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Re: MAOI users--experiences please » SLS

Posted by SLS on December 21, 2003, at 9:56:48

In reply to Re: MAOI users--experiences please » SLS, posted by cubbybear on December 21, 2003, at 1:46:13

Hi Cubbybear.

> > I experienced a serious tyramine reaction to eating 2 thin slices of pepperoni on a pizza. Pounding occipital headache - the works.

> Scott--you make a good point about different people reacting differently to different foods. You probably know that I've taken Parnate for many years. I've never had a hypertensive crisis and that's no doubt a result of not eating ANY cheese, etc.

> Now for the first time, I would like to see what happens if I sample a small pizza, because the recent research indicates that fresh mozarella is OK.

The inexpensive processed mozzarella is fine to eat. Most pizzarias use this. However, some pizzarias also use parmesan cheese when making the sauce. I would try to stay away from using a lot of parmesan, but I have never worried about the small amount that might be found in the sauces. I've never had a problem with Pizza Hut. I just stay away from the pepperoni and sausage.

> On the other hand--what you said raises a question: how can you be sure your hypertensive crisis was the result of the pepperoni and not the cheese? Did you do OK with pizza previously, then suddenly got the headache after adding the meat?

Exactly. I had eaten plain cheese pizza from this same restaurant all of the time. I was quite amazed at how little pepperoni it took to induce a reaction.

> It seems to be me that if just one or two people can get a bad reaction from eating a small pizza, then all those new revised guidelines about fresh mozarella being OK are probably "not so" OK. What do you think?

Remember, some pizzas contain other types of cheeses and perhaps meat extracts. After having been on and off MAOIs for the last 20 years, I am confident that most cheese pizzas are OK to eat. Just be careful with the toppings. Inexpensive processed American cheese is OK, but cheddar is not. Ricotta is generally OK. Try to stay away from expensive imported aged cheeses.

> I'm also curious to know what your BP was during the hyp. crisis and how you handled it.

I don't know what my BP was. I was at work during a busy day and was rushed to eat lunch as quick as possible. I was just careless. I had taken two bites of a slice of pepperoni pizza before I realized my error. Within ten minutes, a pounding headache developed in the back of my head near the base of the skull. It felt worse when I sat, so I remained standing for about 45 minutes until the reaction subsided. I gambled that the crisis would pass without medical intervention. I like to carry around a capsule of nifedipine, a calcium channel blocker, just in case I should encounter another reaction. Some people recommend biting the capsule open before swallowing. Others claim that it is better to swallow it whole. I don't know if nifedipine readily passes through the buccal or sublingual membranes, so I would want to swallow the majority of it. Maybe someone else can shed some light on this issue.


- Scott

 

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