Psycho-Babble Medication Thread 75408

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Re: MAO followup - Another Question

Posted by Bobbiedobbs on September 18, 2002, at 22:50:40

In reply to Re: MAO followup - Another Question, posted by jsarirose on September 18, 2002, at 14:00:48


> it says that smoked fish is okay. Does anyone know if that means smoked salmon, trout, chubb, etc. are okay? I mean, I guess so. I'm also guessing lox is still out as it's smoked/cured a slightly different way. Maybe the difference is if it's fresh smoked vs. smoked & cured.


Regarding 3 issues raised within the past day:
1) smoked fish - My only experience is salmon jerky (in Michigan), without any ill effect.
2) Regarding alcohol, I've consumed enough white wine to actually have passed out on several occasions 5-10 years ago without any seeming effect; I was taking 30-60 mg of Nardil at the time. This is not by way of boasting. I find that these days I am much more alcohol-sensitive (it affects me more), whether that is because of the Parnate or aging I'm not sure.
3) Re MAO dose. I generally find some freedom from social inhibition/anxiety at the mid-range MAO levels. I was often euphoric at 60 mg of Nardil. That period was probaby the best time of my life professionally, socially and romantically. But I eventually grew overly sensitive to the side effects and switched to Parnate. I don't real feel "great" at any level (my doctor will only let me go up to 40 mg) but I do get some relief from anxiety and depression. My drug-prescriber (who is not my therapist) basically is disdainful of MAOs - particularly Nardil - and won't prescribe more than 50 mg. Parnate. Jessica, sounds like you prospered at the higher level but the $ and other stuff got in the way. It's such a luxury not to have to avoid people all of the time and feel so stymied in "social" (i.e. people situation). When I was taking Nardil I actually was engaging and looked forward to some social situations. Phil.

Has anyone been eating smoked fish while on Parnate or Nardil? What kind?
>
> Thanks,
> Jessica

 

Re: MAO cheese, soy, etc followup

Posted by cybercafe on September 18, 2002, at 23:57:12

In reply to Re: MAO cheese, soy, etc followup, posted by jsarirose on September 18, 2002, at 13:46:16

thanks for the descripted post jess, much appreciated

btw i think i have an email of yours i forgot to reply to, sorry, at first i put it aside so as to not annoy you, then i increased my dose of gabapentin, and became somewhat sane/social/optimistic ... i think i've actually got myself an awesome part time job ...

i don't know what to think about fulltime work .... i mean i could get a degree in pharmacy and work 20 hours a week and earn a good $2400 a month .... if things were really bad i could work in an all night pharmacy and relax... but theoretically when i become well i might actually want to work 8 hours a day, god, i can't imagine what that would feel like so it is so hard to plan... i hope i don't become too sane :)

 

Re: MAO cheese, soy, etc followup

Posted by jsarirose on September 19, 2002, at 0:38:53

In reply to Re: MAO cheese, soy, etc followup, posted by cybercafe on September 18, 2002, at 23:57:12

> i don't know what to think about fulltime work .... i mean i could get a degree in pharmacy and work 20 hours a week and earn a good $2400 a month .... if things were really bad i could work in an all night pharmacy and relax... but theoretically when i become well i might actually want to work 8 hours a day, god, i can't imagine what that would feel like so it is so hard to plan... i hope i don't become too sane :)
>
>

Sounds like the med is actually working for you! Optimism is the first positive effect I think. Even contemplating normalcy is a great step in the right direction. Just go slow, and take one step at a time!

-Jessica

 

Re: Smoked fish, and my update

Posted by ayrity on September 19, 2002, at 23:50:18

In reply to Re: MAO followup - Another Question, posted by jsarirose on September 18, 2002, at 14:00:48

Hi:
I accidentally ate smoked salmon when I first started on Parnate (I was on 30 mg at the time). A few hours later, like a lightbulb switching on, I thought "Oh, sh**, I wasn't supposed to eat that!" Nothing happened, but I wouldn't try it again.

I'm still quite scared to try any cheese and don't plan to do so in the near future, especially since I've already had a lot of BP problems.

Interestingly, the spontaneous hypertension I was having after a dose (unrelated to food) seems to be getting better. We've gone up on my dose very gradually- I've just started 70 mg this week. Sleep is a nightmare (pun intended)- Trazadone helps a bit, but leaves me feeling washed out the next day. Sonata did nothing for my sleep. I have a bit of dizziness sometimes when I stand too quickly, but not troublesome and otherwise very few side effects so far. I haven't noticed much benefit yet, though. If anything, I feel more withdrawn and antisocial, though more content and less depressed about being alone, if that makes sense.

> Has anyone been eating smoked fish while on Parnate or Nardil? What kind?
>
> Thanks,
> Jessica

 

Re: Smoked fish, and my update

Posted by jsarirose on September 20, 2002, at 0:10:10

In reply to Re: Smoked fish, and my update, posted by ayrity on September 19, 2002, at 23:50:18

> Interestingly, the spontaneous hypertension I was having after a dose (unrelated to food) seems to be getting better. We've gone up on my dose very gradually- I've just started 70 mg this week. Sleep is a nightmare (pun intended)- Trazadone helps a bit, but leaves me feeling washed out the next day. Sonata did nothing for my sleep. I have a bit of dizziness sometimes when I stand too quickly, but not troublesome and otherwise very few side effects so far. I haven't noticed much benefit yet, though. If anything, I feel more withdrawn and antisocial, though more content and less depressed about being alone, if that makes sense.
>

Wow - 70mg and no effect? I wonder if this is going to be the drug for you. I felt soemthing by 60mg or so, and the benefit increased as I increased the dose. I hope you start feeling a bit better soon.

Don't be too afraid of cheese. Some of the cheeses have basically no tyramine. I wouldn't worry about cream cheese, ricotta cheese, fresh mozzarella, chevre, montrachet, etc. You may be a little more wary with feta, brie, gruyere, muenster, etc.

Some people like Klonopin for sleep. I prefer the Trazodone personally, but I've tried Klonopin too. You may want to try it. I don't recommend Sonata or Ambien because they're real sleep medications that will build up in your system causing an addiction or need for increased dose. Klonopin can be addicting, but as a sleep aid I've never heard of it being so. (I guess some people take it as a street drug - always seemed strange to me.)

Anyway, good luck with the increases. If you feel too dizzy, try splitting the dose into three or so times per day.

-Jessica

 

Re: Smoked fish, and my update

Posted by ayrity on September 21, 2002, at 0:34:13

In reply to Re: Smoked fish, and my update, posted by jsarirose on September 20, 2002, at 0:10:10

Thanks for the reply and the advice, Jessica.

I guess there has been some beneficial effect. I feel a bit more talkative when I encounter people; I just don't feel like searching people out and I still feel very isolated. I likely have a bit of social anxiety, but my major problem is atypical depression, which has not responded to anything so far. I've failed a lot of meds, so there's not much left, so this better be the one to do it. I have an experienced pdoc who really knows his stuff and is a good guy, too; from the very beginning he hasn't pushed the meds on me, but we decide together what seems right. He has no problem pushing up the dose of Parnate further as long as the side effects and my BP are acceptible.

The dizziness has not been much of a problem so far, just a bit now and then when standing too quickly. I do divide the dose, btw (30 mg in the am, 20 at noon, 20 in the afternoon). Sleep is a major problem. I don't wan't something that might be addicting, so I don't know about Klonopin. I don't like the idea of putting even more drugs in my system (I have other medical issues as well that I won't get into), so sleep aids really turn me off, but I don't have much choice at the moment.

As far as cheese, well, I'll keep away for now. I'll give it a go in the future, if things work out with the Parnate.

Thanks again!


> Wow - 70mg and no effect? I wonder if this is going to be the drug for you. I felt soemthing by 60mg or so, and the benefit increased as I increased the dose. I hope you start feeling a bit better soon.
>
> Don't be too afraid of cheese. Some of the cheeses have basically no tyramine. I wouldn't worry about cream cheese, ricotta cheese, fresh mozzarella, chevre, montrachet, etc. You may be a little more wary with feta, brie, gruyere, muenster, etc.
>
> Some people like Klonopin for sleep. I prefer the Trazodone personally, but I've tried Klonopin too. You may want to try it. I don't recommend Sonata or Ambien because they're real sleep medications that will build up in your system causing an addiction or need for increased dose. Klonopin can be addicting, but as a sleep aid I've never heard of it being so. (I guess some people take it as a street drug - always seemed strange to me.)
>
> Anyway, good luck with the increases. If you feel too dizzy, try splitting the dose into three or so times per day.
>
> -Jessica

 

Re: my update Hypertensive Reaction!

Posted by jsarirose on September 21, 2002, at 19:19:09

In reply to Re: Smoked fish, and my update, posted by ayrity on September 21, 2002, at 0:34:13

> I guess there has been some beneficial effect. I feel a bit more talkative when I encounter people; I just don't feel like searching people out and I still feel very isolated. I likely have a bit of social anxiety, but my major problem is atypical depression, which has not responded to anything so far. I've failed a lot of meds, so there's not much left, so this better be the one to do it. I have an experienced pdoc who really knows his stuff and is a good guy, too; from the very beginning he hasn't pushed the meds on me, but we decide together what seems right. He has no problem pushing up the dose of Parnate further as long as the side effects and my BP are acceptible.


Having a good doc is more than half the battle! I'm glad you're getting some positive effect as well. I know the desire not to excessively medicat, but if you do reach your limit and find you get some relief but not enough you can also look into augmenting the Parnate with another drug to boost the effect. I have Treatment Resistent Depression too so I can understand the extreme frustration with medications. They are continually a mixed blessing (and usually not a blessing at all).

Regarding the diet - all I can say is even after being on Parnate for almost a year I still make mistakes. I haven't had a reaction in over 8 months and I guess I got lax. I had a tap beer last night and had my first hyptensive crisis in ages. I took the Thorazine (my emergency pill) right away. It helped, but I still had nausea, a migraine, sweating and red, blotchy skin. I think since I took the pill so quickly it wasn't as bad as it could have been. While my head did hurt I've had much worse migraines previously. My friend drove me home (this is the first time I had a reaction when I wasn't already home), and I took 1/2 an oxycodone for the pain. Then I slept for about 15 hours. Today I just feel a bit dizzy when I stand or walk and have a slight headache when I move around. I'm also a bit tired. Most of the dizziness and tiredness is left over from the Thorazine.

So the lessons I was reminded of are 1) always have that pill with me, and 2) don't be lax! Just because the beer was from a big microbrewery doesn't mean the cafe I was at has clean equipment. That's really the only thing I've occasionally been lax about, but obviously it's hit or miss (as the tyramine analyses state). Stick to bottled beer from larger breweries.

-Jessica

 

Re: my update Hypertensive Reaction!

Posted by ayrity on September 22, 2002, at 2:05:39

In reply to Re: my update Hypertensive Reaction!, posted by jsarirose on September 21, 2002, at 19:19:09

Hi again, Jessica-
Sorry you had a bad reaction. Despite my numerous (sometimes quite high) spikes in BP, only one of them (the first time, actually) was a real "crisis" with pounding headache, etc. Quite scary, so I know how you felt. I carry around nifedipine (this is controversial and some recommend against its use; it's probably safe if you're young and no history of heart disease)- took one and it brought my BP right down and the symptoms were gone.

Given the problems I've had, I'd strongly recommend that anyone on an MAOI get a blood pressure machine for home. There are alot of inaccurate junk machines out there, so you have to look for a good one (check with you primary MD)and double check it with a manual cuff BP in your doc's office. Well worth the investment and piece of mind.

Yeah, as you say, treatment resistant depression sucks. Nothing seems to work for me, and the only thing I seem to get out of meds is side effects. My doc has mentioned augmentation (I already did that on SSRIs with no help), but we first want to make sure my BP is stable and that I'm safe on the Parnate- jury's still out on that. I'm one of those rare ones (figures) that get spontaneous high spikes in BP right after taking the medication, unrelated to diet. Seems to be improving it still occurs at times.

As you also said, finding a good doc is half the battle. He's a good guy and know's his stuff. More like seeing a friend than a therapist (transference, maybe? :-) ) Still, I'm paying a fortune, even with insurance covering about 50%. We have almost weekly sessions- does that sound excessive? Probably not necessary, but I (mostly) enjoy them, and I don't have anyone else to talk to anyway except my ex-wife, who's great but I can't confide everything (or much at all) in her anymore.

Sorry for the rambling! :-)
Thanks again for your support.


> Having a good doc is more than half the battle! I'm glad you're getting some positive effect as well. I know the desire not to excessively medicat, but if you do reach your limit and find you get some relief but not enough you can also look into augmenting the Parnate with another drug to boost the effect. I have Treatment Resistent Depression too so I can understand the extreme frustration with medications. They are continually a mixed blessing (and usually not a blessing at all).
>
> Regarding the diet - all I can say is even after being on Parnate for almost a year I still make mistakes. I haven't had a reaction in over 8 months and I guess I got lax. I had a tap beer last night and had my first hyptensive crisis in ages. I took the Thorazine (my emergency pill) right away. It helped, but I still had nausea, a migraine, sweating and red, blotchy skin. I think since I took the pill so quickly it wasn't as bad as it could have been. While my head did hurt I've had much worse migraines previously. My friend drove me home (this is the first time I had a reaction when I wasn't already home), and I took 1/2 an oxycodone for the pain. Then I slept for about 15 hours. Today I just feel a bit dizzy when I stand or walk and have a slight headache when I move around. I'm also a bit tired. Most of the dizziness and tiredness is left over from the Thorazine.
>
> So the lessons I was reminded of are 1) always have that pill with me, and 2) don't be lax! Just because the beer was from a big microbrewery doesn't mean the cafe I was at has clean equipment. That's really the only thing I've occasionally been lax about, but obviously it's hit or miss (as the tyramine analyses state). Stick to bottled beer from larger breweries.
>
> -Jessica

 

Re: my update Hypertensive Reaction!

Posted by jsarirose on September 22, 2002, at 2:15:54

In reply to Re: my update Hypertensive Reaction!, posted by ayrity on September 22, 2002, at 2:05:39

> Given the problems I've had, I'd strongly recommend that anyone on an MAOI get a blood pressure machine for home. There are alot of inaccurate junk machines out there, so you have to look for a good one (check with you primary MD)and double check it with a manual cuff BP in your doc's office. Well worth the investment and piece of mind.
>

I have a home machine, of course I didn't have it with me when I needed it! That's the first time I've experienced the sweating and redness though. I don't think my bp spiked with the other reactions I had. I'm feeling better now - just a little dizzy and slightly headachy.


> As you also said, finding a good doc is half the battle. He's a good guy and know's his stuff. More like seeing a friend than a therapist (transference, maybe? :-) ) Still, I'm paying a fortune, even with insurance covering about 50%. We have almost weekly sessions- does that sound excessive? Probably not necessary, but I (mostly) enjoy them, and I don't have anyone else to talk to anyway except my ex-wife, who's great but I can't confide everything (or much at all) in her anymore.
>

I see my psych for meds only (it's cheaper) and I'm currently looking for a therapist. My last therapist is moving out of state (the second one I've lost that way, maybe it's me?). I prefer to see a psychotherapist at this stage in the game, no cognitive/behavioralists. My psycho is cognitive oriented so I don't really want to see her for therapy but I like her for meds. How frequently I see her depends on if I'm ramping up a med, changing meds, etc. It's good if you like talking to your doc. I think a good therapist is even harder to find than a good med doc.

> Sorry for the rambling! :-)
> Thanks again for your support.
>
No problem! I often ramble! And the people here are great for support! Take care.

-Jessica

 

Re: my update Hypertensive Reaction!

Posted by cybercafe on September 22, 2002, at 8:50:31

In reply to Re: my update Hypertensive Reaction!, posted by jsarirose on September 21, 2002, at 19:19:09

>8 months and I guess I got lax. I had a tap beer last night and had my first hyptensive crisis in ages. I took the Thorazine (my

wow you really are brave :)

i hope you're doing okay now... i imagine it must be quite an inconvenience to go through something like that in public ...

i'm curious -- how many bottled beers have you tried without problem? i'm hoping to have a drink or two sometime myself ... up here we have bottled labatt, molson, mostly

>emergency pill) right away. It helped, but I still had nausea, a migraine, sweating and red, blotchy skin. I think since I took the pill so quickly it wasn't as bad as it could have been.

so it happens fast and is serious enough to make you have to immediately take action? or can you escape a social situation more calmly without fanfare? basically i'm wondering if i should try that first beer alone

 

Re: my update Hypertensive Reaction!

Posted by jsarirose on September 22, 2002, at 15:22:22

In reply to Re: my update Hypertensive Reaction!, posted by cybercafe on September 22, 2002, at 8:50:31

> >8 months and I guess I got lax. I had a tap beer last night and had my first hyptensive crisis in ages. I took the Thorazine (my
>
> wow you really are brave :)

Not brave, stupid actually. Just because it was okay once doesn't mean it's always okay if it's on the list. Bottled beers from big breweries are just fine. They are considered okay. The danger is molds from poor bottling or serving practices. So a microbrewery is more likely to have unpasteurized beer and a pub with taps possibly has mold in the hoses. If you stick to bottled beer, you should be just fine. Labatt's, Molsen, etc. are huge companies. I would drink their beer with no worries at all! My problem is I really like the small, microbrewery dark beer.

I've actually been drinking beer all along and never had a problem. For the most part I stuck to bottled beer, no taps and no homemade (I have a friend that gave me a bunch of homebrew that I gave away).

That's definitely the worst reaction I've ever had. It came on faster that previously. Before I was home already when it started (so I had about an hour after eating until I reacted). I didn't even get through the whole beer. It must have been chock full of molds and such causing really high tyramine levels. Yech.

I'm lucky to have such nice friends. It was a little awkward since they are co-workers and this is only the second time we've been out socially. But most people understand. And I usually explain it as an allergic reaction rather than a reaction to an antidepressant. Unless I'm close to the person, it's too complicated to explain.

Don't worry about drinking beer if you keep to the rules. And use this as a reminder to keep an "emergency" pill with you at all times. I keep one in my wallet and one in my car (and some at home). That way I should always have one with me.

-Jessica

 

Re: separating discussions

Posted by katie tkm on September 22, 2002, at 16:13:39

In reply to Re: separating discussions, posted by Dr. Bob on January 27, 2002, at 2:55:30

Dear Dr Bob,

Thank you for your site - the information here has made a big difference to me.

I'm aware you want to keep this thread to medications but I wanted to let you know I wouldn't have found the other discussion and reading the postings on CBT here gave me huge relief.

I suffer from severe recurrent depression and it was wonderful to read that other patients had felt the same anger and despair when CBT hadn't worked for them.

I felt acutely to blame when no matter how much homework I did it didn't help me to feel better. What was wrong with me that this "wonder therapy" wouldn't work? It was obviously my fault!

I felt even more suicidal and hopeless than before.

I think many mental health professionals' obsession with CBT and their assurances to clients that this theory of depression explains it all is frankly dangerous.

On a happier note, after trying 7 other drugs my psychiatrist finally decided to try the unpopular MAOI's. I am on Nardil, and though it is early days (and the exhausting side effects pretty hard to take) it already seems this drug is going to help me enormously.

Katie

 

bacon and eating out » Bobbiedobbs

Posted by katie tkm on September 22, 2002, at 16:28:52

In reply to Re: MAO cheese, soy, etc followup, posted by Bobbiedobbs on September 8, 2002, at 18:41:25

aha! finally i've found some brand info on which soy sauce are ok - thanks bobbiedobbs. do you know where i can get any more information on specific brands etc? i've found the shulman write-ups but not a complete report on brands tested.

also, i'm really surprised no diets mention bacon. it's smoked, but so is the sometimes safe sliced ham. can you eat it safely?

does anyone else have the same problems finding foods to eat out that i do and how do you get around it? i love asian food (vietnamese, chinese etc) and this seems like a definite no-no. i also find the idea of never having any sauces, gravies or soups hard to take.

i read in the shulman report that chicken and beef boullion seem to be ok. this is in direct opposition to other diets. does this mean i can actually use stock cubes. anybody else's expereience and knowledge would be great to know.

thanks,
katie

 

Re: bacon and eating out

Posted by jsarirose on September 22, 2002, at 16:46:30

In reply to bacon and eating out » Bobbiedobbs, posted by katie tkm on September 22, 2002, at 16:28:52

> aha! finally i've found some brand info on which soy sauce are ok - thanks bobbiedobbs. do you know where i can get any more information on specific brands etc? i've found the shulman write-ups but not a complete report on brands tested.
>
> also, i'm really surprised no diets mention bacon. it's smoked, but so is the sometimes safe sliced ham. can you eat it safely?
>
> does anyone else have the same problems finding foods to eat out that i do and how do you get around it? i love asian food (vietnamese, chinese etc) and this seems like a definite no-no. i also find the idea of never having any sauces, gravies or soups hard to take.
>
> i read in the shulman report that chicken and beef boullion seem to be ok. this is in direct opposition to other diets. does this mean i can actually use stock cubes. anybody else's expereience and knowledge would be great to know.
>
> thanks,
> katie
>
>

Bacon is a little tricky because most, regular bacon is just fine. It's the aged bacon that can cause a problem. So something like proscuitto, pancetta, aged/smoked bacon, etc. would not be allowed. I've eaten regular, cheap bacon with no problems.

Boullion is not inherently taboo. It's the autolyzed yeast that many cheaper brands have that's the problem. I eat out fairly often. And I don't worry about gravies and sauces as long as I know the basic ingredients. The amount of autolyzed yeast in boullion and then used in sauces is so tiny it shouldn't make a difference. I'm more wary with foreign restaurants, especially Asian. Unless I know the ingredients or the server knows english well enough for me to have a good discussion about ingredients, I stay away from it. I do eat sauces with soy sauce in it, but I don't add any extra. That may be living a little dangerously as soy sauce types vary. But I've never had a problem with soy sauce, and my understanding is that it's okay in limited amounts (at least according to the diets I've seen).

When you see contradicting information, always look at the date of the study. They are continually updating the lists and allowing more foods. Anything prior to 1996 is especially suspect as they did a major overhaul after that.

Have you seen the very latest list with actual tyramine amounts? Check out:

http://www.vh.org/Providers/Conferences/CPS/19.html

-Jessica

 

Re: bacon and eating out » jsarirose

Posted by katie tkm on September 22, 2002, at 17:01:21

In reply to Re: bacon and eating out, posted by jsarirose on September 22, 2002, at 16:46:30

thanks so much for info
best wishes
katie

 

Re: bacon and eating out

Posted by cybercafe on September 22, 2002, at 17:45:19

In reply to bacon and eating out » Bobbiedobbs, posted by katie tkm on September 22, 2002, at 16:28:52


i think the schulman report mentions a report by wing and chey or something with more specific information on chinese food -- i would love to get my hands on that article

> aha! finally i've found some brand info on which soy sauce are ok - thanks bobbiedobbs. do you know where i can get any more information on specific brands etc? i've found the shulman write-ups but not a complete report on brands tested.
>
> also, i'm really surprised no diets mention bacon. it's smoked, but so is the sometimes safe sliced ham. can you eat it safely?
>
> does anyone else have the same problems finding foods to eat out that i do and how do you get around it? i love asian food (vietnamese, chinese etc) and this seems like a definite no-no. i also find the idea of never having any sauces, gravies or soups hard to take.
>
> i read in the shulman report that chicken and beef boullion seem to be ok. this is in direct opposition to other diets. does this mean i can actually use stock cubes. anybody else's expereience and knowledge would be great to know.
>
> thanks,
> katie
>
>

 

soy cheese » cybercafe

Posted by katie tkm on September 22, 2002, at 17:50:28

In reply to Re: bacon and eating out, posted by cybercafe on September 22, 2002, at 17:45:19

hi
thanks for these messages.
more questions for the maoi munching masses - does anyone know about soy cheese?
katie
p.s. i'm in oz

 

Re: soy cheese

Posted by jsarirose on September 22, 2002, at 21:28:23

In reply to soy cheese » cybercafe, posted by katie tkm on September 22, 2002, at 17:50:28

> hi
> thanks for these messages.
> more questions for the maoi munching masses - does anyone know about soy cheese?
> katie
> p.s. i'm in oz

I looked into that before because I was going to try it. As long as it's not aged (and it tends not to be) it should be okay. It's made from soy, which is fine. The things that may make a specific brand bad would be if they used aged soy or I would wary if it was smoked (although it should be okay anyway). You should also read the ingredients just in case they've added some strange no-no like autolyzed yeast (not that they would, but just in case).

Other than that - regular soy cheese is no problem. Just like soy milk is fine too.

-Jessica

 

Re: soy cheese

Posted by Bobbiedobbs on September 23, 2002, at 0:02:17

In reply to Re: soy cheese, posted by jsarirose on September 22, 2002, at 21:28:23

Katie: I don't know if the report you saw is the one that discusses soy. There were five soy sauces tested _ Wing's, Kimlan, Ozeki Sashemi, Pearl River and Kikomannan. The only one that had a high level of tyramine was Pearl River. However, I would hardly regard these tests as conclusive. Shulman, based on these tests, recommends avoiding all soy sauces and soybean products. However, when I called SmithGlaxo (which makes Parnate) they told me soy products are OK as long as they are not fermented. They said "yes" to Tahini and sesame paste and no to tofu, tempeh and tamari sauce. That may be a bit cautious (they ARE the manufacturer). The key is to avoid any fermented product and be judicious with soy sauce. I have had lots of soy sauce over the years - mostly the watered down, Americanized versions like La Choy - without any problems.
I don't know of any problem with bacon or ham in conventional form.
You need to be vigilant when eating in Asian restaurants. A big no no is miso soup. I've eaten in Malaysian, Thai and Chinese without problems but again one needs to be careful about special ingredients.
Anyway, good luck to you. I think Nardil can be a great drug. I took it for years and it really helped me alot.
Where is your Oz?
Phil

 

Re: soy cheese

Posted by jsarirose on September 23, 2002, at 0:23:41

In reply to Re: soy cheese, posted by Bobbiedobbs on September 23, 2002, at 0:02:17

I wholeheartedly agree with Phil. The only thing I would add is that tofu (not aged, not tempeh) is just fine too. I can't imagine why GSK would say it's not if they said soy is fine. It's simply soy in another form. I've eaten a lot of it over the months - no problems at all!

-Jessica

 

Re: soy cheese » Bobbiedobbs

Posted by katie tkm on September 23, 2002, at 6:12:56

In reply to Re: soy cheese, posted by Bobbiedobbs on September 23, 2002, at 0:02:17

hey phil

thanks for your posts - i've found them really helpful. the specific info on brands is perfect - do you know where i can get this full report? i don't mind sending away for it or going to a university library for back issues of the journal. all the shulman and gardner reports i've been able to find on the net haven't listed the kind of detail you mention.

my particular oz is australia. i could be wrong but i figured most of the other users were american or candadian. this doesn't make a huge difference with brands because we have a lot of the same products. i just thought i'd mention it in case it had some relevence.

reading some of the other posts i must admit i feel lucky to be in a country where all medications (even the new ones) are covered by the public system. all prescriptions for low income earners are $3.20. how awful to know there could be something which can you help you but you can't afford to take it.

nardil does seem to be helping me at the moment and i'm cautiously excited about it. i'll just have to wait and see if i continue to improve and whether the exhausting side effects fade with time.

goodluck and best wishes
katie

Katie: I don't know if the report you saw is the one that discusses soy. There were five soy sauces tested _ Wing's, Kimlan, Ozeki Sashemi, Pearl River and Kikomannan. The only one that had a high level of tyramine was Pearl River. However, I would hardly regard these tests as conclusive. Shulman, based on these tests, recommends avoiding all soy sauces and soybean products. However, when I called SmithGlaxo (which makes Parnate) they told me soy products are OK as long as they are not fermented. They said "yes" to Tahini and sesame paste and no to tofu, tempeh and tamari sauce. That may be a bit cautious (they ARE the manufacturer). The key is to avoid any fermented product and be judicious with soy sauce. I have had lots of soy sauce over the years - mostly the watered down, Americanized versions like La Choy - without any problems.
> I don't know of any problem with bacon or ham in conventional form.
> You need to be vigilant when eating in Asian restaurants. A big no no is miso soup. I've eaten in Malaysian, Thai and Chinese without problems but again one needs to be careful about special ingredients.
> Anyway, good luck to you. I think Nardil can be a great drug. I took it for years and it really helped me alot.
> Where is your Oz?
> Phil

 

Re: soy cheese

Posted by Bobbiedobbs on September 24, 2002, at 20:11:46

In reply to Re: soy cheese » Bobbiedobbs, posted by katie tkm on September 23, 2002, at 6:12:56

Katie: Dr. Shulman is very good about sending free copies of the reports, at least based on my experience. I sent him international postage to the USA in a return envelope, and he not only sent me the study but returned unused the postage.
The address is:
Kenneth I. Shulman MD, Dept. of Psychiatry, 2075 Bayview Ave., Toronto, Ontario, Canada M4N 3M5. Email is [email protected]
The specific report with the soy tests is "Refining the MAOI Diet, Tyramine Content of Pizzas and Soy Products." It appeared in the Journal of Clinical Psychiatry in March of 1999 (Vol 60, p. 191-193).
The other article, which summarizes his colleagues' research on MAOIs to date, is "A Reevaluation of Dietary Restrictions for Irreversible MAOIs,", in a publication called Psychiatric Annals, June, 2001. I don't know whether this publication would be available in a library, even an academic one. That report gives tyramine content of various wines among other things. He believes (and I agree) that these medications will actually be a lot safer if people are given (and follow) scientifically-sound dietary restrictions rather than a whole panoply of dated, unduly restrictive prohibitions based an anecdotal evidence.
I should have realized that OZ was Australia. I thought you were being metaphorical. Well compared to our medical system Australia is OZ. I just paid a $50 copay for a month's supply of Parnate and that is WITH a decent health insurance policy. Unfortunately, there is no generic equivalent.
Hopefully the benefits of the Nardil will over a reasonable time outweigh the side effects for you. I'm taking Parnate and it definitely takes a bite out of me above a certain (30 mg) threshhold. Parnate and Nardil appear to act differently even though they are related. When I first began with Nardil it actually made me hypermanic. Anyway, hope that helps. Best wishes, Phil.

 

acne!

Posted by cybercafe on September 24, 2002, at 21:38:51

In reply to Re: soy cheese, posted by jsarirose on September 23, 2002, at 0:23:41


hey jess i am getting really bad acne (strangely small, little bumps, but many, many of them on my forehead) .... have you had any success? ... is it diet, exercise, anti-acne medication, what works best?

 

Re: acne!

Posted by jsarirose on September 25, 2002, at 1:13:44

In reply to acne!, posted by cybercafe on September 24, 2002, at 21:38:51

>
> hey jess i am getting really bad acne (strangely small, little bumps, but many, many of them on my forehead) .... have you had any success? ... is it diet, exercise, anti-acne medication, what works best?
>

While I'm not happy that you are sharing this symptom with me, I am glad to get a little companionship. I don't think it's a very common side effect for everyone. It was hard to verify that the Parnate was causing it - but since it became horrible as I went up to 100mg and has since improved as I went back down to 40mg - I'm completely convinced it's the Parnate.

So - what to do. I see a dermatologist. All we do is treat it as a bad case of acne. I really don't know of any information specific to Parnate acne that suggests alternative treatment. I take Erythromycin (and there are other stronger antibiotics to combat it, but this one doesn't make me nauseas), and I use 10% Bactril (sp?) topical in the shower. And I do all the other regular things to treat acne. I also went back on the pill which helped quite a bit for me, however I don't recommend you try it! It does make me wonder if Parnate effects hormones at all (I've never heard that it does). However I have fairly messed up hormones anyway, so the pill takes care of several issues for me. Unfortunately that is all we've come up with so far.

I'm more than happy to trade info if you learn of anything though! I really didn't find much about it on the internet.

-Jessica

 

side effects of MAOI's » Bobbiedobbs

Posted by katie tkm on October 2, 2002, at 10:41:57

In reply to Re: soy cheese, posted by Bobbiedobbs on September 24, 2002, at 20:11:46

What would I do without you guys? The shared info and support have been invaluable. It's wonderful to know there are people out there dealing with the same meds and issues. Thanks very much to Jessica and Phil for your time and generosity. The best of luck to both of you.

Would you guys (and anyone else) mind telling me about your side effects on different MAOI's? I know it's a bit personal so I don't mind if you don't want to.

All other classes of antidepressants have been unsuccessful in treating my severe recurrent depression. Nardil seems to be very good for me but I am having some trouble with side effects. I'm going to see if they fade with time (I've been on it for a month, 45mg, and already some side effects have faded). If they don't fade I may change to selegiline or parnate. We have moclobemide in Australia but apparently it's effects are fairly weak.

Like you Jess, my pschiatrist knows much less about MAOI's than I do because they are not often prescribed anymore. Thank goodness the drugs even exist! I find him very good in general but he doesn't have much experience of different side effects, diet etc.

The major problems I'm having are with fatigue (I have to nap a lot and limit my activity), insomnia (difficulty dropping off and waking up during the night) and anorgasmia (can't come - not very important at the moment but I'm sure/hope sex will be in the future!).

x katie


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