Posted by djmmm on May 24, 2003, at 10:39:19
In reply to Hypertensive reaction., posted by Questionmark on May 24, 2003, at 0:10:53
> i've been on Parnate for 2 weeks (1 wk on 20mg), and already i've had my first hypertensive reaction. Take the dietary restrictions seriously if you're on an MAOI.
> i haven't been too concerned about the dietary restrictions yet since i'm on a fairly low dose and well, i just didn't wanna be. But today i was at a resturaunt and, totally forgetting about the dietary restrctions, ate a plentiful serving of mac and cheese (and some baked haddock). i went home and took my 2 Parnates for the day (as i didn't in the morning). About two hours later i started feeling like crap-- pounding heart, fatigued but really nervous, and just a general feeling of malaise. i went in my room and lied down on the floor, after 10 seconds of which i started to get a terrible pounding headache, mostly occipital. Then i realized i definitely must have eaten something wrong, and i remembered the mac and cheese. Having no nifedipine and not at all wanting to go the ER, i took 0.5mg clonazepam, 20mg propanolol, and half a pill of some phenothiazine i had gotten for nausea awhile back, and i decided to try and sleep for awhile. i thought i'd either get lucky and die, get intracranial bleeding & brain damage and have to willfully "step out" myself, or, most likely, experience about half an hour more of bad pain and discomfort until those pills counteracted the excess tyramine and i could sleep. For better or worse, the latter is what occurred. (By the way, i do NOT recommend relying on those types of drugs to relieve a hypertensive reaction, but it's all i had).
> Anyway, i don't know why i wrote all this exactly, but, moral of the story: don't f**k around with the food restrictions if you're on an MAOI (at least/ especially the ones that are completely restricted).For what it's worth, Benzos and Inderal are often used in hospitals in cases of hypertensive reactions. The goal of medicating a hypertensive crisis is obviously lowering your blood pressure at a consistant rate, and safely. Klonopin will help by attenuating further catecholamine release, and Inderal, will selectivly compete for norepinephrine sites (via non-selective beta-adrenergic receptor blocking). I believe Inderal is such a competetive drug, it may displace norepinephrine (and epinephrine in the heart), making it a good choice for mild hypertensive episodes. Inderal is indicated for hypertension. I believe in more serious case of hypertensive "crisis" a med called Nitroprusside is used because of it's rapid rate of onset.
poster:djmmm
thread:228757
URL: http://www.dr-bob.org/babble/20030520/msgs/228816.html