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Re: New on Nardil

Posted by policebox on August 14, 2011, at 0:55:52

In reply to New on Nardil, posted by Cass on August 13, 2011, at 15:11:52

Hello Cass,

I'm sorry to hear you are having a difficult time. I too started taking an MAOi drug during the past few months (Parnate in my case). Like you, I was very much concerned about the food restrictions. Not so much that I would have to give up certain foods, but that I might make a lethal mistake through the accidental intake of a forbidden food.

The good news is, after several months of using Parnate, I haven't experienced any problems when it comes to the restricted diet. Although, as others have mentioned, every individuals' physiology is different, I think it's safe to say that the diet restrictions are fairly conservative (over-cautious).

Caffeine in moderation is okay to have, meaning one soda probably isn't going to cause you a problem. The reason it is contraindicated in large quantities is that Nardil (and other MAOi) can act as a stimulant in the central nervous system (CNS). Caffeine is also a CNS stimulant. Therefore, too many stimulants in your blood stream will cause an increase in your blood pressure, which could result in a hypertensive crisis.

For chocolate, most American chocolate, especially milk chocolate, is also generally safe in small quantities. I'm no expert on this subject, but I think most people say to avoid European chocolates, more expensive, and exotic chocolates. I'm not sure how the formulation is different, perhaps it's the amount of cocoa. For me, I eat a different brand of fiber bars with chocolate chips, and I've never had a problem. I eat Reese's peanut butter cups, chocolate chip cookies, etc. and have never had a problem.

It may be perhaps that the stress and tension you experienced from being afraid of eating the chocolate that caused the headache. Although I've never experienced one for myself, other people have described a hypertensive crisis related headache as one of the worst pains they have ever experienced.

As for avocados, from the description I've read regarding the MAOi diet, the important point is not to eat overripe ones, which contain higher levels of tyramine. If not overripe, it's apparently fine to eat about 1/2 cup of avocado, which I'd guess is about a normal-sized portion.

My suggestion is to take the anxiety of "not knowing" about your blood pressure out of the equation by purchasing a blood pressure/heart rate monitor. They are relatively inexpensive and are an important investment for anyone taking an MAOi.

The general rule is to avoid anything that's been aged, might be overripe, or spoiled. You want to eat fresh foods as much as possible. Even left-overs more than a day or two old can cause a problem for some people. I suggest if you want to eat something you are worried about, then try a small amount and check your blood pressure. If you don't have a reaction, it will probably be okay to eat. However, some people have eaten foods for years and then one day have a spontaneous reaction to them.

So I'd say the larger advice I can give is to not panic. Purchase a blood pressure monitor to reduce your anxiety about not knowing what your blood pressure is. If Nardil is helping with your depressive symptoms and overall improves your quality of life, then with a little caution, you can be confident you'll be alright.

I wish you all the best.




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