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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 199 to 223 of 488. Go back in thread:
Posted by jsarirose on July 26, 2002, at 14:44:48
In reply to Re: hypertensive experiences? » jsarirose, posted by SLS on July 26, 2002, at 14:23:48
> > > Surely, Nardil is not known to produce episodes of spontaneous hypertension as does Parnate. "
>
> > Did you mean to say 'not known to' ? I'm not questioning you at all, I just wasn't aware that this difference existed. I thought people on Nardil had to adhere to the same diet restrictions as those on Parnate and that the same risks were involved. How interesting.
>
>
> Hi Jessica.
>
> First of all, it would be very silly of you not to question me. :-)
>
> It is true that I have never been wrong, though. One time I thought I was wrong, but it turned out that I was mistaken.
>
> There's a joke in there somewhere.
>
> I'm glad you replied the way you did. Others may have also misinterpreted what I said, which of course is dangerous. I wish that I had the good sense to better clarify my statement.
>
> The key word in my post is "spontaneous". For some people, Parnate can cause high blood pressure spikes all by itself. They don't have eat anything for this to happen. It is thus spontaneous. This is what was being referred to in the post I replied to. To the best of my recollection, I have never seen this happen at all with Nardil.
>
> Of course, both of these MAOIs, along with Marplan, are capable of producing a dangerous hypertensive reaction to the foods and drugs that are to be avoided.
>
> Is my post still confusing?
>
>
> - Scott
>
>
Got it! Thanks for the clarification. I guess I wasn't as familiar with that side effect as I the danger of BP dipping too low.-Jessica
Posted by SLS on July 26, 2002, at 15:06:21
In reply to Re: hypertensive experiences? » ayrity, posted by LLL on July 25, 2002, at 13:50:19
Hi there LLL.
Here are a couple of sources.
:-)
I guess these are the most local source:
http://www.dr-bob.org/tips/split/Spontaneous-hypertensive-r.html
http://www.dr-bob.org/babble/19990301/msgs/3436.html
--------------------------------------------
http://www.mhinfosource.com/expert/exp1061900c.htmlhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2486182&dopt=Abstract
--------------------------------------------
- Scott
Posted by SLS on July 26, 2002, at 15:18:48
In reply to To SLS, posted by judy1 on July 25, 2002, at 11:09:35
> This has nothing to do with this thread, I just wanted your attention :-). I have a thread on Psycho-Psycho Babble (my symptoms on manic psychosis) where I mention your offer to e-mail you when I was getting manic. If you remember any of that, would you mind contributing? Thanks a lot! Now back to regular programming.... Take care, judy
Hi Judy.If I am reading between the lines properly, you are asking for my email address. Dear Judy, you are invited to write to me whenever.
The only thing I ask is that you don't share my email address with anyone else. I would hate to have it posted in a public forum for all to see!
;-)
- Scott
Posted by LLL on July 26, 2002, at 15:37:50
In reply to Re: hypertensive experiences? » LLL, posted by SLS on July 26, 2002, at 15:06:21
Thank you Scott, that was very informative. However, since my pulse (not b/p) is now the issue and elevated on the Parnate (117 this a.m. an hour after the first dose!), I'm afraid that my only hope is now lost! I guess I could try the Nardil again, but I recall the constant carbohydrate craving and weight gain, daytime narcolepsy attacks, anorgasmia etc. ARGGGGHHHHHHHHHH!
I don't understand why it doesn't agree with me now - it worked before and It got to where I didn't feel like I was anything!
Posted by jsarirose on July 26, 2002, at 21:04:33
In reply to Re: hypertensive experiences? » SLS, posted by LLL on July 26, 2002, at 15:37:50
> I don't understand why it doesn't agree with me now - it worked before and It got to where I didn't feel like I was anything!Sorry to jump in here, but how much are you taking and do you split up the dose? I find I handle the Parnate the best when I take it three times a day. I try not to take it close to bed time so I take the first dose when I get up, the second dose around 3 hours later and the third dose three hours after that. It sounds hard, but it isn't really if you just carry a little pill box around with you. Also, except for the first dose, the other two could vary an hour or so with no ill effects. Only if I forgot the first dose and took it an hour or more late did I experience dizziness and fatigue. I'm taking 70mg now but was up to 100mg and this allowed me to handle it without getting too dizzy.
Just a thought.
-Jessica
Posted by LLL on July 26, 2002, at 21:14:33
In reply to Re: hypertensive experiences?, posted by jsarirose on July 26, 2002, at 21:04:33
I've just started and haven't gotten beyond one 10mg in the a.m and 5mg (yes, I cut that little buger in half) by 3:00 pm! This tacychardia occurs after my intial morning dose. My goal was to slowly increase to 50mg.s, however my heart will explode first! I skipped the afternoon dose today and do not plan to continue. I have an appt. with a new doc early next week. I'm very disheartened because this was so helpful in the past and now I'm sunk! I guess I could go back on Nardil, but I recall so many side effects and who knows, maybe I'll have the same reaction!
Any luck out there for panic disorder/agoraphobia with Selegilene or the reversible MAOI's?
My choice of drugs I can use are getting smaller and smaller and I'm getting more desperate!
Posted by jsarirose on July 26, 2002, at 21:28:55
In reply to Re: hypertensive experiences? » jsarirose, posted by LLL on July 26, 2002, at 21:14:33
> Any luck out there for panic disorder/agoraphobia with Selegilene or the reversible MAOI's?
Wow - that's an amazing reaction. I guess I didn't have that at all. I ramped up to 60mg pretty quickly.
Unfortunately that's the only MAOI I've tried and never tried Selegilene. (Gee, and I thought I'd tried EVERYTHING!)
Sorry I can't be more of a help.
Good luck,
Jessica
Posted by ayrity on July 26, 2002, at 23:06:13
In reply to Re: hypertensive experiences? » ayrity, posted by LLL on July 25, 2002, at 13:50:19
> I'm unaware of Parnate causing "spontaneous increases in hypertentsion" without diet/drug violations. Can you please provide the source of your information?
> ThanksThere are quite a few articles in the medical literature describing spontaneous hypertensive reactions on parnate; this doesn't seem to occur (or not as often) with other MAOI. I don't have access to it right now, but a medline search will bring up those articles (you might want to try PubMed- you can probably find a link by searching Google).
Posted by ayrity on July 26, 2002, at 23:14:20
In reply to Re: hypertensive experiences? » SLS » SLS, posted by cybercafe on July 26, 2002, at 0:15:21
> i believe some people commented that parnate >can react with it's own stimulant-type metabolites to cause a spontaneous hypertensive crisis? though i imagine this must be quite rare
>Yes, this is quite rare- lucky me! As I've written before, I seem to get all the side effects of meds and little benefit.
Update- I'm still on the Parnate 30 daily- instead of taking 20 mg in the AM/10 in the PM I'm spreading the dose evenly throughout the day. My blood pressure *still* spikes after each dose, but not quite as high before and I might be adapting to it. We're giving it another few weeks; if no change then off with the Parnate. Since 30 mg doesn't seem to do much for my mood and energy (in fact I feel worse, more withdrawn, irritable and tired), there's no sense in continuing it if we can't up the dose without causing more BP problems.
In answer to someone's previous question, yes my doc's MAOI of choice is Marplan- he feels it's equally effective and has fewer side effects, though he does prescribe Nardil as well (I guess it depends on the case; knowing all the bad side effects I'm prone to, maybe he feels Marplan is a better choice).
Posted by KellyM on July 27, 2002, at 8:41:30
In reply to Re: Refining the MAOI Diet, posted by jsarirose on July 26, 2002, at 1:41:09
> >
> > jess: which soy sauces have you tried in the past? ... and were they fresh, or restaurantish?
> >
> > i am wondering if the "tyramine content in chinese food", Wing Y-K, Chen C-N, journal clinical psychopharmacology 1997, might have yet even more information, but i can't seem to find a copy online .........
>
> I've had different types of soy sauce, from the ones in restaurants to store bought (cheap & expensive like Tamari). Haven't had a problem with any. In a restaurant if I'm eating something that has soy sauce in it I don't tend to add more - but that's more of a taste preference than being worried about tyramine.
>
> Was there a big difference in the five soy sauces tested?
>
> I also don't know if there could ever be a difinitive listing of tyramine content in chinese food. Restaurants vary so much as to the way they make similar dishes.
>
> -JessicaThere are a couple of chinese restaurants that I have gone to with no problems. I am pretty adamant about telling them to use less sauce when preparing the dish. The food has just a slight "glistening" on it. Of course I add no extra soy sauce to it. I don't want to give anyone the impression that this would always be safe for everyone- just my experience. I might add that I'm taking 60mg Nardil, so it's not an extra high dose.
I don't notice a great deal of taste difference either. I suppose you could also add non soy based sauces also (I like chile sauce :)}
Kelly
Posted by cybercafe on July 29, 2002, at 20:57:14
In reply to Re: hypertensive experiences?, posted by ayrity on July 26, 2002, at 23:14:20
just wondering, have any of you guys ever been eating and noticed a hypertensive crisis starting before you finished eating.. and were able to stop your meal and only get a partial migraine??
Posted by felipe on July 29, 2002, at 23:35:29
In reply to Re: Refining the MAOI Diet, posted by cybercafe on July 26, 2002, at 10:50:45
does anybody know if these restrictions also apply to st john's wort,since it is supposed to be a weak maoi?im about to start taking sjw but if all this can interact i wont.however i havent read anywhere that certain foods should be avoided while taking it.if anyone knows something about this please tell me.
Posted by cybercafe on July 30, 2002, at 6:45:56
In reply to Re: Refining the MAOI Diet-st johns wort, posted by felipe on July 29, 2002, at 23:35:29
> does anybody know if these restrictions also apply to st john's wort,since it is supposed to be a weak maoi?im about to start taking sjw but if all this can interact i wont.however i havent read anywhere that certain foods should be avoided while taking it.if anyone knows something about this please tell me.
my friend took it and didn't go by any diet.. but i can't say for sure you won't die if you eat the wrong thing, sorry, maybe someone else can
Posted by LLL on July 30, 2002, at 9:02:10
In reply to Re: MAOI diet short list, posted by Bobbiedobbs on July 23, 2002, at 23:21:15
Have you used Kraft's grated parmesan cheese that comes in the plastic container? I recall using the fat free kind in the past while on MAOI's and not having a problem with it, but am not trusting my memory. Have you had any experiences with this and would you consider this to be "processed" cheese?
Thanks,
Lisa
Posted by jsarirose on July 30, 2002, at 14:38:46
In reply to Re: MAOI diet short list, posted by LLL on July 30, 2002, at 9:02:10
> Have you used Kraft's grated parmesan cheese that comes in the plastic container? I recall using the fat free kind in the past while on MAOI's and not having a problem with it, but am not trusting my memory. Have you had any experiences with this and would you consider this to be "processed" cheese?
> Thanks,
> Lisa
That's a really good question. I've used real parmesan in moderate quantities. For example, if it's in a recipe I won't add it to the top, but if the recipe contains none I'll add a tbsp or so (of shredded, not grated).I haven't used the processed parmesan though. I know processed american cheese is listed as okay and so is macaroni and cheese but I've been too nervous to try it. I'm also curious whether the natural macaroni and cheese would count as okay or is it unprocessed (for example, Annie's brand).
I guess if we knew more about what 'processed' meant and what takes the tyramine out of it, we might be able to figure it out.
Anyone?
-Jessica
Posted by LLL on July 30, 2002, at 17:57:03
In reply to Re: MAOI diet short list, posted by jsarirose on July 30, 2002, at 14:38:46
As always, thanks Jess. Hoping Bobbydobbs will respond since he's a veteran MAOI user!
Lisa
Posted by Bobbiedobbs on July 30, 2002, at 22:33:27
In reply to Re: MAOI diet short list, posted by LLL on July 30, 2002, at 9:02:10
Re: Krafts processed Parmesan. I can't give you a technical answer. I am probably more liberal with diet restrictions than most, yet I've avoided it. I will eat a highly processed food WITH parmesan in it if it is very low in a long list of ingredients. I've never experienced any blood pressure elevation (or visceral reaction) in any way from that. But "parmesan", even in processed form, is not considered "processed American cheese" as defined in the diets that allow it.
Posted by jsarirose on July 30, 2002, at 22:51:57
In reply to Re: MAOI diet short list, posted by Bobbiedobbs on July 30, 2002, at 22:33:27
What do you think about a natural mac & cheese. I guess it wouldn't technically be processed like Kraft would. Has anyone actually eaten Kraft Mac & Cheese? Is it really okay?
-Jessica
Posted by LLL on July 30, 2002, at 23:07:27
In reply to Re: MAOI diet short list, posted by Bobbiedobbs on July 30, 2002, at 22:33:27
I posted my question on two different threads and the response below was very helpful! I recommend going to the link to read the attached data, it was quite informative and thorough.
Re: parmesan cheese tyramine content » LLL
Posted by christophrejmc on July 30, 2002, at 22:26:20In reply to Calling all experienced MAOI dieters, posted by LLL on July 29, 2002, at 16:33:03
According to http://www.vh.org/Providers/Conferences/CPS/19.html Kraft brand parmesan cheese contains about 0.2mg of tyramine per serving--not enough to cause any problems.
Posted by jsarirose on July 30, 2002, at 23:16:01
In reply to Re: MAOI diet short list » Bobbiedobbs, posted by LLL on July 30, 2002, at 23:07:27
Can we really eat all those cheeses? I've been eating mozzarella all along because it's a 'fresh' cheese as opposed to aged, but according to that list there are several others that are safe: Gruyere, Muenster, Feta, Brie... I'd love to eat some of these, but I'm still nervous. Anyone experimented?
-Jessica
Posted by cybercafe on July 31, 2002, at 3:49:32
In reply to Re: MAOI diet short list, posted by jsarirose on July 30, 2002, at 23:16:01
> Can we really eat all those cheeses? I've been eating mozzarella all along because it's a 'fresh' cheese as opposed to aged, but according to that list there are several others that are safe: Gruyere, Muenster, Feta, Brie... I'd love to eat some of these, but I'm still nervous. Anyone experimented?
i eat whatever they sell in the store at subway or mcdonald's or major pizza joints...
i can't say that it will be safe for you too of course... :(
but wow... i had no idea marmite was so incredably bad
Posted by LLL on July 31, 2002, at 8:36:45
In reply to Re: MAOI diet short list, posted by jsarirose on July 30, 2002, at 23:16:01
Jessica, the problem with the cheeses you mention is that they vary so much from one manufacturer to the next and it's impossible to determine the process they went through. I would use caution with those cheeses.
Posted by cybercafe on July 31, 2002, at 21:11:38
In reply to Re: MAOI diet short list » jsarirose, posted by LLL on July 31, 2002, at 8:36:45
> Jessica, the problem with the cheeses you mention is that they vary so much from one manufacturer to the next and it's impossible to determine the process they went through. I would use caution with those cheeses.
you know what's strange?
http://www.vh.org/Providers/Conferences/CPS/19.html
says Parmesan and Feta have half the tyramine content of mozzerella
Posted by cybercafe on July 31, 2002, at 22:22:04
In reply to Re: MAOI diet short list, posted by jsarirose on July 30, 2002, at 23:16:01
maybe chlorpromazine is better than nifedepine:Weekly Web Review in Emergency Medicine
Article Review: January 31, 1997
SHOULD A MORATORIUM BE PLACED ON SUBLINGUAL NIFEDIPINE CAPSULES GIVEN FOR HYPERTENSIVE EMERGENCIES AND PSEUDOEMERGENCIES?
Grossman E, Messerli FH, Grodzicki T, et al. JAMA, October 23/30, 1996; 276:1328BACKGROUND: Nifedipine is a peripheral vasodilator that produces hypotension, along with reflex tachycardia and myocardial contractility. Although sublingual short-acting nifedipine is often given in the emergency department to rapidly lower elevated blood pressure, such use has not been approved by the Food and Drug Administration. The safety of this practice has never been demonstrated; in fact, adverse effects associated with nifedipine-induced precipitous blood pressure reduction include cerebral ischemia and infarction, acute myocardial infarction, complete heart block, and death. In actual hypertensive emergencies (severe hypertension with secondary encephalopathy, stroke, myocardial infarction, dissecting aortic aneurysm, or acute renal failure), more reliable and controllable agents such as intravenous nitroprusside are indicated. In other settings, physician attempts to lower blood pressure acutely are often merely "blood pressure cosmetics," with significant risks but little potential benefit. The authors conclude that the routine use of short-acting nifedipine capsules in hypertensive emergencies and pseudoemergencies should be abandoned.
Posted by jsarirose on July 31, 2002, at 23:55:52
In reply to Re: MAOI diet short list, posted by cybercafe on July 31, 2002, at 21:11:38
> you know what's strange?
> http://www.vh.org/Providers/Conferences/CPS/19.html
> says Parmesan and Feta have half the tyramine content of mozzerella
>
>Well I know I've never had a problem with Parmesan although I've never really over done it. But it hasn't seemed to matter how much I've had. I haven't tried feta, but maybe I'll get brave and try it. I really miss greek salads!
Today I had a veggie sandwich with Goat cheese. I thought it was something like chevre, but it was actually goat brie. I had a big bite before I realized that it was brie. I was a little nervous, but no reaction whatsoever. I didn't eat the rest though.
Compared to cheddar, which I had a few bites of once, I started feeling the effect pretty soon.
-Jessica
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