Posted by blueboy on July 28, 2008, at 10:58:00
In reply to Thinking of trying nardil but scared, posted by socialphobic on July 27, 2008, at 7:28:03
> Hi everyone,
>
> I suffer depression with social phobia. I have pretty much tried all the antidepressants available with no success. I've tried all the SSRI's, a handful of TCA's and a few combos with antipsychotics.
>Sounds like me, LOL. I'm still trying, I hope you won't give up hope. I was rediagnosed bipolar a couple of months ago, so I have a whole new series of drugs to try.
> A few years ago I managed to find a GP that gave me nardil. I took one dose then was freaking out for the rest of the day every time I ate something. After that I didn't take any more because the anxiety of getting a hypertensive crisis was too much.
>Yeah, my sympathy. Having anxiety problems sucks, although mine aren't apparently as bad as yours.
> I have done a lot of research into nardil, including these forums. It seems that pretty much everyone who's tried it has raved on about how great it is. I have read many of ace's posts on here and it sounds like a miracle drug for depression and social phobia.
>Let me put Nardil into perspective. I took it for almost two years, 60/mg day.
The side effects were awful for me. However, it was the only drug I ever took that would lift my depression, so I put up with them.
It did not help my social anxiety very much. I have found that 1mg clonazepam (klonopin), taken half an hour before I leave the house, is a huge help for this. It sounds like your problem is more severe than mine, but that's the best I can tell you.
> However, I am very concerned about the dietry restrictions. I've read posts where people say they've accidentally ate something wrong which resulted in a bad migrane and a trip to hospital.
>There's no need to worry, as long as you are vigilant. Most times if you get some tyramine in your food, you will not have a dangerous reaction. A lot of sites say that the standard restrictions are too severe and are unneccesary. You can definitely ingest some tyramine with no ill effect.
The restrictions are a pain in the neck but are pretty easy to avoid. Since you can tolerate a certain amount, if you try to avoid them completely, accidental ingestion of a moderate amount shouldn't hurt you.
Personally, I just didn't eat cheese, period. I also wouldn't eat avocado or especially guacamole, for example, but I would eat a firm banana where I could see that there were no brown spots. Especially if you are anxious, I would just get a hamburger without cheese at McDonalds, although as your say, American cheese is probably safe.
A home blood pressure monitor is fairly inexpensive and enormously comforting if you tend towards anxiety. If you get a bad headache and start to freak out, just take a reading. If it is tyramine related, your blood pressure will be extremely high. My systolic pressure is in the 120-130 range normally, and I think my pdoc told me to get worried at 160 and seek emergency attention at 180, which is below the point that I'd fear a stroke or something.
> It's not just the food interactions i'm worried about either. What if you were in a bad accident and required immediate surgery? From what i've heard you can't have anesthetic while on an MAOI? Is this true? If so, wouldn't you be screwed?
>My biggest fear, like yours, was getting knocked out in a car accident or having anesthesia from an idiot. Very serious results are extremely uncommon -- the only death I have heard about came from large injections of demerol, but I haven't done research. I would be VERY careful with cold medication (I just stopped taking anything for colds expect Advil).
However, there are plenty of anesthetics at all levels that do not interact with Nardil. Or, if the anesthetist is not comfortable (usually in a long surgery or for an unusual patient), you can stop taking Nardil a couple of weeks before the procedure.
I got a medic alert necklace and refused to have anesthesia without an anesthesiologist, and I insisted on meeting him and telling him, face to face, that I was taking phenelzine. (Okay, I did have a colonoscopy using a nurse-anesthetist but both he and the doctor seemed to be on top of the situation.)
> If I did work up the courage to try nardil again, is it possible to get a hypertensive "antidote" to lower your blood pressure? Is this advisable?
There are people on this board who say that this was their approach. Personally, if I had ever had a major hypertensive crisis, I would have gone straight to the emergency room.
On the other hand, having some drug in your kit might be a good idea if you're traveling to an area without good hospitals.
poster:blueboy
thread:842271
URL: http://www.dr-bob.org/babble/20080727/msgs/842559.html