Posted by Questionmark on November 3, 2008, at 0:20:29
In reply to For Anyone Who Had A Hypertensive Crisis, posted by jnew12 on November 2, 2008, at 10:26:05
Twice. Both times my own stupid fault (i shall dare not blame the MAOI but indirectly!). I believe I posted about both accounts here at PBabble about a few years prior.
The first was after just starting Parnate-- maybe like a week-- and had some mac and cheese at a diner-- except it was white cheddar not that fake crap. Later terrible pounding occipital headache etc. Ended up taking some clonazepam, propranolol, and, i think a bit of riperidone if i remember correctly, and then sleeping it off in my bed (obviously i am NOT recommending that as a good way to combat a hypertensive episode-- the lying down OR the meds-- and i don't think the meds helped substantially, though i'm pretty sure they did somewhat). I didn't go to the hospital or tell anyone at the time, for various reasons. And definitely never told my doctor. Didn't want hIm freaking out.
The second one was while riding back in a car from a road trip, and was just absolutely shamefully stupid. This was on Nardil. Anyway to make a long story short since i think i already posted about this back in the day-- i took 50mg ephedrine (yes, i said it was stupid) just completely forgetting that, well, i CAN'T DO THAT. So started feeling bad after awhile, realized what i had done... uh oh, blah blah blah then severely painful pounding headache... emergency room, waited 3 freakin hours and eventually finally got some IV clonidine which had immediate relief (even though i was telling the nurses and doctor/s since the moment i GOT there that i was having a hypertensive episode from a sympathetic nervous system stimulant and an MAOI and all i needed was a drug to lower my blood pressure)-- yeah don't even get me started on my time in the ER. My GOODness. I will rant the whole night about that escapade.
Never told my doctor about that one either, but also never had another hypertensive reaction of any kind since then, and that was about... 4 or 5 years ago. But if it wasn't for my own stupidity and absolutely forgetful indiscretion both times, i would have never had any problems.
So please, don't blame the MAOI, blame me.
(Also, if my pdoc would have prescribed me some nifedipine like i wanted it would have saved me 3-plus hours of tremendous suffering plus the $800 of the ER bill-- tho that was mostly covered by insurance through my parents, fortunately).So, there it is, way more info than you probably even wanted.
But my advice is, -- well, first of all, always be wary of what you ingest. Not anxious about it. But aware. As far as foods, above all else just be wary of aged cheeses. And be very cautious when it comes to an kinds of drugs, particularly anything with serotonergic or sympathomimetic properties. Secondly see if your dr would be willing to prescribe you some nifedipine or chlorpromazine (or phentolamine?) as an emergency backup. But regardless, my final advice is, god forbid you do ever happen to have a hypertensive crisis-- which i hope and doubt that you will-- don't even bother telling your pdoc if you can help it. If a psychiatrist read that he or she would probably be appalled-- or at least disappointed-- but, we have to take what little responsibility we can take and hold, into our own hands. I.e., if it truly is in my best interest to stay on an MAOI even after having a hypert. reaction, then... it is in my best interest-- regardless of whether my doctor would be too scared or worried to be able to adequately think rationally about what my best interest is. ... OK i don't even know what i'm talking about anymore. I'm sorry, i'll shut up now.
I must retire to bed.
But be not afraid of the hypertensive crisis! Be only cautious and aware.
> What caused it? Was it a medication or food?
>
> Were you on Parnate, or Nardil?
>
> What did it feel like?
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> Did you call 911, or stay home?
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> How were you treated at the emergency room? Did you get help right away? Did they know how to treat a MAOI?
>
> Also, did you doctor know, did he want to take you off it?
>
>
> That's a biggie for me, I am afraid that if I get a hypertensive crisis (which I hope to god I don't ever get) my doc will insist I get off, because it was my idea to try Nardil in the first place, not his.
poster:Questionmark
thread:860361
URL: http://www.dr-bob.org/babble/20081027/msgs/860493.html