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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by socialphobic on August 21, 2008, at 1:59:55
Hi, just wondering if anyone here has had a hypertensive experience on an MAOI that they would like to share? There was a thread about this in the archives but it was dated 2002. I'm guessing there would have been more "hypertensive experiences" since then.
Posted by mav27 on August 21, 2008, at 4:02:02
In reply to MAOI hypertensive experiences?, posted by socialphobic on August 21, 2008, at 1:59:55
out of interest when does it become a hypertensive crisis? anyone know ? Is it just when a certain blood pressure is reached or does something have to actually happen from the increased blood pressure?
Don't think i've ever had a crisis.. i did manage to get my pressure up to 210/140 on parnate but that's obviously not enough to do much harm.
Posted by superman on August 21, 2008, at 13:20:34
In reply to Re: MAOI hypertensive experiences?, posted by mav27 on August 21, 2008, at 4:02:02
* MAOI hypertensive crisis tyrosine cheese-effect parnate Tranylcypromine nardil Phenelzine Phenethylamine PEA high blood pressure *
I foolishly took a large does of phenethylamine (PEA) while on the MAOI Parnate (tranylcypromine) and had a horrible hypertensive crisis. To say the least, it was not fun, and I honestly thought I was going to die.
I notice someone wrote something like 'it's not the 999 an interaction doesn't occur and you don't have a hypertensive crisis, it's the one time it does.' This is quite true. My pdoc told me when I started the med that the whole "cheese-effect"/hypertensive crisis risk got blown out of proportion when it was first discovered. For the most part, I agree with him. I experiemented with very small amounts of food that had large amounts of tyrosine after being very careful for the first while, and eventually found i didn't have to worry at all for even those foods that supposedly contained the *highest* amounts of tyrosine.
having said that however, it wasn't tyrosine that eventually did it for me - it was phenethylamine, which very very similar structurally to tyrosine, and I suspect I had the hypertensive crisis for the same reason some people do with MAOIs + tyrosine.
In retrospect, I should have gotten to emergency ASAP. My blood pressure shot through the roof, and became drenched in sweat while sitting still in my relatively cold room, threw-up several times, and honestly was in so much pain that I wanted to die. I was too embarrassed to go downstairs and ask my dad to take me to the hospital, although afterwards I realized I should have the second I felt my blood pressure and body temp shoot up. I had a migraine for weeks following, and no doubt did some permanent damage to my young brain (I was 19 at the time).
It's worth being careful, it only takes one time. In my experience, be careful with anything psychoactive while on a MAOI (do your research and assume the worst!), as well as the usual warnings such as cough-syrups and the like.
Just thought I ought to share this.
-T
Posted by desolationrower on August 21, 2008, at 18:28:43
In reply to Re: MAOI hypertensive experiences?, posted by superman on August 21, 2008, at 13:20:34
Phenelethelamine taken with an MAOI is going to behave much like amphetamine. BTW, how much PEA did you take?
Posted by djmmm on August 25, 2008, at 9:50:47
In reply to Re: MAOI hypertensive experiences? » superman, posted by desolationrower on August 21, 2008, at 18:28:43
I 've taken multiple stimulants with MAOIs, The only one I had an issue with was the supplement PEA (phenylethylamine)
As far as food, I had only one bad experience with a specific brand of cheese-filled pasta--unfortunately i can't remember which one....
for me, at least, 99% of the "restricted" food and medications caused absolutely NO problems. However, my reaction--or non reaction-- is probably atypical.
Posted by britney 27 on August 31, 2008, at 7:23:26
In reply to Re: MAOI hypertensive experiences?, posted by mav27 on August 21, 2008, at 4:02:02
Hi, basically, if you have a hypertensive crises you will feel the most unbearable occipital headache which may radiate frontall and you will need to rush to the emergency room to get a needle. The headache will usually start within 30 minutes of taking the parnate.
Posted by britney 27 on August 31, 2008, at 7:28:58
In reply to Re: MAOI hypertensive experiences?, posted by superman on August 21, 2008, at 13:20:34
Superman,
Wow, I am glad you are ok. Can what level of the dose you were on at the time the hypertensive crisis occured?
Also what treatment where you given in the emergency room (oral medication?) to lower your blood pressure?
cheers
B
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