Posted by KaraS on January 11, 2005, at 13:47:24
In reply to Re: My friend w/ PD had hypertensive crisis- selegili, posted by King Vultan on January 11, 2005, at 8:04:48
> > My friend takes selegiline for Parkinson's Disease. She usually takes 10 mg. a day but recently her doctor told her she could take 15 mg. Unfortunately he never told her anything about the diet or the risk of hypertensive crisis. We were talking on the phone tonight and I mentioned that I'm considering an MAOI and we discussed the risk of hypertensive crises. She said that sounded like what happened to her the other night. She had just thought that it was a horrible migraine. She had eaten cheddar cheese earlier in the day. Since she didn't know what was happening to her, she didn't go to an emergency room or take anything to lower her blood pressure. If we hadn't spoken, who knows how many times this might have happened to her.
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> > She had bought a big hunk of cheddar cheese and would definitely have eaten it again. I'm just so angry that she had to go through that and that her ignorant doctor didn't warn her. This is one of the major PD medications and he doesn't know enough to warn his patients about the MAOI diet?
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> The tyramine potentiation studies I've seen suggest that even 20 mg selegiline is much less problematic than 60 mg Nardil or 20 mg Parnate. I'm a little surprised she had this much of a reaction, but tyramine sensitivity does vary widely among individuals. As I recall, the Parnate study I saw suggested one person may require only 2-3 mg tyramine to boost their BP 30 mm Hg while on 20 mg Parnate, while another person taking the same amount of Parnate might need to ingest 10 times that amount of tyramine (20-30 mg) to experience the same effect.
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> Cheddar cheese is just chock full of tyramine, and eating large amounts of it can sometimes cause headaches and other problems even in people who are not on MAOIs. However, even on 10 mg selegiline, I think it makes sense to limit one's intake of extremely tyramine rich foods like this one (I would not recommend entering a sauerkraut eating contest, either).
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> Todd
There is definitely a lot of individual variation. She never did have any problems at 10 mg. It was only going up to 15 that seemed to cause her problems. Yet I've heard of others who have had problems at only 5 mg. of selegiline (if one post here at PB was accurate). It's important to know which type you are and to take into account which medication you're on and the amount you're taking. Of course it's best to have your doctor tell you about the risks to begin with!!!
K
poster:KaraS
thread:440536
URL: http://www.dr-bob.org/babble/20050108/msgs/440686.html