![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by jms600 on August 26, 2009, at 16:17:02
OK - so I guess this post follows on from the previous one. Can alcohol be drunk throughout Nardil therapy?
I think it's getting to the point now when I've got to think about an MAOI as everything else I've tried for my panic disorder has failed (including benzos).
Thing is, drinking beer is one of the few pleasures I have in life and - if I did take Nardil - I wouldn't want to have to do without another thing that I enjoy. I don't drink excessively, but I do drink three or four pints of beer or maybe a couple of shorts when I go out.
Could anyone advise on what my options are? Is there an alcoholic drink which is safer to take with Nardil then other drinks??
Thanks!
Posted by atypical on August 26, 2009, at 16:31:22
In reply to Can I drink alcohol with Nardil??, posted by jms600 on August 26, 2009, at 16:17:02
It is OK to drink alcohol in a limited fashion on Nardil. Stick to BOTTLED beer as opposed to tap. And white wine as opposed to red wine. I have had red wine without problem, but not worth the risk. I will drink no more than 1/2 - 1 glass of it. I try to limit my consumption to 2-3 drinks at a sitting.
I can totally understand your great pleasure of drinking beer. My advice, having gone through a reaction just recently, is just be careful, be aware of your body, and moderation. Sounds like you do that already.
Posted by SLS on August 26, 2009, at 16:35:13
In reply to Can I drink alcohol with Nardil??, posted by jms600 on August 26, 2009, at 16:17:02
Beer is okay as long as it is bottled and from a major brewery. Microbreweries and beers on draught (tap) pose some risk. You may find that it takes less beer to become intoxicated when taking a MAOI.
- Scott
Posted by jms600 on August 26, 2009, at 18:58:59
In reply to Can I drink alcohol with Nardil??, posted by jms600 on August 26, 2009, at 16:17:02
Posted by stargazer2 on August 26, 2009, at 22:33:47
In reply to What about spirits like whiskey or gin?? (nm), posted by jms600 on August 26, 2009, at 18:58:59
Different articles says different things, of course, and my mantra with MAOs is moderation and no aged food or drings, so if a liquor is aged like whiskey, forget about it. The rection risk is too high is my opinion.
One list I have says ...no more than 2 bottled or canned beers, or 4 oz of red or white wine, but says red wine may produce headache unrelated to a rise in BP, hence my earlier suggestion to obtain a BP cuff to be sure of headache cause.
Another list says high tyramine foods (forbidden list) include ales and beers, burgandy wine, chianti wine, sherry and vermouth.
The moderate tyramine list, says drink only 1/4 to 1/2 cup of red, white or port wines. (that's fairly restrictive)and also included distilled liquor, which would be vodka and gin.
Another list says red wine is high in tyramine
but white wine on moderate to low level.So, it is always unclear what is allowed, so that is where the risk comes into the equation.
What I am comfortable drinking is white wine and vodka drinks (martinis, cosmos) or margaritas. I had a gin and tonic before without an issue, but again, I think the most important thing is airing on the side of caution, especially when first taking MAO's. Over time you begin to know your limits, at least I think I have. But it is always a risk.
It is a serious medication and warrants alot of thought before taking it. I have no other choice so I have to watch what I eat and drink, there are no other options, and I have no desire to end up in an ER.
Posted by tepi on August 26, 2009, at 23:59:45
In reply to Can I drink alcohol with Nardil??, posted by jms600 on August 26, 2009, at 16:17:02
I have tried almost any drink except wine and tap beer with no risk
All of them and in great quantities to feel a little safe in parties,The list included bottled beer , whiskey , vodka , ron , brandy , tequila and more more
I have been ok
Posted by jms600 on August 27, 2009, at 7:12:56
In reply to Can I drink alcohol with Nardil??, posted by jms600 on August 26, 2009, at 16:17:02
Posted by FredPotter on August 27, 2009, at 19:05:25
In reply to Re: Can I drink alcohol with Nardil??, posted by tepi on August 26, 2009, at 23:59:45
I think you need to avoid "rustic" wines like Chianti. Draught beer is OK if you're certain the landlord cleans the pipes regularly. Steer clear of aged Belgian beer esp the white beer. Remember the tyramine response is not all or nothing. The more tyramine you consume the more your BP will rise
Posted by SLS on August 29, 2009, at 13:45:25
In reply to Re: Can I drink alcohol with Nardil??, posted by FredPotter on August 27, 2009, at 19:05:25
> I think you need to avoid "rustic" wines like Chianti. Draught beer is OK if you're certain the landlord cleans the pipes regularly. Steer clear of aged Belgian beer esp the white beer. Remember the tyramine response is not all or nothing. The more tyramine you consume the more your BP will rise
It is also worth noting that the tyramine reaction is unpredictable. One can ingest a particular suspect food or drink many times without triggering a reaction and yet provoke a reaction at another time.
- Scott
Posted by pedr on September 15, 2009, at 13:05:50
In reply to Can I drink alcohol with Nardil??, posted by jms600 on August 26, 2009, at 16:17:02
> Thing is, drinking beer is one of the few pleasures I have in life and - if I did take Nardil - I wouldn't want to have to do without another thing that I enjoy. I don't drink excessively, but I do drink three or four pints of beer or maybe a couple of shorts when I go out.
All bottled beer: OK
Tap beer: probably OK but you're playing with fireFrom PubMed:
Tailor SA, Shulman KI, Walker SE, Moss J, Gardner D.Department of Pharmacy, Sunnybrook Health Science Centre, University of Toronto, North York, Ontario, Canada.
A case report of a hypertensive crisis resulting from the ingestion of tap beer in a patient on an irreversible monamine oxidase inhibitor (MAOI; phenelzine) stimulated the investigation of different kinds of beer for tyramine concentration. The objective was to determine the tyramine concentration in tap and bottled beers. A total of 98 beer samples (79 different brands of beer) were analyzed by high-performance liquid chromatography for tyramine. Of these 98 beers, 49 were bottled or canned beers and 49 were beers on tap. All of the bottled beers analyzed had safe tyramine concentrations (< or = 10 mg/liter; range, 0 to 3.16 mg/liter) and, thus, do not require restriction in patients receiving MAOIs. Therefore, the consumption of canned or bottled beer, including dealcoholized beer, in moderation (fewer than four bottles or cans; 1.5 liters within a 4-hour period) appears to be safe and does not require restriction in patients receiving MAOIs. Only 4 of 98 beer samples studied were found to have a dangerous (> 10 mg/liter) tyramine concentration, one of which was the index beer. The tyramine concentration in these four beers ranged from 26.34 to 112.91 mg/liter. All four of these beers were tap beers produced by bottom fermentation (lagers) and brewed by a secondary fermentation process. Although we did not find any visible bacterial growth in the tap beers with high tyramine content, this finding does not preclude the possibility that bacterial contamination, bacterial growth, production of tyramine, and eventually bacterial death occurred at some earlier time. Therefore, to err on the side of caution, it is recommended that patients on irreversible MAOIs avoid beers on tap.
Pete
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.