Psycho-Babble Medication Thread 55333

Shown: posts 1 to 6 of 6. This is the beginning of the thread.

 

MAOIs are safe for you: consider them now

Posted by SalArmy4me on March 2, 2001, at 9:18:06

--I took Tranylcypromine for three months last year.

MAOIs: Dangerous?

I never had a hypertensive crisis, but there is a chance of a hypertensive crisis in which blood pressure increases so rapidly that a huge headache occurs. The chance of a hypertensive crisis from eating foods with tyramine is 6% from the last study done on it; modified to only 3% with the application of a special diet. These are pretty low percentages. But even if such a hypertensive crisis occurs, a simple dose of oral nifedipine will stop it immediately... The truth is that most hypertensive crises are mild, if they even occur.

Actually, there is more of a chance of _low_ blood pressure (orthostatic) with MAOIs than with the opposite. This may sound like a terrible illness, but it is merely annoying and does not cause any damage to the body. It may make you dizzy when you go from lying down to standing upright. It is easily remedied with a high sodium diet.
http://www.dr-bob.org/tips/split/Orthostatic-hypotension-on.html
If a first or second-line antidepressant fails for you, you should consider an MAOI (Phenelzine, Tranylcypromine, or the now available isocarboxazid. MAOIs are the only medications that work on

A disadvantage of MAOIs is that they can have severe interactions with other medications. Sometimes a Serotonin Syndrome or Neuroleptic Malignant Syndrome occurs. But to avoid such reactions, all you have to do is remember to ask your doctor before taking any medication with an MAOI. Or, you can use Dr. Koop's Drug Checker at www.drkoop.com.

MAOIs are perfectly safe, that is why they are still used after 40 years of existence. They just require that you get used to the idea of taking them and not erroneously think that they will kill you. Point in case: Nobody ever sees an article about someone dying from an MAOI in the paper.

Other stuff: http://www.dr-bob.org/tips/split/Orthostatic-hypotension-on.html
http://www.dr-bob.org/tips/split/MAOI-diet-update.html

Blood & Fire: The Salvation Army USA West

 

Re: MAOIs are safe for you: consider them now

Posted by blackjack on March 2, 2001, at 16:29:59

In reply to MAOIs are safe for you: consider them now, posted by SalArmy4me on March 2, 2001, at 9:18:06

I had 2 hypertensive crises while taking Parnate, and in neither case had I had any food that should have been high enough in tyramine to trigger it. The problem with Parnate is that it metabolizes into, among other things, an amphetamine-like chemical that can trigger spontanious hypertensive crises. It's really rare tho. The worse of the two crises was like being beaten in the back of the head of the head with a 2x4. The other one was just a bad headache.

But, annoying as these episodes were, the only real danger MAOI's present is, like Sal said, when they are mixed with other drugs. Which can be annoying if you get a cold or have asthma...

All that being said, Parnate was far and away the most effective AD I ever took, and if it hadn't started working (I seem to have built an actual tolerence--it took increasing dosages to keep from having withdrawl symptoms) I'd be taking it today, cheese or no cheese.

 

Re: MAOIs are safe for you: consider them now

Posted by SalArmy4me on March 3, 2001, at 9:37:14

In reply to Re: MAOIs are safe for you: consider them now, posted by blackjack on March 2, 2001, at 16:29:59

I myself was on Parnate for three months and didn't follow the dietary guidelines. My blood pressure is low, so I may have had an increase in blood pressure due to tyramine-- but not known about it. Most increases in blood pressure are miniscule on Parnate.

 

Re: MAOIs are safe for you: consider them now

Posted by kate9999 on March 4, 2001, at 3:43:07

In reply to Re: MAOIs are safe for you: consider them now, posted by SalArmy4me on March 3, 2001, at 9:37:14

WHY didn't you follow the dietary guidelines?

> I myself was on Parnate for three months and didn't follow the dietary guidelines. My blood pressure is low, so I may have had an increase in blood pressure due to tyramine-- but not known about it. Most increases in blood pressure are miniscule on Parnate.

 

Re: MAOIs are safe for you: consider them now

Posted by blackjack on March 4, 2001, at 14:43:48

In reply to Re: MAOIs are safe for you: consider them now, posted by SalArmy4me on March 3, 2001, at 9:37:14

It's definitely one of those your-milage-may-vary things. If everybody reacted the same way to meds, this whole thing would be much simpler.

To my knowlege, nobody has ever died from a _food_ reaction with an MAOI, tho somebody already at risk for stroke could conceivably do it.

Side note: human liver, fava beans and chianti are all tyramine-rich foods. Was Dr. Lechter trying to boost his dopamine levels or something?

 

I also don't follow all MAOI dietary guidelines -

Posted by jb on March 10, 2001, at 1:34:28

In reply to Re: MAOIs are safe for you: consider them now, posted by blackjack on March 4, 2001, at 14:43:48

In my opinion, the dietary guidelines and the scare about MAOI's has been vastly overblown. The chief items to avoid are the aged products - aged cheeses, aged beer, red wine, dates, and similar items. I eat pizza constantly, drink light beer, and otherwise don't watch what I eat. The medicine contraindications are another thing, in my opinion. For example, I don't even consider taken an SSRI while taking an MAOI. I also tell my physician which meds I'm taking.

Over the last 8 years, I've found Nardil and Parnate to be safe and effective. My problem with Nardil is the weight gain and complete anorgasmia. With Parnate, my problem has been very dry mouth and slowed speech.

I keep wondering if high dose selegiline, it loses its MAO-B selectivity above 10-15 mg/day, might be the answer.

JB


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