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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by jnew12 on November 2, 2008, at 10:26:05
What caused it? Was it a medication or food?
Were you on Parnate, or Nardil?
What did it feel like?
Did you call 911, or stay home?
How were you treated at the emergency room? Did you get help right away? Did they know how to treat a MAOI?
Also, did you doctor know, did he want to take you off it?
That's a biggie for me, I am afraid that if I get a hypertensive crisis (which I hope to god I don't ever get) my doc will insist I get off, because it was my idea to try Nardil in the first place, not his.
Posted by JadeKelly on November 2, 2008, at 12:14:25
In reply to For Anyone Who Had A Hypertensive Crisis, posted by jnew12 on November 2, 2008, at 10:26:05
> What caused it? Was it a medication or food?
I'm of the rare, sorry breed, who has them spontaniously. I'm only aware of one other poster here with that problem. But will be curious to see who responds.
>
> Were you on Parnate, or Nardil?Parnate, 30mg day
>
> What did it feel like?Scary and painful.Woke at 6am with a nasty pounding headache. I had low blood pressure prior to that so lucky I had a cuff at home. Not sure I would have known What was happening.
>
> Did you call 911, or stay home?With a head ache like that I pretty much knew where I was going. My nephew was here and he called. We did ask couple of times if they had the antidote on board they said yes. I couldn't really talk cause of pounding in my head.We told 911 my BP, 190 and rising, and they said I def had to go.They were there in like, 5 minutes.
Course my big plan was to get antidote and stay home, but they took me on stretcher to hospital.No antidote.
> How were you treated at the emergency room? Did you get help right away? Did they know how to treat a MAOI?The nurses didn't know what an MAOI was. Didn't see Doc for quite awhile. I think because these usually resolve within couple hours on there own, and I geuss there are some risks in treating (not sure under what conditions they wait it out. Maybe my BP had stopped rising by then I don't remember. I do remember begging for pain meds!! Anything!! Advil! haha.I didn't like how I was treated. They took blood and I laid there for three hours. No Antodote and Torodal after 2 1/2 of being there for headache which had largely dissapated. They are not familiar, as a whole, with the MAOI scene as far as I could tell.
>
> Also, did you doctor know, did he want to take you off it?Well, I knew hosptal would call him anyway so I called first. Like you, I wanted to find way to stay on Parnate because it was workg so well. I scoured my house for what could have caused it. Finally, I thought it may have been a protien bar (soy protien) Pdoc and I agreed on that. He let me keep taking it if I monitored my BP.I'd been on it 11 days no prob. Every day after, same spike 1/2hr or so after dose. tried splitting it up, spike after last dose.Waited those out at home. No fun.
Called Pdoc, asked for antidote until next appt. he called in "Nifedipine" 10mg. Directions said take one daily, havent had a spike since. Only thing he made mistake on instructions, I was only to take it with crisis. Couldn't go there anymore so we compromised and I'll stay on till I see him next week.Don't know after that.
>
>
> That's a biggie for me, I am afraid that if I get a hypertensive crisis (which I hope to god I don't ever get) my doc will insist I get off, because it was my idea to try Nardil in the first place, not his.Be careful not to have one in the first place.If you do, get quick treatment, don't base it on your Pdoc's reaction. Its an emergency and you should treat it as one.
Remember, I'm the excepton, so if you follow the restricts, to a T, you should be fine. Buy a cuff, your BP is all over the place at first, low mostly. Get the antidote script with the Parnate script. You'll feel much better knowing you have it. If you have the worst headache ever (10), pounding in the back of your head, probly should take one. And call Dr. Remember these are powerful drugs, just prepare and educate yourself 1st. Don't rely only on Pdocs info either. I was not prepared at all.
Good luck! They work well if you respond, 4-5 days for me!Jade
Posted by Phillipa on November 2, 2008, at 12:21:08
In reply to Re: For Anyone Who Had A Hypertensive Crisis, posted by JadeKelly on November 2, 2008, at 12:14:25
How scarey so glad you're okay. Phillipa
Posted by Questionmark on November 3, 2008, at 0:20:29
In reply to For Anyone Who Had A Hypertensive Crisis, posted by jnew12 on November 2, 2008, at 10:26:05
Twice. Both times my own stupid fault (i shall dare not blame the MAOI but indirectly!). I believe I posted about both accounts here at PBabble about a few years prior.
The first was after just starting Parnate-- maybe like a week-- and had some mac and cheese at a diner-- except it was white cheddar not that fake crap. Later terrible pounding occipital headache etc. Ended up taking some clonazepam, propranolol, and, i think a bit of riperidone if i remember correctly, and then sleeping it off in my bed (obviously i am NOT recommending that as a good way to combat a hypertensive episode-- the lying down OR the meds-- and i don't think the meds helped substantially, though i'm pretty sure they did somewhat). I didn't go to the hospital or tell anyone at the time, for various reasons. And definitely never told my doctor. Didn't want hIm freaking out.
The second one was while riding back in a car from a road trip, and was just absolutely shamefully stupid. This was on Nardil. Anyway to make a long story short since i think i already posted about this back in the day-- i took 50mg ephedrine (yes, i said it was stupid) just completely forgetting that, well, i CAN'T DO THAT. So started feeling bad after awhile, realized what i had done... uh oh, blah blah blah then severely painful pounding headache... emergency room, waited 3 freakin hours and eventually finally got some IV clonidine which had immediate relief (even though i was telling the nurses and doctor/s since the moment i GOT there that i was having a hypertensive episode from a sympathetic nervous system stimulant and an MAOI and all i needed was a drug to lower my blood pressure)-- yeah don't even get me started on my time in the ER. My GOODness. I will rant the whole night about that escapade.
Never told my doctor about that one either, but also never had another hypertensive reaction of any kind since then, and that was about... 4 or 5 years ago. But if it wasn't for my own stupidity and absolutely forgetful indiscretion both times, i would have never had any problems.
So please, don't blame the MAOI, blame me.
(Also, if my pdoc would have prescribed me some nifedipine like i wanted it would have saved me 3-plus hours of tremendous suffering plus the $800 of the ER bill-- tho that was mostly covered by insurance through my parents, fortunately).So, there it is, way more info than you probably even wanted.
But my advice is, -- well, first of all, always be wary of what you ingest. Not anxious about it. But aware. As far as foods, above all else just be wary of aged cheeses. And be very cautious when it comes to an kinds of drugs, particularly anything with serotonergic or sympathomimetic properties. Secondly see if your dr would be willing to prescribe you some nifedipine or chlorpromazine (or phentolamine?) as an emergency backup. But regardless, my final advice is, god forbid you do ever happen to have a hypertensive crisis-- which i hope and doubt that you will-- don't even bother telling your pdoc if you can help it. If a psychiatrist read that he or she would probably be appalled-- or at least disappointed-- but, we have to take what little responsibility we can take and hold, into our own hands. I.e., if it truly is in my best interest to stay on an MAOI even after having a hypert. reaction, then... it is in my best interest-- regardless of whether my doctor would be too scared or worried to be able to adequately think rationally about what my best interest is. ... OK i don't even know what i'm talking about anymore. I'm sorry, i'll shut up now.
I must retire to bed.
But be not afraid of the hypertensive crisis! Be only cautious and aware.
> What caused it? Was it a medication or food?
>
> Were you on Parnate, or Nardil?
>
> What did it feel like?
>
> Did you call 911, or stay home?
>
> How were you treated at the emergency room? Did you get help right away? Did they know how to treat a MAOI?
>
> Also, did you doctor know, did he want to take you off it?
>
>
> That's a biggie for me, I am afraid that if I get a hypertensive crisis (which I hope to god I don't ever get) my doc will insist I get off, because it was my idea to try Nardil in the first place, not his.
Posted by JadeKelly on November 3, 2008, at 14:31:52
In reply to Re: For Anyone Who Had A Hypertensive Crisis » jnew12, posted by Questionmark on November 3, 2008, at 0:20:29
Hi Jnew,
Sounds like questionmark and I had identical experience at ER. The answer here is to get antidote like Nifedipine. My crisis wasn't due to stupidity, (hah, sorry Q), so I really had no choice but to tell PDoc as I kept having them. He said if I call him with so much as a headache, he'll take me off it. NOOOOOOO!! haha
Most people on this site who have been taking MAOI for many years have had a crisis. Often Because they ate something they didn't know had a restrict food in it (sauces, Etc.) Just take antidote if you have a crisis, you'll know, believe me. If they continue on regular basis, I think you should tell PDoc. My brain is still a little fuzzy from that morn. Slowly going away though!
Cheers, hope success for you!!!Jade
Posted by Questionmark on November 5, 2008, at 11:45:31
In reply to Re: For Anyone Who Had A Hypertensive Crisis, posted by JadeKelly on November 3, 2008, at 14:31:52
Yes, I definitely agree with that. If you get hypertensive reactions on a regular basis or get them randomly from the MAOI alone (this occurs much more often with Parnate than Nardil, but still not sure how frequent it is with Parnate), you should definitely tell your dr.
> Hi Jnew,
>
> Sounds like questionmark and I had identical experience at ER. The answer here is to get antidote like Nifedipine. My crisis wasn't due to stupidity, (hah, sorry Q), so I really had no choice but to tell PDoc as I kept having them. He said if I call him with so much as a headache, he'll take me off it. NOOOOOOO!! haha
>
> Most people on this site who have been taking MAOI for many years have had a crisis. Often Because they ate something they didn't know had a restrict food in it (sauces, Etc.) Just take antidote if you have a crisis, you'll know, believe me. If they continue on regular basis, I think you should tell PDoc. My brain is still a little fuzzy from that morn. Slowly going away though!
>
>
> Cheers, hope success for you!!!
>
> Jade
This is the end of the thread.
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