,id rather go knowing i fought this with no regret,opposed to living in pain another decade.
I also dont hold an extreme amount of value in docs,yess they are there to help,however they simply cant put the time,the desire blood and sweat i need in helping me,and i also dont limit what i can do to fight the disease to what some doc out of a million might believe.
My demon stays behind me because he knows not to face me or he will loose,i no longer fear him but desire to know and see more about my enemy,i just no longer see a way to do this aside from "trial and error"
Posted by stargazer2 on January 26, 2008, at 22:24:18
In reply to Re: No-No foods +No-No meds = hypertensive reaction, posted by ny2bk on January 26, 2008, at 17:27:39
NY2,
History for me, more than 30 years, first took Nardil in 1987, so I've been around the block with depression myself, with lots of life lost, careers, relationships, life too unimaginable to remember,etc, etc. Back then,not as much aggressive treatment, only drugs were TCA's and MAO's. Prozac only came out in the early to mid 90's, I think.
I still believe in following restrictions to avoid the dreaded hypertensive crisis...have you experienced it? Until you do, you can't understand the significance of following the diet or drug interactions seriously. And many ER's are not familiar with MAO's and don't know how to handle the situation correctly.
Here's the article that sanctions Nortriptylline, written by the Harvard guys at Mclean Hospital,outside Boston...for what it's worth, probably many more articles but this one is easy to read and is clear about what drugs are safe with MAO's.
http://www.dr-bob.org/babble/20061003/msgs/693453.html
Stargazer
Posted by ny2bk on January 27, 2008, at 20:42:51
In reply to Re: No-No foods +No-No meds/ny2, posted by stargazer2 on January 26, 2008, at 22:24:18
> NY2,
>
> History for me, more than 30 years, first took Nardil in 1987, so I've been around the block with depression myself, with lots of life lost, careers, relationships, life too unimaginable to remember,etc, etc. Back then,not as much aggressive treatment, only drugs were TCA's and MAO's. Prozac only came out in the early to mid 90's, I think.
>
> I still believe in following restrictions to avoid the dreaded hypertensive crisis...have you experienced it? Until you do, you can't understand the significance of following the diet or drug interactions seriously. And many ER's are not familiar with MAO's and don't know how to handle the situation correctly.
>
> Here's the article that sanctions Nortriptylline, written by the Harvard guys at Mclean Hospital,outside Boston...for what it's worth, probably many more articles but this one is easy to read and is clear about what drugs are safe with MAO's.
>
> http://www.dr-bob.org/babble/20061003/msgs/693453.html
>
> StargazerYess i have had two maoi interactions,second very severe,and i had to waste my last breaths repeating to 18 yr old emts calling me in that it was not an allergic reaction,then i had to BEG the main doc to look up maois.
Finaly a specialist came in,many things took place,what i remeber what vital signs were kept on watch,immediate mri scans for brain heorage were taken as i felt my head was gonna burst in pain,bags of ice were laid beside me,no medicine was given me which i understood,but still dident help the intense pain i was in.
I never moaned in pain at a docs before as i can have a lil ego issue,but i dont think i stopped maoning and hollering for a doc but there at this time was nothing could be done.
I was given activated charcaol which helped greatly,and was seen by a toxicolist who to my delight knew everything on maois however still couldent offer much,i had to wait it out and see if my body was gonna withstand it.Well it did,i was put in icu which is sorta of a roundish floor where the center desk can see everyone.
For being desperate for help and listening to some old post somewhere i was declared suicdal and was why i was in icu.
Going home that afternoon my biggest fear actualy was if this was going to cause my psych doc to stop parnate.
So even through that nightmare of a night ill never forget,i still choose to use parnate because that was one night of pain,vs what is and will be decades of more slower brutal emotional and pyshical pain all around.
I dont push a soul to play with maois,or even take them unless they know the dangers and how real they are,and accept them.
I also dont advocate my actions,im telling m y story above to show there is severe ramifacations to do what i do,however i do have to show my respect and understanding for the few like me who for specific reasons choose to take risks such as these.
I hope all posts,defintaly ones maoi based are to be read with the understanding they are not written word,please make sure u use a responsable means to end when u make any decision on these meds,meaning u feel totaly confident in your decision and how and why u do.
I just hope my aim comes out as i am meaning it to which is not pro nor con but just information for both.
This is the end of the thread.
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