Posted by Adam on June 29, 2000, at 11:22:36
In reply to Re: MAOIs??? Beer? Other Questions, posted by harry b. on June 28, 2000, at 7:32:48
Harry,
Beer: I've consumed moderate amounts (1-2 bottles over the course of an entire evening) and had no problems. I'd say stick to moderate amounts of bottled beer if you are going to drink at all, and avoid tap beers, since, for a variety of reasons, they may have more tyramine in them. The first few times you consume a bottle of beer, check your blood pressure a few hours later, and always have someone around who is familiar with your condition and can help you get to an ER if there is a negative reaction.
Caffeine: I have the occasional Coke, but that's it. Two Cokes in a row leave me feeling transiently hyper and then ill, but it's not a b.p. effect. I seem to have a particularly low tolerance for caffeine on selegiline, and that may have more to do with the stimulat properties of this drug (I'm not sure, to be honest). If you wind up on selegiline (Eldepryl) or tranylcypromine (Parnate), you might want to avoid caffeine altogether, as those drugs tend to be "activating" and can cause a lot of insomnia. The last thing you will want in your system, especially at first, is a lot of caffeine. Caffeine, in large amounts, could be dangerous because of catacholamine release (namely norepinepherine). I think moderate consumption is likely to be safe.
Origins: The first MAOI, iproniazid, was developed in an attempt to improve the action of ioniazid, a drug used to treat tuberculosis. In a trail of iproniazid in a VA hospital, using elderly TB patients as subjects, physicians observed marked mood elevating effects, and thus serendipetously discovered the first class of antidepressants. Later the MAO-inhibitory properties were elucidated, as well as a couple other potentially beneficial effects. They appeared at first to be a great improvement over the opiates and amphetamines currently employed (as in fact they were), but hepatotoxic and harmful catecholamine-elevating effects (leading to hypertensive crisis, among other things) were soon observed, and later focus shifted to the antihistamine-derived tricylics, which were also serendipetously discovered. MAOIs never fell completely out of use, and their speceficity and tolerability was improved. The have, in the past ten years or so, seen greater employment than one might have expected, given the wealth of safer alternatives currently available. My feeling is that MAOIs, due to their multiple mechanisms of action (primarily either monoamine elevation+psychostimulant effects or monoamine elevation+GABA potentiation), may have the most robust mood-elevating properties of any single molecule available, and have proven to be, as they have in the past, the only good solution for many who have not responded well to other drugs. They are not a panacea by any means, and many either do not respond or cannot tolerate them. However, for some, they are by far the best alternative, and are certainly worth a trial, IMO.
> jane & kazoo, thanks for your info, much appreciated.
>
> kazoo- Yes, I'd be interested to hear how the MAOIs
> came into being.
>
> Did the MAOIs help with chaotic, troubling, obsessive
> thoughts, assuming you had them? If you did not,
> can someone with experience with this advise me?
>
> Why did you stop the MAOI's?
> --------------------------------------------------
> Now the beer. I'm not a drinker but I do enjoy a
> beer or 2 with a good crabcake, etc. I've read
> several lists of dietary restrictions and beer is
> listed. I'd estimate that I drink maybe 4 beers
> per month. Not a lot to give up, but I really do
> enjoy them.
>
> And, unfortunately, I like imported beers (Becks).
> My domestic choice is Rolling Rock.
>
> MAOI users: Have you done any experimenting with
> beer? I know, YMMV, but would one or 2 beers (max)
> cause a mild/moderate/severe/fatal reaction?
>
> Caffeine is also listed. Would my usual morning
> 20oz cup from the convenience store be too much?
>
> I'd also like to hear about any reactions MAOI users
> have experienced. Causes, severity, etc.
>
> Thanks
> hb
>
>
poster:Adam
thread:38343
URL: http://www.dr-bob.org/babble/20000619/msgs/38704.html