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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by deerock on December 5, 2013, at 13:48:17
i was rushing around this morning and ate some gruyere cheese about 4 oz worth. got to work and started sweating and feeling like i was going to pass out. i work in a psychiatric locked hospital and had one of the techs take my blood pressure and it was 160/100. they called 911. i was taken to the ER and my BP was down to 140/90 and my heart was OK so they discharged me. i left a message for my psychiatrist have not heard back yet. not sure if i will continue the nardil ill let my doc decide. it was scary as hell.
no one understood what was going on until a psychiatrist came in while i was waiting for the ambulance. i said to him hey doc i take nardil and i ate aged cheese for breakfast...and he was like oh yeah go to the ER. he knew right away.
this has my head spinning. im just so upset over this.
Posted by Sheilac on December 5, 2013, at 14:57:43
In reply to landed in the ER - nardil reaction to cheese, posted by deerock on December 5, 2013, at 13:48:17
That's awful! I hope you feel better. This is exactly why I wouldn't try this med. My old pdoc suggested it, but I just couldn't deal with the diet restrictions.
Posted by ed_uk2010 on December 5, 2013, at 16:55:16
In reply to landed in the ER - nardil reaction to cheese, posted by deerock on December 5, 2013, at 13:48:17
Hi,
You really must concentrate on learning about the dietary restrictions. It takes a bit of study but it's worth it.
Posted by deerock on December 5, 2013, at 20:06:00
In reply to Re: landed in the ER - nardil reaction to cheese, posted by ed_uk2010 on December 5, 2013, at 16:55:16
hi ed. from what i can tell its smoked foods, banana peels and aged meats, herring and aged cheese.
can you point me to any resources?
my doctor called and said yes what happened is from the cheese and didnt say anything else...so i think he is leaving it up to me to continue the medication or stop it.
Posted by baseball55 on December 5, 2013, at 20:23:53
In reply to Re: landed in the ER - nardil reaction to cheese, posted by deerock on December 5, 2013, at 20:06:00
All cheese is aged cheese, except maybe American and mozzarella. I have small amounts of aged cheese sometimes - like 1/2 an ounce-- without a problem. But 4 oz? Are you trying to kill yourself?
> hi ed. from what i can tell its smoked foods, banana peels and aged meats, herring and aged cheese.
>
> can you point me to any resources?
>
> my doctor called and said yes what happened is from the cheese and didnt say anything else...so i think he is leaving it up to me to continue the medication or stop it.
Posted by deerock on December 5, 2013, at 20:38:03
In reply to Re: landed in the ER - nardil reaction to cheese, posted by baseball55 on December 5, 2013, at 20:23:53
not consciously...thats for sure.
its not unusual for me to eat a lot of cheese. i had tempted fate with other foods that react without a problem. for some reason i thought i would be safe. i threw the cheese out. i think if i were trying to kill myself i would have held onto the cheese.
Posted by stargazer2 on December 6, 2013, at 13:33:37
In reply to Re: landed in the ER - nardil reaction to cheese » baseball55, posted by deerock on December 5, 2013, at 20:38:03
You obviously love cheese more than I do but interestingly you have no fear in tempting fate with mixing NArdil with a variety and quanity of foods, i.e. red wine, 24 oz tea and 4 oz Guyere. Maybe Nardil and more specifically the MAOs are not for you.
You have to respect the warnings and be wary of what the tyramine reaction will do to you. If you have no fear of this then no matter what anyone says, you will not take the seriousness of the reaction as a life or death one.
I respect the reactions although I have only had the "one". I will eat the cheeses I am allowed, cream, cottage, american, somm mozz but know when to stop. The only wine I can have is white but not more than a glass or two.
Some of us have difficulty with moderation so the risk of eating something we shouldn't is always there. IN the case of MAO's, this can be fatal or result in a stroke which is even worse.
Are you able to adhere to the diet now that you've had something specific happen to you?
I hope you can because if the meds are working the food restrictions are well worth the benefit of feeling better. If not, you'd be better giving them up.
Posted by ed_uk2010 on December 6, 2013, at 14:20:14
In reply to Re: landed in the ER - nardil reaction to cheese, posted by deerock on December 5, 2013, at 20:06:00
> hi ed. from what i can tell its smoked foods, banana peels and aged meats, herring and aged cheese.
>
> can you point me to any resources?Yes, you should avoid ALL cheese except small amounts highly processed American 'hamburger' cheese, which is not really proper cheese. ALL other cheeses are aged, because this is part of the cheese-making process. Also, Cottage cheese is not actually cheese, and is safe.
Any type of meat or fish which is aged, past its expiry, not stored properly, smoked, pickled, dried, preserved, stale or possibly 'going off' is not OK. Only fresh/frozen meats, fish and poultry are safe. There's nothing specifically bad about herring, but pickled herring is unsafe because it is not remotely fresh, and so the proteins in the fish have degraded into tyramine.
Avoid beer (on tap) and wine. Very small quantities of white wine may be tolerable but I do not recommend it. Well known brands of bottled beers are often acceptable in small quantities only, but I do not recommend trying this early during treatment. Spirits (eg. gin, whiskey and vodka) do not contain any tyramine, and are usually safe in moderation, but large quantities may cause dizziness and fainting.
Soy sauce is not safe. Avoid foods which are likely to contain it eg. Chinese ready meals etc. All other fermented soya bean extracts are unsafe. Be careful with takeaways and restaurants. A lot of soy sauce may be added by some as a flavour enhancer.
Meat and yeast extracts are unsafe. These include Oxo, Marmite, Vegemite and Bovril. Brand names vary according to the country. Most are used to spread on bread/toast (eg. Marmite) or as flavour enhancers.
Broad bean pods, banana peels and Sauerkraut are unsafe - but these are not usually popular foods anyway!
Do NOT take any type of medication, including non-prescription medication without checking its safety (+Nardil) with the pharmacist.
Drug and food interactions persist for 2 weeks or more after Nardil has been stopped.
An early warning symptom of a hypertensive crisis is a throbbing headache. It may be useful to buy a blood pressure monitor.
I personally rate Nardil as a very useful drug for patients who do not respond well to other antidepressants and anti-anxiety drugs. It does require a lot of learning though, but it becomes easy after a while.
Posted by jono_in_adelaide on December 6, 2013, at 21:53:20
In reply to Re: landed in the ER - nardil reaction to cheese » deerock, posted by ed_uk2010 on December 6, 2013, at 14:20:14
160/100 isn't a hypertensive crisis, hundreds of thousands of americans have BP within tis range and come to no immediate harm.
Take the Nardil and throw your BP monitor away
Posted by stargazer2 on December 7, 2013, at 17:15:41
In reply to Re: landed in the ER - nardil reaction to cheese, posted by jono_in_adelaide on December 6, 2013, at 21:53:20
160/100 may not be a hypertensive crisis but it can cause alarm in someone who is not used to feeling the symptoms of a tyramine reaction. Have you ever experienced the headache and sweats from an elevated BP? If you have low BP to begin with, an elevation from 90/50 to 180/100 can be alarming so it certainly warrants monitoring your BP so that you know when and if you have to go to the ER. Knowing mine was 230/130 using my BP monitor, it allowed me to take Nifedipine and monitor the effect so as to avoid going to the ER.
A BP cuff is crucual for anyone that takes these meds. If you've never taken a MAO and never had a hypertensive reaction your advice is irrelevant.
Posted by ed_uk2010 on December 8, 2013, at 2:44:27
In reply to Re: landed in the ER - nardil reaction to cheese, posted by jono_in_adelaide on December 6, 2013, at 21:53:20
> 160/100 isn't a hypertensive crisis....
It isn't... but the absolute rise and rate of rise in BP are very relevant. Millions of people have asymptomatic chronic hypertension of 160/100 or more, but for someone who's BP is normally 100/60, for example, an extremely abrupt rise to 160/100 would be symptomatic. Tyramine reactions can also cause other 'adrenergic' symptoms.
BP cuffs are useful, so long as they don't become an obsession!
Posted by jedi on December 15, 2013, at 2:36:57
In reply to Re: landed in the ER - nardil reaction to cheese » jono_in_adelaide, posted by ed_uk2010 on December 8, 2013, at 2:44:27
I have had a couple of hypertensive episodes in my 15 years of Nardil use. The worse was when I took nipehepine as an antidote and spent a night in the hospital when the hypertensive crisis passed and the niphedipine continued to lower my blood pressure. I no longer carry an antidote.
Nardil is not really a dangerous med, but it demands respect. You must take your self education to another level. If you use the drug long term, as I do, you are the one that will be educating the medical community. Many people in the medical field know absolutely nothing about MAOIs.
You have to read labels very carefully and make sure you know what is in prescription meds. I never take a new medication without checking it out for myself. I do not trust pharmacists or MDs. I trust my own knowledge and my ability to research a medication thoroughly for reactions. For example, codeine for a cough is just fine. Mix it with a decongestant, which is often done, not good!
Be careful out there,
Jedi
Posted by Lamdage22 on December 15, 2013, at 8:41:26
In reply to Re: landed in the ER - nardil reaction to cheese, posted by deerock on December 5, 2013, at 20:06:00
The only time i had an reaction was when i took like 10 pills at once or when i used supplements like PEA in excess.
I always carry Nifedipine in my Wallet when im on MAOI.
No biggie. Although i urge you to know how an when to use the Nifedipine and being very careful.
I used small amounts of coffee, i was fine, then i used a bit more.. and like that with everything No big deal. I mean you can take the alternatives if you want, but im sick of them.
I was careful but i didnt have to change my eating habits alot at all. For me, its like i only get a reaction if i deliberately ate a ton of aged cheese or drank whine. Im not a whine person and not a cheese person.
No big deal for me.
This is the end of the thread.
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