![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by atypical on August 26, 2009, at 15:31:31
At about 1:00am on Tuesday morning, I lay down in bed to go to sleep. I noticed my heart was pumping very strong and fast. I was short of breath. Ok. So it will pass. Is this an MAOI hypertensive crisis coming on? I started getting scared. It wasn't until the severe headache emanating from the back of my neck that I knew something was very wrong. What had I eaten? The only thing I can think of was that at 12:00am I had eaten some Monterey Jack cheese. I've eaten this cheese before with no problem, so what gives? This time it was not melted; I ate it straight from the bag in the fridge. I took a Nifedipine tablet, bit into it. I figured this is pretty serious so I took a cab a few blocks to the ER. The nurse took my blood pressure and it was high. Really high. 193/101. Whoa. So I waited for the doctor, which took like 1.5 hours. And during that time my blood pressure went down to a relatively healthy 137/83. I asked them to send me home. They did.
Folks, this has truly shaken me up. BIG TIME. Please take care when taking MAOIs.
Posted by Phillipa on August 26, 2009, at 16:53:48
In reply to My first hypertensive crisis (from Nardil), posted by atypical on August 26, 2009, at 15:31:31
Well thankfully you had the niphedipine and your're okay now will you continue on the maois? Phllipa
Posted by Maxime on August 26, 2009, at 17:30:03
In reply to My first hypertensive crisis (from Nardil), posted by atypical on August 26, 2009, at 15:31:31
I'm glad that you are okay. I had a hypertensive episode on Parnate and the headache was really painful.
Apparently, sometimes you can eat foods that should be avoided and not get a hypertensive episode. Then the next time you eat it, a hypertensive episode can happen. It's best to play it safe.
Take care.
Posted by Maxime on August 26, 2009, at 19:41:47
In reply to Re: My first hypertensive crisis (from Nardil) » atypical, posted by Phillipa on August 26, 2009, at 16:53:48
> Well thankfully you had the niphedipine and your're okay now will you continue on the maois? Phllipa
Why stop the Nardil? It was just one episode. They happen sometimes.
Posted by zzzz7 on August 26, 2009, at 21:27:12
In reply to Re: My first hypertensive crisis (from Nardil) » Phillipa, posted by Maxime on August 26, 2009, at 19:41:47
Do you think that the cheese had sat for a while and its chemistry had changed in the same way that other food that isn't fresh changes?
Posted by stargazer2 on August 26, 2009, at 21:51:13
In reply to Re: My first hypertensive crisis (from Nardil), posted by zzzz7 on August 26, 2009, at 21:27:12
I eat Monteray Jack cheese all the time with Nardil. Are you sure it wasn't something else?
Are you on any other meds?I had a similar reaction but could monitor my BP after taking Nifedepine and avoid going to the ER. Do you have a BP cuff? I would advise anyone on a MAO to have one, since you could just have a headache and not be sure if you ate something that may be affecting your BP or just have a headache.
Did they give you anything in the ER or were they unfamiliar with how to take care of a MAO/cheese reaction. Some docs don't know what do do when they find out you are on a MAO.
I have never had a reaction with food just medications, so far, thankfully. Its scarey for me and my pdoc really got freaked out.
SG
Posted by atypical on August 26, 2009, at 22:14:24
In reply to Re: My first hypertensive crisis (from Nardil), posted by stargazer2 on August 26, 2009, at 21:51:13
Do you usually eat the Monterey Jack cheese melted or regular? It wasn't an old bag of cheese by any means. Perhaps 1 week old. I also ate with it corn chips (tortilla style) and a slice of whole wheat bread. I am on Lithium as augmenting for depression. The BP cuff is a good idea. I actually do have one but I couldn't find it!
I assume since I took the Nifedipine and my BP went down, they did not treat me with any additional meds. The ER doc seemed to be familiar with MAO reactions.
> I eat Monteray Jack cheese all the time with Nardil. Are you sure it wasn't something else?
> Are you on any other meds?
>
> I had a similar reaction but could monitor my BP after taking Nifedepine and avoid going to the ER. Do you have a BP cuff? I would advise anyone on a MAO to have one, since you could just have a headache and not be sure if you ate something that may be affecting your BP or just have a headache.
>
> Did they give you anything in the ER or were they unfamiliar with how to take care of a MAO/cheese reaction. Some docs don't know what do do when they find out you are on a MAO.
>
> I have never had a reaction with food just medications, so far, thankfully. Its scarey for me and my pdoc really got freaked out.
>
> SG
Posted by stargazer2 on August 26, 2009, at 22:41:36
In reply to Re: My first hypertensive crisis (from Nardil), posted by atypical on August 26, 2009, at 22:14:24
Either way, melted or not, doesn't seem to matter. Did you eat alot of nachos?
When I first took a MAO, I was afraid to eat pizza with mozzarella cheese, now I do and haven't had an issue with it. I would never eat more than 3 slices though.
I think there are so many variables with anything you eat or drink. I don't think I ever had a food reaction and I've been on NArdil on and off for many years.
What dose of Nardil are you on? I'm only on 30 mg but take wellbutrin too.
Posted by ColoradoSnowflake on August 26, 2009, at 23:32:38
In reply to Re: My first hypertensive crisis (from Nardil), posted by stargazer2 on August 26, 2009, at 22:41:36
Hi:
I think I had a little Parnate scare too. Last week I ate some rotisserie chicken from Costco. It had been in my fridge 2 nights. I ate very little (standing at the fridge) and then was reading. I started getting a headache in the front of my head, then in my neck. I thought, oh, oh I'd better be prepared to go to the E.R. I couldn't find my blood pressure kit. My pdoc didn't give me any nifir.... He said more people have hurt themselves worse with too low BP. Since I had eaten so little of the chicken, I just waited for a while and it went away in an hour or so.
I think I will ask my pdoc for that bp lowering med.
I have so few problems with the diet it was a little reminder to be careful!
gayle
Posted by atypical on August 27, 2009, at 8:10:56
In reply to Re: My first hypertensive crisis (from Nardil), posted by stargazer2 on August 26, 2009, at 22:41:36
I eat nachos at home -- with Monterey Jack cheese and Trader Joe's salsa. I do eat pizza -- mozzarella has been known to be OK with MAOI. I pray that this was just a fluke.
I take 60mg of Nardil and 900mg of Lithium as augment for depression. So my good friend asks me "is it worth taking a medication that has a chance for a deadly reaction." Fair question, I guess. I didn't answer her. But inside myself my response was, well, if I can live without feeling sad all the time than I will take the risk.
> Either way, melted or not, doesn't seem to matter. Did you eat alot of nachos?
>
> When I first took a MAO, I was afraid to eat pizza with mozzarella cheese, now I do and haven't had an issue with it. I would never eat more than 3 slices though.
>
> I think there are so many variables with anything you eat or drink. I don't think I ever had a food reaction and I've been on NArdil on and off for many years.
>
> What dose of Nardil are you on? I'm only on 30 mg but take wellbutrin too.
Posted by stargazer2 on August 27, 2009, at 20:33:35
In reply to Re: My first hypertensive crisis (from Nardil), posted by atypical on August 27, 2009, at 8:10:56
Me too, the risk is worth it, but just hearing about reactions from others is knowledge to never take food reaction for granted. Also medication reaction, since docs prescribe meds that can interact all the time. Double check any new med to see if compatible with MAO's.
A drug reference book and a BP cuff are required when you are on a MAO. And if you can a few Nifedipine capsules, just in case. Better to be safe than sorry. MIne are pretty old. I should get a few new ones the next time I see my pdoc.
Posted by Nadezda on August 30, 2009, at 0:39:37
In reply to Re: My first hypertensive crisis (from Nardil), posted by stargazer2 on August 27, 2009, at 20:33:35
One point: a food that is safe in small or single portions can become more dangerous if you have it several times in a row, in a short period of time, say a few days or even week (depending on how much you have, etc.)
Since Mao only is renewed slowly in the body, one portion may be safe, but if you further stress your system, before the Mao can be replaced, it can reach the threshold where there's a hypertensive reaction. Similarly with several foods, each of which individually would be safe.
Nadezda
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.