Posted by reflecting on January 4, 2012, at 17:49:30
In reply to Re: Nardil - should I change brand/stop/go down and up, posted by Erewhonian on January 4, 2012, at 11:17:41
> Gah, another pdoc afraid to give a patient an emergency hypertension pill! I'm afraid the valium won't cut it; it will help calm you down, but won't do much for the blood pressure in a serious tyramine hypertensive crisis.
>
> Try suggesting chlorpromazine (aka Thorazine in the US), that's a popular choice now that all the doctors are afraid of nifedipine. The thorazine has pretty strong alpha-1 adrenergic receptor blocking action, which would be a major side-effect if you were taking it as an antipsychotic; but in the case of maoi tyramine hypertension, it's not a bug, it's a feature.
>
> The pdocs are all afraid that if they give you a real anti-hypertension drug you'll take too much of it, or will take it in a panic when you don't actually have a hypertensive crisis. The thorazine is safe enough that it shouldn't put you into a serious case of hypotension, even if you take it when you're not in the middle of a real tryamine induced hypertensive episode.Yeah, I read different things about this... that Nife is a bad choice seems to be consense now in the profession.
Ken Gillman (www.psychotropical.com) even writes that one should not do anything about high blood pressure (except for benzo) unless there is real evidence of ongoing endorgan-damage... I don't know, maybe a high dose like 20mg sublingual of Valium already reduces it to some degree (and if not enough one would have to go to the ER).But you are right that sth. like the thorazine may be a good idea for a case where there is no ER close by.
poster:reflecting
thread:1006214
URL: http://www.dr-bob.org/babble/20111226/msgs/1006336.html