Psycho-Babble Medication Thread 204334

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Any Update On Nardil Availability?

Posted by cosis on February 27, 2003, at 11:40:02

Nardil Users,

Any updates? This is getting annoying! I am still able to get Nardil through a drop-shipment but the fact that it's the only way has my worried about the future of it...

Thanks,
Nick

 

Call Pfizer and let us know what they say (nm) cosis

Posted by Jack Smith on February 27, 2003, at 12:38:00

In reply to Any Update On Nardil Availability?, posted by cosis on February 27, 2003, at 11:40:02

 

Re: Call Pfizer and let us know what they say

Posted by cosis on February 27, 2003, at 13:10:26

In reply to Call Pfizer and let us know what they say (nm) cosis, posted by Jack Smith on February 27, 2003, at 12:38:00

Someone I been talking with called this morning and the rep. didn't have a clue.

 

Re: Call Pfizer and let us know what they say cosis

Posted by Jack Smith on February 27, 2003, at 17:40:42

In reply to Re: Call Pfizer and let us know what they say, posted by cosis on February 27, 2003, at 13:10:26

That's a pain. I would be shocked if Pfizer actually stopped production altogether. It is probably a fairly profitable drug. It doesn't cost much to make and their is only one or two competitors in its class of meds. If Pfizer did make such a decision, some sort of letter writing campaign or something would have to begin from the grassroots. It would be a serious blow to psychiatry.

 

Re: Any Update On Nardil Availability?

Posted by SLS on February 28, 2003, at 7:24:13

In reply to Any Update On Nardil Availability?, posted by cosis on February 27, 2003, at 11:40:02

> Nardil Users,
>
> Any updates? This is getting annoying! I am still able to get Nardil through a drop-shipment but the fact that it's the only way has my worried about the future of it...
>
> Thanks,
> Nick


Two weeks ago, my pharmacist told me that her wholesaler said Nardil was again available for normal distribution. As I have since discontinued taking Nardil, I haven't followed-up.

I wouldn't worry about the continued manufacturing of Nardil. I'm sure it's plenty profitable for Pfizer to keep the assembly line going, especially since it was the retooling of line that was the reason for the suspension of production in the first place. As far as I know, there are no new safety issues that have surfaced.

If for some reason Nardil remains unavailable, I would offer the suggestion of trying Marplan as a substitute if Parnate doesn't do the trick. Marplan is chemically related to Nardil (hydrazines), whereas Parnate is not.


- Scott

 

Re: Any Update On Nardil Availability?

Posted by exbenzouser on February 28, 2003, at 9:18:27

In reply to Any Update On Nardil Availability?, posted by cosis on February 27, 2003, at 11:40:02

> Nardil Users,
>
> Any updates? This is getting annoying! I am still able to get Nardil through a drop-shipment but the fact that it's the only way has my worried about the future of it...
>
> Thanks,
> Nick

Yes, I called the number you put up and the person I talked to said the production problems have been cleared up and it is now getting back to normal distribution. I then went to my pharmicist who ordered it and had it in the next day. I'm sure glad to be back on it.

Larry

 

Re: Any Update On Nardil Availability?

Posted by Katia on February 28, 2003, at 15:18:35

In reply to Re: Any Update On Nardil Availability?, posted by exbenzouser on February 28, 2003, at 9:18:27

Any of you gain weight on Nardil? (I know Ace gained weight, but I'd like to hear of other's experiences as well). It's different for a woman gaining weight, I think. Any woman out there on Nardil who did or did not gain weight?
Thanks.

 

Re: Any Update On Nardil Availability? Katia

Posted by Eilidh on March 1, 2003, at 6:13:06

In reply to Re: Any Update On Nardil Availability?, posted by Katia on February 28, 2003, at 15:18:35

I have been using Nardil for 31/2 months and have found that I lost weight.I'm fairly sure this was due to my eating less convenience foods and more fresh produce. Also less comfort eating and visiting the gym as my mood improved. However, my weight has been static over the past 3-4 weeks, and I am wondering if this is my new "Nardil weight ".
As time has past I am more adventurous about what I eat.The most up to date dietry advice is less rigid about what is unsafe, while encouraging a common sense approach to avoidance of hazerdous foods, e.g. I missed cheese but can now eat brie cheese as long as I absolutely leave the rind alone. I am not suggesting that this will be suitable for everyone,but am aware that we all have our own idividual tolerance levels re tyramine levels in food items. What is okay for one will be a nightmare for others.
I am fed up of having to put effort into my food preparation etc. Maybe it is a self esteem issue and it is time to think about a Nardil increase? I'll have to think about this.
It is weird feeling more emotionally more stable after so long.I sometimes find myself thinking"Is this a normal way to think or do I need more/less medication?" . Only the passage of time at an improved level will boost my self confidence I suppose.
Any observations welcome.
Eilidh.

 

Nardil: please be careful *hypertensive crises*

Posted by Anonne on March 3, 2003, at 0:17:49

In reply to Re: Any Update On Nardil Availability? Katia, posted by Eilidh on March 1, 2003, at 6:13:06

Hello.
As someone who has been on Nardil off and on since 1985, and who has now had three (3) hypertensive crises, the last one documented to have caused intracranial hemorrhage, I must warn you that tyramine amounts (and one's sensitivity to that) can vary tremendously!

I am now OFF of Nardil (MUCH to my dismay, on Effexor XR and maybe adding Remeron soon).
(Am in the U.S.)

This will be reasonably brief right now, since this is my first post and I must sleep. However,
out of the three ER visits for hypertensive crisis due to ingestion of tyramine laden products, only the last ER visit (each at a different hospital) warned me properly. If I could find empirical evidence of say, nifepidine or some other agent to take at the immediate ONSET of a hypertensive crisis, AND have a psychiatrist well-versed in handling this kind of medication, I would consider going back on Nardil.
----

First crisis, 1990: ate a bagel w/ alfalfa sprouts, tomatoes (cooked) and a small bit of Swiss cheese. I had been able to eat pizza, bananas, chocolate, some beer and white wine (never red) without a problem. The tiny amount of Swiss cheese MUST have aged or chemically done something to elevate tyramine.
ER did nothing to reduce my blood pressure - basically waited for several nasty hours w/ HORRIBLE pounding blinding headache, radiating chest pain, palpitations, running cold water on my forehead until the doctor saw me - and gave me painkillers.
Nothing said about CAT scans or anything.

1998, 2nd hypertensive crisis: Food was Chinese takeout, asked for NO MSG, just white rice, lemon chicken. (Have been able to add soy sauce to much food, including teriyaki, w/ no problem, in the past. I don't believe there was ANY soy sauce to my knowledge in the dinner.) By dessert, which was Haagen Dasz icecream and mango, I had my 2nd hypertensive crisis.
The ER, even when I told them that my BP was normally VERY low, and that now it was over 145/99 (normally 100/70), AND saw my Nardil MAO-I list of WARNINGs on reactions (from the manufacturer), did nothing but take an EKG and administer Ativan. Which did in fact lessen the horrid shotgun headache and accompanying chestpain.
It was noted in my chart that what had, in fact, occurred, was merely a "panic attack" or "stress". Suffice to say that simply mentioning a psychiatric history (and the fact that the offending medication was a psychotropic) seemed to completely obviate (word?)/negate every piece of evidence brought forth of a hypertensive crisis.
I still need to write to that hospital and inform them of their lack of judgment, and suggest improvements in triage. (even if the percentage is tiny of medication induced hypertensive crises, this could be lifesaving).

Apparently, relatively low jumps in blood pressure for some people who normally have VERY low blood pressure can be signs of potential real cerebro-vascular damage. Most ERs are not trained in recognizing this.

2002: 3rd and last. Sleep deprived, stressed out, chain-smoking cigarettes, and then Indian take-out. I have eaten Indian food a zillion times. I had not tried this particular restaurant before, though.
It was either the butter chicken or the fish - they tasted fine. The palpitations, tell-tale radiating chest pain and nausea, then shotgun headache told me something was up again. This time, I was terrified of going to another ER- the thought made me SICK of being dismissed again, plus the terror of being so much in pain and trapped in this body... I don't know, I just was UNINFORMED. For 18 years!!!!

I had no idea, despite my relatively expansive readings on psychotropics AND Nardil, that CAT scans should be asked for.
I didn't THINK of cerebral damage!
I didn't know that meat, especially foreign (i.e., Indian, Chinese, anything covered w/ strong spices/sauces) could be dangerous - I knew to avoid liver and chicken liver, anything smoked or pickled - but this was just plain weird.
Perhaps the chicken or fish had undergone some putrefication (undetectable in taste), as it was peppered with all sorts of yummy spices.
Remember, I had eaten varieties of these kinds of foods for years, w/ no adverse effect (except 1998, which still didn't make sense - lemon chicken and rice???).

The meat putrefication apparently can do some pretty weird things w/ tyramine; at least, that's what it seems happened. Perhaps the combination of spices and meat, perhaps some disguised MSG, perhaps the addition of a stressed out system (chain smoking, tire blew out, sleep deprivation of 24+ hours) can alter one's receptivity to tyramine and all that chemical combustion.

In any case (Nardil doses varied throughout the years from 45 - 90 mg/day, btw), I took a Klonopin which helped some. The headache, however, lasted for 4 days. Each time before, the pain went away w/in 2 days at most, I think. This time, it didn't, and I luckily called my psych. (who was amenable to researching potential life saver 'nifedipine' or Haldol pills for emergency situations, after 1998 crisis - however, as nothing in the literature was conclusive, I kind of forgot about it.) - and said, "should I go to the ER, as the pain is localized on one side (right), and hasn't gone away?"

He said to get checked out. I also said I hadn't taken my Nardil since the crisis, 4 days before, as I was afraid that would aggravate the reaction. He concurred. That was it. Nothing about "GET A HEAD CAT SCAN A.S.A.P.!"

Long story short (ha): CAT scan showed hemorrhage. Referred to an MRI. That didn't come w/in several hours.
I was having bad anxiety and crying bouts, as I was cold-turkeying off the Nardil. So, frustrated, I asked the attending doctor if I could not just godd*mn it, go home until the MRI was ready. Like, make an appt. and come back.

He told me that unless I wanted to die in my sleep, or worse, I should stay put at the ER however long it takes until the MRI is available.

So I stayed for 4 days, transferred w/in the same night to a hospital room.

MRI showed hemorrhage OR calcification. Neurologist told me to get a new CAT scan in a month, to see if the lesion in fact was hemorrhage, or simply calcification. Meanwhile, no smoking, no caffeine, and certainly no Nardil.

I asked what about other Antidepressants - to be safe, he said, none for that month.
It was a month from hell. The next CT scan showed resolution (no more lesion/hemorrhage), so it was assumed that indeed there was intracranial bleeding which had since healed. I held off on antidepressants for 2 more months after.

I shudder to think of all the possible previous 'brain damage' I could have had w/ the other two hypertensive crises. On top of some pretty vicious clinical depressive episodes throughout childhood, teen years, and adult years. And ECT, and psychotropics.

I'm done for now. Not gonna edit.
Be careful out there.

 

Re: Nardil: please be careful *hypertensive crises*

Posted by Anonne on March 3, 2003, at 0:20:16

In reply to Nardil: please be careful *hypertensive crises*, posted by Anonne on March 3, 2003, at 0:17:49

P.S. I want to add that the migraine-like pain, during the last hypertensive crisis, was on the right side of the head.

The hemorrhage occurred on the left side, somewhere deep within the basal ganglia.

Odd.

 

Re: Nardil: please be careful *hypertensive crises*

Posted by Jack Smith on March 3, 2003, at 12:17:22

In reply to Nardil: please be careful *hypertensive crises*, posted by Anonne on March 3, 2003, at 0:17:49

(, AND have a psychiatrist well-versed in handling this kind of medication, I would consider going back on Nardil.
> ----

There are plenty of them out there, you should find a good psychiatrist who knows what s/he is doing and get back on Nardil if your current meds don't work.

 

Re: *hypertensive crisis* OMG! Anonne

Posted by LUKA62 on March 4, 2003, at 16:34:34

In reply to Nardil: please be careful *hypertensive crises*, posted by Anonne on March 3, 2003, at 0:17:49

Anonne: Thank you for your post!! It's really made me think. Over 16yrs, varied dosages, and one really Major hypertensive crisis I'd been wondering if the Nardil would suddenly start effecting me differently. I know how extremely sensitive I am, where just one more pill, or one less would make a noticeable difference. I think I've really taken things for granted for a long time, figuring I've always been able to eat just about anything I wanted; and in the case of country ham, I'd enjoy a little in trade for a Big headache, or some chest pain.
After reading your post, I was jolted back to several years ago; I was in my neurologist's office, and he seemed very concerned,and told me to walk directly across the lot to be admitted for tests. Protein in the cerebrospinal fluid abnormal,and he was concerned about a bleed (he was right, and it too resolved.) But LISTEN to this!!
-------I was to have an arteriogram (a very painful diagnostic test--they run a catheter up, around the heart and up into the carotid arteries,,then they cut off oxygen supply to the brain, for 4 seconds, and 6 seconds , etc. (Excruciating.)I was not given Valium before the procedure, because night before, I was complaining of the worst headache in my life, and that was saying a lot, because I've had severe migraines for a very long time. I was in so much pain I couldn't think. My chart was clearly flagged for Nardil. The resident docs gave me Demerol that night, and I went into cardiac arrest! These docs just were not properly trained.
I thought if demerol never bothered me before...
And as far as ER's go, I too have had terrible experiences with doctors who didn't understand the reactions of Nardil, with food, OTC meds, as well as prescription meds. It's only been the last couple of months I seem to be havng some problems. (I also take Ultram daily for chronic pain, and I wonder if is part of the problem. I think I may have posted about this once before, but several weeks ago after taking 100mg of Ultram, I got a real heavy feeling in my chest, and couldn't breathe well, and it felt like my throat was closing up on me. It was bad enough to scare me into calling paramedics, but they said "if you were having an allergic reaction, ...." I told them this wasn't an Allergic reaction, but a drug Interaction. But I felt like an idiot, and didn't go to ER. I don't want to be a dead idiot, but going through that kind of treatment is terrible.

 

Hypertensive Crisis

Posted by IsoM on March 4, 2003, at 18:02:05

In reply to Re: *hypertensive crisis* OMG! Anonne, posted by LUKA62 on March 4, 2003, at 16:34:34

Thank you both for posting your experiences - quite an eye opener! My ex was on an MAO inhibitor for a time & he refused to watch his diet. It sounds like he was very lucky to escape without an incident. I think it's because of the possibility of a hypertensive episode & many people's noncompliance with their diet that doctors won't use MAOIs much now.

Both are scarey stories & I hope any one taking an MAOI reads this & will bear it in mind when they want to eat what they used to.

In case this is helpful for you, protein foods form these pressor amines (that cause the hypretension) when the protein is stored for a while & protein breakdown starts occuring. It doesn't even have to be spoiled or such, but fresh meat & unaged cheeses are generally safe. That's why anything femented (soy is high in protein) or aged is taboo. But if you go to fancier restaurants that may serve well aged, tender beef, or places where chicken or other meats have been kept sufficiently cold but stored a while, they're more likely to give problems. The lemon chicken was probably sitting in their fridge for a day or two.

Any good doctor should be willing to prescribe nifedipine to take sublingually for emergencies, especially with your previous history, & the fact that you do try to take care. I hope you find one.

 

Re: Hypertensive Crisis to LUKA and IsoM

Posted by Anonne on March 4, 2003, at 20:56:47

In reply to Hypertensive Crisis, posted by IsoM on March 4, 2003, at 18:02:05

Thanks you two, too, for posting!
That sounds like a horrific experience (Luka), and yes, IsoM, I had read about the pressor amines etc. back in '98, and then again after the last hypertensive crisis. I'm surprised I didn't have MORE of those episodes. But yes, it's possible I had "mini" episodes, now that I think back. At least once that I definitely now correlate (back in 1986, I think).... could have been the strawberry daiquiri that just gave me such a nasty headache..or perhaps I was off Nardil and on a Ludiomil trial. (not helpful).

You know, IsoM, I was soooo stuck on HAVING to have Nardil (because at least it was better than being off of it!) that I was willing to find someone who would administer it.. despite 4-5 ++ opinions of "DON'T GO THERE AGAIN!"...

But I thought that nifedipine was NOT conclusively the best agent, after more research, which is why I didn't investigate further. At this point, the EffexorXR has mitigated the worst of the depression (knock on wood), and frankly, I knew that I was only partially responsive to Nardil in the long term. I just didn't want to guineapig around...too stressful.

I will write again. LUKA, do write again too, I'm not too coherent right now, and boyfriend came home and multi-tasking....

A

 

Re: *hypertensive crisis* OMG! LUKA62

Posted by Anonne on March 4, 2003, at 21:43:22

In reply to Re: *hypertensive crisis* OMG! Anonne, posted by LUKA62 on March 4, 2003, at 16:34:34

Luka,
you wrote ...

".... Protein in the cerebrospinal fluid abnormal,and he was concerned about a bleed (he was right, and it too resolved.) But LISTEN to this!!
-------I was to have an arteriogram (a very painful diagnostic test--they run a catheter up, around the heart and up into the carotid arteries,,then they cut off oxygen supply to the brain, for 4 seconds, and 6 seconds , etc. (Excruciating.)I was not given Valium before the procedure, because night before, I was complaining of the worst headache in my life, and that was saying a lot, because I've had severe migraines for a very long time. I was in so much pain I couldn't think. My chart was clearly flagged for Nardil. The resident docs gave me Demerol that night, and I went into cardiac arrest! These docs just were not properly trained."

How did you get this reading of the protein in csf? (cerebrospinal fluid)... Thrue a spinal tap?
Those are HORRIBLY painful in themselves, but it sounds like what you went through w/ all the rest, including cardiac arrest, was even worse...!

I hope you have a good doctor/neuro/psychopharm now - any idea what methods to take IF an H.Crisis were to take place? I didn't even finish printing out my MED-ID tag I was gonna make as a "Nardil ingester"... But were I to go on MAOIs again, I definitely would have a med ID tag/card, INSTRUCTIONS for the ER on a printed page (laminated or several copies), Haldol, Nifedipine, and other agents on hand. Including Klonopin (or Ativan or Valium, one of those benzos, which really do reduce the headache, and probably the blood pressure).

What else? Oh, isn't Demerol "meperidine"??? if so, that's a major contraindicated drug. My mother said something about "throat swelling/closing" - another DAngerous sign!

Maybe we should get Ace the Australian Nardil champion to read these, so he can prepare in case of emergency... I hate scaremongering stuff, but in this case, one can probably control (the situation, potential situation) more than one thinks. I just wish I had..

 

Re: Nardil: please be careful *hypertensive crises* Anonne

Posted by Ron Hill on March 4, 2003, at 23:59:04

In reply to Nardil: please be careful *hypertensive crises*, posted by Anonne on March 3, 2003, at 0:17:49

Anonne,

Let me chime in with the others and add my "thank you" for your eye opening post. Thanks for taking the time required to type it up for our benefit.

Welcome to pbabbleland!

-- Ron


P.S. You write well.

 

Re: *hypertensive crisis* OMG! LUKA62 Anonne

Posted by LUKA62 on March 5, 2003, at 2:47:59

In reply to Re: *hypertensive crisis* OMG! LUKA62, posted by Anonne on March 4, 2003, at 21:43:22

> Luka,
> you wrote ...
>
> ".... Protein in the cerebrospinal fluid abnormal,and he was concerned about a bleed (he was right, and it too resolved.) But LISTEN to this!!
> -------I was to have an arteriogram (a very painful diagnostic test--they run a catheter up, around the heart and up into the carotid arteries,,then they cut off oxygen supply to the brain, for 4 seconds, and 6 seconds , etc. (Excruciating.)I was not given Valium before the procedure, because night before, I was complaining of the worst headache in my life, and that was saying a lot, because I've had severe migraines for a very long time. I was in so much pain I couldn't think. My chart was clearly flagged for Nardil. The resident docs gave me Demerol that night, and I went into cardiac arrest! These docs just were not properly trained."
>
> How did you get this reading of the protein in csf? (cerebrospinal fluid)... Thrue a spinal tap?
> Those are HORRIBLY painful in themselves, but it sounds like what you went through w/ all the rest, including cardiac arrest, was even worse...!
>
> I hope you have a good doctor/neuro/psychopharm now - any idea what methods to take IF an H.Crisis were to take place? I didn't even finish printing out my MED-ID tag I was gonna make as a "Nardil ingester"... But were I to go on MAOIs again, I definitely would have a med ID tag/card, INSTRUCTIONS for the ER on a printed page (laminated or several copies), Haldol, Nifedipine, and other agents on hand. Including Klonopin (or Ativan or Valium, one of those benzos, which really do reduce the headache, and probably the blood pressure).
>
> What else? Oh, isn't Demerol "meperidine"??? if so, that's a major contraindicated drug. My mother said something about "throat swelling/closing" - another DAngerous sign!
>
> Maybe we should get Ace the Australian Nardil champion to read these, so he can prepare in case of emergency... I hate scaremongering stuff, but in this case, one can probably control (the situation, potential situation) more than one thinks. I just wish I had..
>

I am now under the care of a very well resepected neurodoc, as well as a fine psych-doc. However I am unaware of these meds being dispensed for possible Hypertensive creisis I do have valium and ativan at home. Not familiar with nifedipine.

Sure sounds like thebad symptoms I had a little while ago when taking Ultram (for the umpteenth time) But I absolute;u dread going off dthe pain med/...luka


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