![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by ross on February 23, 2002, at 21:31:51
everything is going a-ok so far into day 3 on Nardil but at 8pm at work i took my BP several times and it was down!!
i was running about 117/80 pre-Nardil
today i had readings of 105/61
104/61
99/67
my BP wrist moniter is extremly accurate. its a Medisana perfect.
elizabeth was saying you need to drink lots of fluids while taking Nardil. i have been drinki9ng a bottle of seltzer a day. do i need to drink something with sugar and sodium in it?
does anyone know any remedies?
i did not feel faint at all but how can you keep your BP up?
ross
Posted by Ray on February 25, 2002, at 1:17:46
In reply to how do you keep your BP up on Nardil?, posted by ross on February 23, 2002, at 21:31:51
1) Good question to call and ask your Dr. how low is ok. I had never checked mine much. It is possible that initially may be exaggerated.
2) Could lower dose tempoararily if concerned.
3) Caffeine (Jet Alert at Target or No-Doz about anywhere)
4) Salt also like you mentioned.
5) Can talk with Dr. and if in long term still concerned can lower Nardil a bit and add low dose Provigil. You might enjoy a synergistic response .
6) I wouldn't recommend any other stimulants or drugs at least that I'm aware of. Ritalin and Dexedrine are just as likely to lower BP as raise it.
Ray_3888@yahoo.com
http://www.socialfear.com/> everything is going a-ok so far into day 3 on Nardil but at 8pm at work i took my BP several times and it was down!!
> i was running about 117/80 pre-Nardil
> today i had readings of 105/61
> 104/61
> 99/67
> my BP wrist moniter is extremly accurate. its a Medisana perfect.
> elizabeth was saying you need to drink lots of fluids while taking Nardil. i have been drinki9ng a bottle of seltzer a day. do i need to drink something with sugar and sodium in it?
> does anyone know any remedies?
> i did not feel faint at all but how can you keep your BP up?
> ross
Posted by dennison on February 25, 2002, at 4:37:25
In reply to how do you keep your BP up on Nardil?, posted by ross on February 23, 2002, at 21:31:51
> everything is going a-ok so far into day 3 on Nardil but at 8pm at work i took my BP several times and it was down!!
> i was running about 117/80 pre-Nardil
> today i had readings of 105/61
> 104/61
> 99/67
> my BP wrist moniter is extremly accurate. its a Medisana perfect.
> elizabeth was saying you need to drink lots of fluids while taking Nardil. i have been drinki9ng a bottle of seltzer a day. do i need to drink something with sugar and sodium in it?
> does anyone know any remedies?
> i did not feel faint at all but how can you keep your BP up?
> rossHi Ross Hypotension from maoi's, you have encountered the one big disadvantage that forms most of the complaints concerning maoi's. This is indeed orthostatic "postural" in nature, but of a totally dissimiliar nature to hypotension which occurs with tricyclics for instance where the cause is the blocking of the alpha-1 post synaptic receptor, thus effectively dampening vasoconstrictive hemodynamic effects which occur as someone stands, thus fall in blood pressure occurs. Maoi hypotension stems from a so called "false-neurotransmitter" replacing norepinephrine in the autonomic "sympathetic nervous division". False neurotransmitter is called octapmine and it replaces norepinephrine in the secretory granule that would normally release norepinephrine, since octapmine has only 1% of the physiologic effect of actual norepinephrine, the post synaptic alpha-1 receptor that needs to be stimulated with norepinephrine to cause the venous and to a much lesser extend arterial constriction doesn't occur. This results in the fall of bloodpressure as venous pooling occurs. Remember veins are contigent on sympatheic innervation to constrict, without this constriction they can pool large amounts of circulating blood so thus less is pumped back to heart as well as bloodpressure dropping. Muscular movement aids venous return, but can't totally replace this lost of venoconstriction. >OK,enough of what's causing it and let's get to what you can do about it. Ok I'm going to take this info straight from Journal Clinical Psychiatry 48:1 "Management Of Antidepressant-Induced Side Effects: A Practical Guide For The Clinician" Authors Mark H.Pollack, M.D. and Jerrold F. Rosenbaum, M.D. >#1 Suggestion-- One cup strong brewed coffee!!!! >#2 Suggestion-- Addition of triiodothyronine 25 micrograms q.d. or thyroxine .100>.200 micrograms q.d. >#3 Suggestion--Small doses Ritalin or dexedrine-yes I know-these are typically strongly contraindicated -But have indeed been combined with maoi's to augment as well as offset any side-effects of maoi's. Close supervision is required here of course as well as starting at very small doses and careful observance of any bloodpressure responses. >#4 Suggestion-- Salt tablets 600>1800mg B.i.d.---This is not indicated if you have cardiac or renal troubles however. Maintianing adequate salt intake though is important. >#5 Suggestion-- 9-alpha-fluorohydrocortisone 0.025mg>0.05mg q.d.-b.i.d.. Precautions and close observance on this regiment is important,but it's used fairly common to treat low blood pressure. >#6 Suggestion --I will ommit it's too hard to follow and too controversial!!! >OK -- On more simple practical basis, one big method to avoid largest drops in blood pressure, the old tried n true method "divided doses". >Support hose to minimize peripheral venous pooling, can help!!!!! >Abdominal binder, this I myself have tried and found it to have a very dramatic immediate effect. >Maintain fluid intake is important, dehydration even if only minimal will decrease plasma volume something that will enhance any bloodpressure and more importantly cardiac return. Remember Starling's Law myocardial contraction and filling are directly related,less filling, weaker contraction. Don't need that!! >Ok that's all my suggestions hopefully you will never need a single one, but just in case you do at least these are a few to potentially help. >Good Luck Ross Hope Nardil "phenelzine", works like a dynamo for you !!!! :):):)
Posted by ross on February 25, 2002, at 18:32:59
In reply to Re: how do you keep your BP up on Nardil?, posted by dennison on February 25, 2002, at 4:37:25
thank you very much for that detailed description on some remedies. my BP today was fine all day. tonight im going to 60mgs of Nardil, so im taking 15mgs Q.I.D.
orange juice seems to be helping alot if i feel it drop a bit.
i was in hampton hospital back in 91' and i was placed on Anafanil and at about 200mgs my BP was running low. one day we going out on a trip to a park and i was just resting on my bed for 20 inutes when everyone was ready and i got up suddenly and fell flat to the ground. i was dizzy and the psych nurses brought me up to the front and gave me orange juice? well it brought my BP back up but they kept me from going to the park.
thanks alot
ross
Posted by Elizabeth on February 28, 2002, at 1:46:05
In reply to how do you keep your BP up on Nardil?, posted by ross on February 23, 2002, at 21:31:51
If you're not feeling faint, don't worry about it. Just make sure to stay hydrated so you don't *get* faint. Low blood pressure in the range you're talking about isn't dangerous in itself.
-elizabeth
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.