Posted by jedi on February 27, 2010, at 1:05:58
In reply to Spontaneous Hypertensive Crisis on MAOI, posted by George Romero on February 26, 2010, at 23:25:29
Hi George,
The same thing happened to me, which ended my last Parnate trial. I went back to my old standby Nardil, with all the side effects. I was really hoping Parnate would work for me, but I don't get headaches and this was an obvious spontaneous hypertensive episode.You have to be careful with nifedipine also. It can lower your blood pressure too quickly and for too long a time after the hypertensive episode is over. I ended up in the hospital on IV fluids overnight, because the hypertensive crisis ended and my BP kept dropping, after taking nifedipine. Really, low BP kills people too. This is why some docs won't prescribe the medication any longer.
Jedi
Reference:
Int J Clin Pract. 2004 May;58(5):517-9.
Adverse events associated with aggressive treatment of increased blood pressure.Yanturali S, Akay S, Ayrik C, Cevik AA.
Dokuz Eylul University Hospital, Department of Emergency Medicine, Izmir, Turkey. sedat.yanturali@deu.edu.tr
Patients with severely increased blood pressure often present to the emergency department. Rapid lowering of blood pressure can precipitate or worsen end organ damage. We report two cases that developed cerebrovascular and cardiovascular adverse events associated with aggressive treatment of increased blood pressure by the use of sublingual nifedipine capsule. The first patient had developed ischaemic stroke; the second patient actually had acute left ventricular failure causing deteriorated, and required positive inotropic treatment for persistent hypotension. These cases emphasise that the pseudoemergency may rapidly progress into a real emergency when blood pressure is rapidly and aggressively reduced.
PMID: 15206510 [PubMed - indexed for MEDLINE]
> I had a spontaneous hypertensive crisis on Parnate--i hadn't eaten anything in at least 24 hours that could have contained tyramine, and i hadn't taken a dose of Parnate in about 6 hours. was only on 20 mg at the time.
>
> now my doctor is saying we're going to have to try something else--that if it wasn't tyramine-induced, then there's no way i can prevent it. but i've already tried everything, and parnate is the only med that's worked well for me. this is the best i've felt in 10+ years (hypertensive episode notwithstanding, of course). is that really it? if i stay on parnate, am i destined to keep having these episodes spontaneously just b/c i had one once? can't i just carry around that sublingual med that rapidly lowers bp, or are doctors not doing that anymore?
>
> i'm supposed to have already started tapering off parnate, but i just can't bring myself to do it--it's so hard to affirmatively take steps toward being horribly depressed, which i know is exactly what's waiting for me. on the other hand, being rushed to the e.r. on a stretcher with a sky-high bp was pretty horrifying too. i just keep hoping for a solution.
poster:jedi
thread:938043
URL: http://www.dr-bob.org/babble/20100216/msgs/938046.html