Posted by jkshrews on August 7, 2008, at 22:16:12
In reply to Re: MAOI diet short list, posted by Justherself54 on August 7, 2008, at 12:04:59
> > The only thing I have ever heard of someone have a food reaction to was chianti wine.
> >
> > The really dangerous thing would be to take a cold or allergy pill (or alkaselter plus) that contained a decongestant. As I recall, 20 or so people died from hypertensive crisis while taking Parnate (the most dangerous MAOI), and I would bet that most of them died from taking a decongestant of some sort.
>
> Why is Parnate the most dangerous MAOI? I'm on it and hearing that 20 people have died from a hypertensive crisis is very frightening...
>
>Around 20 people, as I recall, at the time I researched this about two decades ago....
It seems the severity of hypertensive reactions of MAOIs increases with the chemical similarity to d-amphetamine. Of all the MAOIs, Parnate happens to be the most similar to d-amphetamine. If I recall correctly, it is different from d-amphetamine by a single chemical bond. That is why it is stimulating and appetite suppressing. In addition to being an MAOI, it is active at the amphetamine receptor.
But, this similarity to d-amphetamine may also mean that it is the strongest and most effective MAOI. (My speculation.)
I would not worry too much, but I would be very well informed about what not to eat and drink, and what meds to avoid.
http://www.gsk.ca/english/docs-pdf/parnate_pm_02242006.pdf
Also, you might carry an antidote with you. Get a small prescription of Thorazine (chlorpromazine) 25 mg. Buy the larger size steel pill fob at the drug store and carry some of the pills with you. If you get a sudden headache while at a restaurant after drinking that glass of red wine you should not have had, take 50 mg of the Thorazine before heading to the ER. By the time you get to the hospital and get help, you might already have absorbed enough to start getting better. (There is also some other drug that is now used as an MAOI hypertensive crisis antidote, but I don't know what it is.)
I also recommend getting a card for your wallet that says you are taking Parnate (tranylcypromine), an MAOI, and must not be administered sympathomimetic drugs of any kind. That way, if you end up at an ER in an unconcious state for some reason, they won't accidentally kill you.
It is also good to know the name of the correct ER drug for treating a hypertensive crisis (and maybe carry a list of the forbidden drugs) for the ER doctor. The treatment drug is called Rogitine (phentolamine) injectable. I have a friend who was on Parnate, went to a restaurant in a small town, drank red wine, and suddenly got a splitting headache. His wife took him straight to the little local hospital. Fortunately, this friend is himself an ER doctor, and knew what treatment he needed. They did not stock Rogitine at this place, so the small-town doctor on duty wanted to give him demerol, which would have killed him. (My friend was able to ride the episode out. He didn't know about the Thorazine avenue of treatment.)
poster:jkshrews
thread:75408
URL: http://www.dr-bob.org/babble/20080805/msgs/844884.html