Posted by jedi on February 27, 2010, at 16:58:08
In reply to Re: Spontaneous Hypertensive Crisis on MAOI, posted by stargazer2 on February 27, 2010, at 15:18:28
Though they are rare, spontaneous hypertensive episodes on MAOIs have been documented. They are more common with Parnate than Nardil.
JediReference:
Biol Psychiatry. 1993 Aug 1;34(3):146-51.
Spontaneous hypertensive reactions with monoamine oxidase inhibitors.Lavin MR, Mendelowitz A, Kronig MH.
Department of Psychiatry, Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY.
Despite long-standing concerns over hypertensive reactions, monoamine oxidase inhibitors (MAOIs) have grown in popularity and are now used in a variety of psychiatric disorders. The risk of hypertensive episodes is less than 1%. This is most likely the result of careful dietary instructions and prudent prescribing of concomitant medications. The possibility exists of spontaneous or unprovoked hypertensive crises in patients receiving MAOIs. In this report, we review the literature on spontaneous hypertensive episodes and present a case report. There has been a total of 11 cases described in six separate reports. We discuss the possible mechanism, risk factors, treatment, and safety of rechallenging the patients with the MAOI. Further research is needed to clarify this reaction. For now, it remains a rare but worrisome phenomenon. It should stand as an additional source of concern for clinicians who are already well aware of the risk of hypertensive episodes in patients receiving MAOIs.
PMID: 8399806 [PubMed - indexed for MEDLINE]
> Are you sure it wasn't from something you ate or drank (alcohol or caffeine) or another medication?
>
> I was not aware of anything called spontaneous, not related to some other factor that could have been overlooked.
>
> What dosage were you on?
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> I had a reaction on Nardil with a stimulant, a tiny dose but I did have Nifedepine and used it successfully. I dropped to the floor with my BP cuff on my arm. It was scarey but I got through it and continued on Nardil, so that didn't make me have to switch as that is devastating when you are stable on something.
>
> I would try and convince my doc to give it another try and make sure you have Nifedipine, handy. I htink a second chance is worth it but that is me and my pdoc, so it is an individual call. MY doc knows me so well he knows I will not take any risks at all. I wouldn't be convinced that it was not something I hadn't eaten, drank or another medication in combination, like an OTC cold medication, those are big NO-Nos. Unfortunately when on a MAO, you forget what goes into your mouth until you have the dreaded reaction.
>
> I've been on MAOs for years and only had a real reaction once, with a few mini ones, that showed me how careful you have to be with anything you put in your mouth and ingest. Many people can not be that disciplined. But if it means you could die, you have to be vigilant.
>
> Good luck with whatever happens with this issue.
poster:jedi
thread:938043
URL: http://www.dr-bob.org/babble/20100216/msgs/938114.html