Posted by Astounder on October 31, 2007, at 7:10:33
In reply to Re: Diet restrictions on EMSAM 9 MGS?, posted by trx resistant on October 29, 2007, at 15:41:02
> After 4 weeks on 6mg patch just started 9mg. The food warnings are scaring me to death . I called Bristol Meyers and found no real answers to food questions. Am I going to drop dead if I injest something that contains soybean oil as I find in my favorite canned protein shakes or soy lecithin found in most protein bars, or whole grain bead containing sprouted soybean? It seems every label I read says it may or may not contain some sort of soy.
> Pharmacist gave me a list for food that said no bananas, figs, raisins, avacado etc. Bristol Meyers say those were OK. What is your experience? Thanks,
> trx resistant
>Honestly, I was using 2x 12 mg EMSAM patches daily (24 mg/d) for two months, while taking 90 mg/d of Remeron, which by blocking the feedback alpha-2 adrenoceptor, would make the tyramine-induced hypertension malignant. I was using propranolol for somatic anxiety & angina, which by unopposed beta blockade would further exacerbate the syndrome. I was also taking various stimulants/sympathomimetics: yohimbine, nicotine, dl-phenylalanine, arecoline (betel nut), ephedrine, caffeine, provigil, and a 600 mg dose of Wellbutrin.
I ate everything I wanted--chocolate, cheeses, pork, nuts and fruit, and though I checked my blood pressure constantly, I never had any trouble with hypertension.
The only issue was a mild serotonin syndrome when I tried taking a few microcapsules of Effexor after a prolonged 5-HTP supplementation to see how much MAO-A had been inhibited, but I was able to bring the temperature down with cyproheptadine.
So my conclusion is that EMSAM is a remarkably safe drug even at supratherapeutic doses and should not require strict dietary guidelines.
If you're really worried, ask for a script for a low dose of desipramine or another norepinephrine reuptake inhibitor. NRIs abolish the pressor response to tyramine by preventing it from entering the noradrenergic terminal and displacing the stored norepinephrine.
A caveat: If you're using Dexedrine or Adderall, it won't work right if you're also using a NRI; you'd want to switch to Desoxyn or Ritalin.
poster:Astounder
thread:662533
URL: http://www.dr-bob.org/babble/20071027/msgs/792477.html