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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by bulldog2 on September 25, 2008, at 8:08:49
It's a shame that more docs don't know about this study. Apparently parnate + amitriptyline gives less rise in bp when tyramine is injected.
Can't find the amount of amitriptyline that they used in this study.
> "This is an approximate order of potency. Iproniazid is seldom used now because of the increased risk of hepatotoxicity. Tranylcypromine is the most likely to cause a 'cheese reaction and isocarboxazid the least. An important paper in The lancet, from St. Bartholomew's Hospital, (Pare et al., l982) described the safety and efficacy of combining amitriptyline (Tryptizol) and tranylcypromine (Parnate) - If the patient was on tranylcypromine alone, the rise in blood pressure produced by tyramine1 the dangerous ingredient in cheese, was substantial. The rise in blood pressure was less following a tyramine injection when the patient was on amitriptyline and tranylcypromine. The safety and efficacy of this combination was demonstrated in a controlled trial from the University of Southern California (Raaani et al, 1983) - The other antidepressants investigated at Barts in combination with tranylcypromine were trimipramine (Surmontil) and dothiepin (Prothiaden). They did not confer the same degree of protective effect as amitriptyline
Posted by azalea on September 25, 2008, at 23:54:54
In reply to amitriptyline + Parnate Less Hypertension, posted by bulldog2 on September 25, 2008, at 8:08:49
Fascinating study. Here's the full reference info:
Title:Will amitriptyline prevent the "cheese" reaction of monoamine-oxidase inhibitors?
Source:The Lancet, Pare yr:1982 vol:2 iss:8291 pg:183-186.There were 5 patients taking MAOI + different doses of amitriptyline, 2 at 75mg, 2 at 100mg, 1 at 150mg.
Only 1 patient was on tranylcypromine. Other MAOIs were parstelin and phenelzine.
> It's a shame that more docs don't know about this study. Apparently parnate + amitriptyline gives less rise in bp when tyramine is injected.
> Can't find the amount of amitriptyline that they used in this study.
>
>
> > "This is an approximate order of potency. Iproniazid is seldom used now because of the increased risk of hepatotoxicity. Tranylcypromine is the most likely to cause a 'cheese reaction and isocarboxazid the least. An important paper in The lancet, from St. Bartholomew's Hospital, (Pare et al., l982) described the safety and efficacy of combining amitriptyline (Tryptizol) and tranylcypromine (Parnate) - If the patient was on tranylcypromine alone, the rise in blood pressure produced by tyramine1 the dangerous ingredient in cheese, was substantial. The rise in blood pressure was less following a tyramine injection when the patient was on amitriptyline and tranylcypromine. The safety and efficacy of this combination was demonstrated in a controlled trial from the University of Southern California (Raaani et al, 1983) - The other antidepressants investigated at Barts in combination with tranylcypromine were trimipramine (Surmontil) and dothiepin (Prothiaden). They did not confer the same degree of protective effect as amitriptyline
Posted by bulldog2 on September 26, 2008, at 17:00:54
In reply to data » bulldog2, posted by azalea on September 25, 2008, at 23:54:54
> Fascinating study. Here's the full reference info:
> Title:Will amitriptyline prevent the "cheese" reaction of monoamine-oxidase inhibitors?
> Source:The Lancet, Pare yr:1982 vol:2 iss:8291 pg:183-186.
>
> There were 5 patients taking MAOI + different doses of amitriptyline, 2 at 75mg, 2 at 100mg, 1 at 150mg.
> Only 1 patient was on tranylcypromine. Other MAOIs were parstelin and phenelzine.
>
> > It's a shame that more docs don't know about this study. Apparently parnate + amitriptyline gives less rise in bp when tyramine is injected.
> > Can't find the amount of amitriptyline that they used in this study.
> >
> >
> > > "This is an approximate order of potency. Iproniazid is seldom used now because of the increased risk of hepatotoxicity. Tranylcypromine is the most likely to cause a 'cheese reaction and isocarboxazid the least. An important paper in The lancet, from St. Bartholomew's Hospital, (Pare et al., l982) described the safety and efficacy of combining amitriptyline (Tryptizol) and tranylcypromine (Parnate) - If the patient was on tranylcypromine alone, the rise in blood pressure produced by tyramine1 the dangerous ingredient in cheese, was substantial. The rise in blood pressure was less following a tyramine injection when the patient was on amitriptyline and tranylcypromine. The safety and efficacy of this combination was demonstrated in a controlled trial from the University of Southern California (Raaani et al, 1983) - The other antidepressants investigated at Barts in combination with tranylcypromine were trimipramine (Surmontil) and dothiepin (Prothiaden). They did not confer the same degree of protective effect as amitriptyline
>
>Thank you!
Posted by jedi on September 27, 2008, at 20:07:59
In reply to amitriptyline + Parnate Less Hypertension, posted by bulldog2 on September 25, 2008, at 8:08:49
Hi,
I've used nortriptyline with Nardil with no ill effects. Nortiptyline is the main metabolite of amitriptyline and has less side effects. I read the article above, before I mixed the two meds, but I did not test it by eating large amount of tyramine containing foods. Two trips to the ER was enough during my 10 years on Nardil.
Jedi
Posted by bulldog2 on September 27, 2008, at 20:15:04
In reply to Re: amitriptyline + Parnate Less Hypertension » bulldog2, posted by jedi on September 27, 2008, at 20:07:59
> Hi,
> I've used nortriptyline with Nardil with no ill effects. Nortiptyline is the main metabolite of amitriptyline and has less side effects. I read the article above, before I mixed the two meds, but I did not test it by eating large amount of tyramine containing foods. Two trips to the ER was enough during my 10 years on Nardil.
> Jedi
>How much nortriptyline were you on?
Posted by jedi on September 27, 2008, at 20:21:44
In reply to Re: amitriptyline + Parnate Less Hypertension, posted by bulldog2 on September 27, 2008, at 20:15:04
> How much nortriptyline were you on?
>100mg nortriptilyne to start with, then added Nardil slowly up to 90mg. According to the research, this is the preferred way to add the meds. Some have added nortrip to an established dosage of Nardil.
Be well,
Jedi
Posted by desolationrower on September 27, 2008, at 22:33:46
In reply to Re: amitriptyline + Parnate Less Hypertension » bulldog2, posted by jedi on September 27, 2008, at 20:21:44
Did you notice anything differnt on the combination?
-d/r
Posted by jedi on September 27, 2008, at 23:30:02
In reply to Re: amitriptyline + Parnate Less Hypertension, posted by desolationrower on September 27, 2008, at 22:33:46
> Did you notice anything different on the combination?
> -d/rEventually, I quit the nortriptyline and just used the Nardil. In my case the tricyclic did not seem to add much to the MAOI. It did seem to help with sleep. I believe that I am a rapid metabolizer of tricyclics. I have tried several at some fairly high dosages. I have never been able to get into the therapeutic window with them.
Jedi
This is the end of the thread.
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