Posted by RN320 on January 12, 2007, at 13:38:16
In reply to Are MAOIs worth it?, posted by UgottaHaveHope on January 2, 2007, at 18:10:34
Hi Michael-
I'm on EMSAM (12mg), and consider myself to be a success story. I have been able to overcome the problems with orthostatic hypotension. the dietary restrictions are really important with the MAOIs. It's supposed to be more relaxed than with the oral forms, but I'm really careful wbout what I eat. You asked about what people do if they have a hypertensive crisis...... I just had one a week ago (my first and hopefully last) when I ate some really wonderful Thai food that the cook and manager promised me had no soy or MSG, or fermented products. Anyway, about 15-20 minutes after I finished eating, I had a severe reaction come on like a hammer with a blinding headache. I was in my car on the way home, and had to pull over because I couldn't see well enough to drive and my heart was racing and the arteries in my neck were sticking out and pulsating, so I knew what was happening. I didn't really know what to do. My pdoc had said that because I'm "overly careful" about my diet that I shouldn't worry about it happening. If he told me something beyond that, i didn't remember. Anyway, I had baby aspirin in my purse, so I immediately chewed 4 or 5 of them (everyone should really carry them if you're middle aged and at risk for a stroke and/or heart attack- it can really save your life). Then the only thing that I could think of was to take some nitroglycerin under my tongue, since it brings your pressure down fast. (I have these by prescription for heart disease.) I took 3 of these a few minutes apart and I could feel my BP coming down and headache dimishing to the point where I could drive. When I got home, I immediately took my BP and it was 176/98 (I normally run 100/60) so only God knows how high it as when I was in my car. It continued to decrease as i took it every half hour for about 4 hours. My pdoc was really stunned, and is in the process of writing a "medical letter" to BMS and the FDA about it, since clearly I could have died. He said that I did exactly the right thing. I had heard that many pdocs used to give a script for "emergency" labetalol, which is a pretty powerful antihypertensive and works quickly. But you're really not supposed to give this with an MAOI, so some now use procardia (gelcaps) and they have people bit them, squirt the contents under their tongue and then swallow it. It is a very effective way to quickly reduce someone's BP.I really don't mean to scare you by telling you this. I guess what I'm trying to say is that I've been able to work around or manage everything that has come up. Sure, I miss using Afrin when I have a cold, and I really really miss cheese- but I am so much better on the EMSAM that I'll do just about anything to stay on it. It would seem to reason that if you're on a drug that finally works for you after so many other failures, you will need to be vigilant about managing restrictions and potential side effects and adverse reactions. To me, there's just something about having a quality of life again!
Best wishes to you.
/m
poster:RN320
thread:718619
URL: http://www.dr-bob.org/babble/20070107/msgs/721686.html