![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 45 to 69 of 85. Go back in thread:
Posted by Jost on May 8, 2006, at 21:35:58
In reply to Re: MAOIs » Jost, posted by Don_Bristol on May 8, 2006, at 19:42:34
>
>
>
>
> Hi Jost. PMFJI. From what you write I sense you have not taken any MAOIs. I am not sure of the mortality rate of ECT but my impression is that it is far less than that of people who have died or been left with heart/brian damage after a serious adverse reaction to food + MAOI.
>
> From the figures in the 2002 AAPCC TESS ANNUAL REPORT in "American Journal of Emergency Medicine" (vol 21, number 5, Sept 2003) there were 81 moderately serious outcomes of MAOI + food and 28 major or death. One third were intentional with the remainder being unintentional. The figures for 2001 are slightly higher.
>
> The statement you make about "very little discipline about what they eat" is rather astonishing. You then refer to a list which strangely includes "certain wines" perhaps because of the old canard about chianti. You might want to dig out some old statements by someone who I recall who found themselves in ER after eating a single slice of pepperoni on a pizza. That person may have been unusually sensitive to that combo of MAOI + pepperoni but I doubt they were necessarily weak willed or "ill disciplined" about their diet as you seem to suggest.
I'm not sure what PMFJI means. Could you clarify.I certainly wouldn't have written what I wrote if I hadn't used Maois, though.
I was on parnate for three years, at a very high dose, without any adverse reaction.
Let me clarify. My implication wasn't that anyone was "weak=willed" at all. Discipline isn't a matter of will-- in my book. It's a lot of things situational, habitual, temperamental-
I would think most people eat this or that without thinking whether it has fermented soy or cheese in it or if it's been sitting out too long-- I'm pretty careful, and I found myself occasionally almost eating things without thinking.
That's all I meant-- you do have to be a bit on guard about stuff, which isn't natural, and is a habit you have to work a little to get on track. But I also think it's a habit, and not so hard to develop for most.
I can see that "have little discipline" could have carried a meaning I didn't intend-- it wasn't put precisely. I meant that most people are more than able to be that careful and thoughtful. I meant that it is a bit unnatural to interrogate every piece of food you put into your mouth during the course of a day.
I don't criticize people who are less able take that approach to food.-- I had an eating binge phase--
There may be some deaths on maois and I'm all for finding ones that are safer-- no argument there. However, I also think that the brain effects of ECT are soft-pedalled, and wouldn't do that myself, under any circumstances. But it is an individual decision, absolutely.
My Psych D was very convinced that deaths from Maois were overstated. He used them a lot for a long time and only had one death--a suicide, which occurred on a plane, where there wasn't any medical help nearby. But he's the expert, not me.
Again, he focussed on certain types of red wine. I didn't ask what types, as I don't drink red wine.
Hope I've responded to all your point.
Jost
Posted by Jost on May 8, 2006, at 21:43:38
In reply to Re: MAOIs, posted by Jost on May 8, 2006, at 21:35:58
Also, I'm not in total agreement about trying every other last AD.
I did try a lot of them, and certainly think it' makes sense to start with an SSRI and maybe cymbalta, rather than go to parnate or nardil first. But I also don't think maois are such drugs of last resort, that you only try if every other option has been exhausted and then some.
Jost
Posted by yxibow on May 9, 2006, at 1:09:44
In reply to Re: MAOIs » Caedmon, posted by Don_Bristol on May 7, 2006, at 6:34:43
> >> Dying from an MAOI-related hypertensive
> >> reaction is extremely rare.
>
> > http://www.acnp.org/G4/GN401000046/CH046.html
> > states thatDying is rare, you're right. However the chance of a stroke and unilateral or bilateral neurological damage is higher. Its worse than death. Its immobilization and life debilitating. But I'm not trying to scare those on MAOIs who have proper instructions from their doctors, and who do not eat the foods that would make themselves vulnerable. As one pointed out, eating out is a difficulty and a pleasure lost. But if it is necessary to come to an MAOI -- well, that's between you and your doctor
Tidings-- Jay
Posted by yxibow on May 9, 2006, at 1:10:04
In reply to Re: MAOIs » yxibow, posted by ed_uk on May 7, 2006, at 11:02:22
> Hi Yxi
>
> >Doesn't mean that I wouldn't want to "feel good" like you have to admit you have done on occasion
>
> I'm not 'admitting' anything. I don't like that you're talking to me as if I've been a 'naughty boy', sorry :(
>
> I don't want to talk about it anymore.
>
> EdAnd I don't either, but it seems to come up quite often, almost obsessively or with transference. You're not a naughty boy for wanting to feel euphoria. Its just a statement of fact, Eddy. Its why its not allowed here in the US any more due to diversion and the DEA -- I can't feel your euphoria.
Gosh I dont know how to put it any other way that I dont care about your minor use of the drug, its a major extended use that I think you could benefit from some drug, I dont know what, other than this.
I told you that you're hurting and I've offered in email to listen to what is going on. Your a good guy, there's no naughty boy coming from here. We've talked about this in private and I think you know what I am trying to say. If you don't, I'm sorry, and I wish I knew more why you are hurting.
There is plenty of ongoing research by the way of sigma and mu receptors by the way, as I have mentioned. Maybe something that doesn't form addiction but addresses those will come of it.You're right, companies spend billions on antipsychotics, but the reason is clear -- the schizophreniform disorder spectrum (and BP I as well) is the largest psychiatric problem by percentage and while the vast majority are catatonic (unfortunately), there are violent behaviours that lead to awful endings like air marshalls taking down people who turn out later to be mentally ill. It doesn't mean that major depression should be overlooked.
Sincerely and lied to rest as I already have,Yours Truly
-- Jay
Posted by Don_Bristol on May 9, 2006, at 14:48:31
In reply to Re: MAOIs, posted by Jost on May 8, 2006, at 21:35:58
> My Psych D was very convinced that deaths from
> Maois were overstated. He used them a lot for a
> long time and only had one death--a suicide,
> which occurred on a plane, where there wasn't any
> medical help nearby. But he's the expert, not
> me.Hiya. I am not sure that your psych doc would be a greater expert than the official stats on MAOI deaths. The figures I mentioned are taken directly (by me) from those stats.
I don't mean to say that I am suddenly a greater doc then yours (no chance) but that there are a non-trivial number of deaths and severe/moderate outcomes from adverse reactions with MAOIs.
I think some MAOI takers, such as yourself and myself too, are less sensitive than usual to the effects of tyramine. Yet other users are probably more sensitive. It's risk & chance ("hemorrhagic roulette"?) and the chance of the downside occuring can be a big worry for some people as it is one way and there is not going to be any bouncing back.
You mention less dangerous MAOIs and I too woul dlike to see them. Moclobemide seems to max out quickly (it did in me) and some say it has only a weak effect.
Take care there.
Don
Posted by ed_uk on May 9, 2006, at 15:22:01
In reply to Re: MAOIs » Jost, posted by Don_Bristol on May 8, 2006, at 19:42:34
Hi Don
>there is a good case for trying the less-lethal ADs first and then moving towards MAOIs if nothing else works
I have never heard of MAOIs being used until a variety of other ADs have been tried. Have you?
You seem concerned about MAOIs. I thought you took Parnate?
Regards
Ed
Posted by ed_uk on May 9, 2006, at 15:35:13
In reply to Re: MAOIs » ed_uk, posted by yxibow on May 9, 2006, at 1:10:04
Hi J
>it seems to come up quite often
Yes, I was feeling annoyed :(
>wanting to feel euphoria
You don't know what I was wanting to feel - you never asked. Where do you draw the line between feeling better and feeling euphoric? How do you know I was euphoric?
>due to diversion
Diversion refers to the act of obtaining prescription medications to sell. People don't 'divert' OTC medications.
>You're right, companies spend billions on antipsychotics, but the reason is clear -- the schizophreniform disorder spectrum (and BP I as well) is the largest psychiatric problem by percentage and while the vast majority are catatonic (unfortunately), there are violent behaviours that lead to awful endings like air marshalls taking down people who turn out later to be mentally ill.
Antipsychotics are indeed useful in the treatment of schizophrenia. Nevertheless, I wouldn't be at all surprised if most prescriptions for APs (especially in the US) were off-label. Most people with schizophrenia are not violent, however seriously ill they are. Pharmaceutical companies make vast profit on atypical APs - they are greatly overpriced. Research is expensive, but it does not justify the ridiculously high costs of atypical APs.
Regards
Ed
Posted by yxibow on May 9, 2006, at 17:25:47
In reply to Re: MAOIs » yxibow, posted by ed_uk on May 9, 2006, at 15:35:13
> Hi J
>
> >it seems to come up quite often
>
> Yes, I was feeling annoyed :(
>
> >wanting to feel euphoria
>
> You don't know what I was wanting to feel - you never asked. Where do you draw the line between feeling better and feeling euphoric? How do you know I was euphoric?I don't know, Ed, we laid this to rest in email and its coming out again, its getting obsessive, honestly and with a caveat of neutrality because I know I'm going to be hit again over the head...
But you're right, I have no idea if you were feeling better, feeling better because of euphoria, or feeling euphoric.
>
> >due to diversion
>
> Diversion refers to the act of obtaining prescription medications to sell. People don't 'divert' OTC medications.Codeine phosphate used to be OTC but one would have to sign a book, typically, in different states. I'm talking about diversion in the US. That is still diversion from its intended purpose and the intended purpose of what I would label as a nebulous nonexistant category at the time of cat VI. It no longer exists here so its a non issue. I'm viewing things from here, not there, Ed.
And oh boy do people divert OTC medications, thats why some states have now made Sudafed a prescription! I mean blast all, you have to get your doctor to sign a mommy and daddy note. *** meth addiction. Enough said.
If someone figures a way to divert OTC levmetamfetamine that will go too. Not that its a particularly used nasal decongestant.>
> >You're right, companies spend billions on antipsychotics, but the reason is clear -- the schizophreniform disorder spectrum (and BP I as well) is the largest psychiatric problem by percentage and while the vast majority are catatonic (unfortunately), there are violent behaviours that lead to awful endings like air marshalls taking down people who turn out later to be mentally ill.
>
> Antipsychotics are indeed useful in the treatment of schizophrenia. Nevertheless, I wouldn't be at all surprised if most prescriptions for APs (especially in the US) were off-label. Most people with schizophrenia are not violent, however seriously ill they are."Catatonic" "Vast majority." That means "most all people." I just said it!
Pharmaceutical companies make vast profit on atypical APs - they are greatly overpriced. Research is expensive, but it does not justify the ridiculously high costs of atypical APs.
Every new medication that comes out in the US, ed, costs between $2 and $3 a pill. You can complain as we do till the cows come home but only Canada and the UK have caps. Do I think granisetron should cost $50 a pill?? But it has to do partly (aforementioned) with supply and demand, and as far as schizophrenic medication, there are so many variations in disorders and so many caveats of EPS and TD and the like that have to come in to play that they are just plain expensive to produce.
I dont like it more than anybody else but on the other hand I wouldn't want a end-all happy pill for antidepression that cost only $1 million to produce to come to market. That would scare me and suggest that they tested it on like 2 patients.
Anyhow. Go petition the FDA, but you're not likely to get anywhere.
Cheers
-- Jay
Posted by Caedmon on May 9, 2006, at 19:30:31
In reply to Re: MAOIs » Jost, posted by Don_Bristol on May 8, 2006, at 19:42:34
Hi Don,
The figures you quoted, were they from http://www.emedicine.com/EMERG/topic318.htm ? You posted a link to the aapcc's website, but I honestly couldn't make heads or tails of anything on it.
I think it's important to note that those figures to do not differentiate among overdose, drug, and food interactions. It is my understanding that drug interactions tend to be the most dangerous and possibly more common, too.
> >> Dying from an MAOI-related hypertensive
> >> reaction is extremely rare.
>
> > http://www.acnp.org/G4/GN401000046/CH046.html
> > states that[yxibow]: Dying is rare, you're right. However the chance of a stroke and unilateral or bilateral neurological damage is higher. Its worse than death. Its immobilization and life debilitating. But I'm not trying to scare those on MAOIs who have proper instructions from their doctors, and who do not eat the foods that would make themselves vulnerable. As one pointed out, eating out is a difficulty and a pleasure lost. But if it is necessary to come to an MAOI -- well, that's between you and your doctor>>
I think those statistics noted a rate for both CVA and death.
Maybe it's just me, but I perceived your post as quite unecessarily negative. I take an MAOI and I have eaten out. Pleasure is not "lost". I have to ask what's in the food I'm eating sometimes, that's all. Many people do that for a variety of health reasons.
When you say "if it is necessary to come to an MAOI -- well, that's between you and your doctor," the tone (which is always difficult to percieve just through writing), seems to be one of, "Oh well, if you want to do something so silly, be my guest, but it's not responsible." That's just how I read it. Maybe you could clarify, if I am reading it wrong. (I have "rejection-sensitive" depression and social phobia, so I can be reading into things without cause.) Otherwise, it does seem to be a sort of judgement call on behalf of others, without really knowing their situations... and I always feel this is risky in boards like these, where stories and advice on mental health are shared.
How many antidepressants do you believe people should try first, before trying an MAOI?
In my own case, I considered ECT. But the cost is prohibitive, and I already am suffering from memory problems secondary to depression. An MAOI seemed much more logical.
Be well,
- C
Posted by Phillipa on May 9, 2006, at 19:49:36
In reply to Re: MAOIs » ed_uk, posted by yxibow on May 9, 2006, at 17:25:47
Jay are you saying most schizophrenics are catatonic? I've never seen that. Most are out of reality. Hearing voices in their heads and delusinal. Did I read you wrong? And why the dicussion of codeine. So what if someone takes it to feel better. People drink alchohol to feel better or euphoric as you call it and it's legal. I think this discussion has gotten out of hand. Maybe E-mail would be better. I thought this was on MAOIS? Love Phillipa
Posted by Declan on May 9, 2006, at 20:34:24
In reply to Re: MAOIs » ed_uk, posted by yxibow on May 9, 2006, at 17:25:47
Posted by Jost on May 9, 2006, at 23:27:19
In reply to Re: MAOIs, posted by Caedmon on May 9, 2006, at 19:30:31
> Hi Don,
>
> The figures you quoted, were they from http://www.emedicine.com/EMERG/topic318.htm ? You posted a link to the aapcc's website, but I honestly couldn't make heads or tails of anything on it.
>
The figures Don quoted, unless I'm mistaken (which I might be) were from a "Summary of fatal exposures reported to TESS in 2002" published in the Am J. of Emergency Med.However, the Summary, as I read it, noted only one death from an maoi, ie parnate; and the cause of death was "ther. err."--ie therapist error, rather than an adverse drug reaction.
Possibly, Don's statistics are from another source. However, the type of AD associated with the highest number of fatalities on this report, by far, was tricyclics, particularly. amitriptyline. Is this the most widely prescribed tricylic?
Most of the deaths were intentional. There are a few other causes, such as "malicious," "adv. react." and "ther. err." The number of adverse reactions is so small that it would seem hard to draw any conclusions from this one report.
Last night I came across a paper--I can't find it now--that suggested that deaths from tricyclics were greater in absolute numbers than those from maois, although a somewhat greater proportion of the maoi fatalities were intentional. The difference didn't seem so great as to make the argument that maois are to be avoided at all costs. Obviously, care must be taken in their use..
I'd be interested in Don's sources, though.
Jost
Posted by yxibow on May 9, 2006, at 23:31:54
In reply to Re: MAOIs, posted by Phillipa on May 9, 2006, at 19:49:36
> Jay are you saying most schizophrenics are catatonic? I've never seen that. Most are out of reality. Hearing voices in their heads and delusinal. Did I read you wrong? And why the dicussion of codeine. So what if someone takes it to feel better. People drink alchohol to feel better or euphoric as you call it and it's legal. I think this discussion has gotten out of hand. Maybe E-mail would be better. I thought this was on MAOIS? Love Phillipa
Email was better, if you want to know the truth, Ed and I have been bantering there and its come out here and I believe Ed has been a bit obsessive about my views, and we've been there over and over so I ended my opinions. I don't believe that it should have been diverted for euphoria in the US because now we can't take it over the counter for cough medication in the US like we used to. I also don't think it is the best choice of a psychiatric medication when there are others out there with less potential for morphine addiction, etc, etc, etc... and that was the whole content of countless emails. End of story, and I've closed the chapter with Ed. And please for goodness sakes, I like ya Eddy, so lets not go on again. And you agree with Ed about alcohol and I agree in moderation, so I'm not going to argue with it. It was not about one-offs, Phillipa, it was about continuous use of it as people use alcohol continuously for GABA use and the continuous use of either drug can be more harmful than some psychiatric medications. Finit, okay.
I used the wrong medical term -- what I meant was the vast majority of schizophrenics that I've observed are dysphoric and exhibit part of the symptoms of catatonia - stupor and stereotypy. My mistake. My point with this whole thread as for schizophrenia was yes, you're right, the vast majority are quiescent and introverted and the word is on the tip of my tongue but I misplaced it.Yes, this started as MAOIs but the whole thread as you can see is multifaceted.
Cheers
-- Jay
Posted by Phillipa on May 9, 2006, at 23:39:14
In reply to Re: MAOIs and everything else » Phillipa, posted by yxibow on May 9, 2006, at 23:31:54
Jay I know you are friends and like to banter about meds. And I like both of you a whole bunch. I just thought some of the stuff you were talking about wasn't meant for everyone. Are we still friends? Love Phillipa
Posted by yxibow on May 9, 2006, at 23:49:45
In reply to Re: MAOIs and everything else » yxibow, posted by Phillipa on May 9, 2006, at 23:39:14
> Jay I know you are friends and like to banter about meds. And I like both of you a whole bunch. I just thought some of the stuff you were talking about wasn't meant for everyone. Are we still friends? Love Phillipa
We are and Ed and I are. It wasn't meant for everyone but somehow there was an obsessive need, and don't take this the wrong way, Eddy dear, for Ed (and I) to play one upmanship and continue this thread where it should have been private. I mean no intrinsic harm by the previous comment but if you look at the whole thread and the number of emails about it , it strikes me as obsessiveness. At any rate, nobody I hope is hurt or harmed by this interruption in the thread, its all good as far as I am concerned, agreements to disagree, and laid to rest.
Posted by Don_Bristol on May 10, 2006, at 9:35:55
In reply to Re: MAOIs » Don_Bristol, posted by ed_uk on May 9, 2006, at 15:22:01
> Hi Don
>
> >there is a good case for trying the less-lethal ADs first and then moving towards MAOIs if nothing else works
>
> I have never heard of MAOIs being used until a
> variety of other ADs have been tried. Have you?I have never heard of MAOIs being used until a variety of other ADs have been tried, either. The poster was hoping for safer MAOIs so they could be tried sooner.
>
> You seem concerned about MAOIs.
>I am concerned about the food reaction with MAOIs. Yes.
>
> I thought you took Parnate?
>Yes I take Parnate. And very good it is too.
Don
Posted by ed_uk on May 10, 2006, at 10:01:59
In reply to Re: MAOIs » ed_uk, posted by yxibow on May 9, 2006, at 17:25:47
>I have no idea if you were feeling better, feeling better because of euphoria, or feeling euphoric
Not sure what that's supposed to mean. Are you saying that if a med makes someone feel better this is a form of euphoria?
>intended purpose
And who is to say what a drug's intended purpose should be? Some people believe that atypical APs should never be used to treat insomnia.......other people believe that using APs to treat insomnia is perfectly acceptable. It's all a matter of opinion.
>divert OTC medications
It seems that you're referring to the diversion of OTC meds after using them to synthesize other drugs. I was thinking more of diversion of drugs in their original state.
>Catatonic" "Vast majority." That means "most all people." I just said it!
I wouldn't say most people with schizophrenia are catatonic. Most people with schizophrenia suffer from delusions, hallucinations and disorganised behaviour. Catatonia is present in some but not the vast majority.
>only Canada and the UK have caps
That's not true at all. Many countries have price controls. Certainly, most European countries do.
>I wouldn't want a end-all happy pill for antidepression that cost only $1 million to produce to come to market. That would scare me and suggest that they tested it on like 2 patients.
Well no, but for widely prescribed drugs like APs pharmaceutical companies do not need to charge such high prices to regain the money they spent on research. They quickly end up making huge profits.
>Go petition the FDA, but you're not likely to get anywhere.
Nah, I won't bother thanks.
Ed
Posted by ed_uk on May 10, 2006, at 10:07:33
In reply to Re: MAOIs and everything else » Phillipa, posted by yxibow on May 9, 2006, at 23:31:54
>Ed has been a bit obsessive about my views
Perhaps, it's in my nature to be obsessive.
>I don't believe that it should have been diverted for euphoria in the US because now we can't take it over the counter for cough medication in the US like we used to
I don't believe my having taken codeine has affected your ability to obtain it Yxi.
Ed
Posted by ed_uk on May 10, 2006, at 10:10:14
In reply to Re: MAOIs » ed_uk, posted by Don_Bristol on May 10, 2006, at 9:35:55
Hi Don
>Yes I take Parnate. And very good it is too.
Did you tell your pdoc what I said about the maximum dose not being 30mg?
Ed
Posted by Don_Bristol on May 10, 2006, at 10:10:32
In reply to Re: MAOIs, posted by Jost on May 9, 2006, at 23:27:19
> > Hi Don,
> >
> > The figures you quoted, were they from http://www.emedicine.com/EMERG/topic318.htm ? You posted a link to the aapcc's website, but I honestly couldn't make heads or tails of anything on it.
> >
>
>
> The figures Don quoted, unless I'm mistaken (which I might be) were from a "Summary of fatal exposures reported to TESS in 2002" published in the Am J. of Emergency Med.
>
> However, the Summary, as I read it, noted only one death from an maoi, ie parnate; and the cause of death was "ther. err."--ie therapist error, rather than an adverse drug reaction.
>
> Possibly, Don's statistics are from another source. However, the type of AD associated with the highest number of fatalities on this report, by far, was tricyclics, particularly. amitriptyline. Is this the most widely prescribed tricylic?
>
> Most of the deaths were intentional. There are a few other causes, such as "malicious," "adv. react." and "ther. err." The number of adverse reactions is so small that it would seem hard to draw any conclusions from this one report.
>
> Last night I came across a paper--I can't find it now--that suggested that deaths from tricyclics were greater in absolute numbers than those from maois, although a somewhat greater proportion of the maoi fatalities were intentional. The difference didn't seem so great as to make the argument that maois are to be avoided at all costs. Obviously, care must be taken in their use..
>
> I'd be interested in Don's sources, though.
>
> Jost
>
>--------------------
Hi Jost
This is the document in PDF form
<http://www.aapcc.org/Annual%20Reports/02report/AnnlRpt02Table22.pdf>;
Go to page 404 (PDF doc page 12).
Read the line across for MAOIs. Last figures shows 2 deaths, 26 major and 81 moderate. I put it into a spreadsheet. http://tinyurl.com/ppmd5 Let me know if the percentages are wrong because I did for my own use and approximate figures were good enough for what I needed. The breakdown by type occurs there which is why I said about a third were intentional (81 out of 181 intentional plus the 81 intentional) because the data is patchy and the categories overlap so UNintentional + Intentional + unknowns will equal the total population sampled.
That is what I was quoting. I used those 2003 figures in June 2004 because they were the lastest available. Now newer figures are available and you can compile them (save me the trouble!) from http://www.aapcc.org/annual.htm then "View Report By Sections" then "Table 22A-22B".
Not sure where you got your data about "ther. err." and that sort of breakdown. Do you have a link?
Was it you who posted this to this thread?: "However the chance of a stroke and unilateral or bilateral neurological damage is higher. Its worse than death. Its immobilization and life debilitating."
In a funny way I really do agree. When you're dead, you're dead. But to live with severe brain damage is a living death and is an even more frightening prospect to me than death.
rgds, Don
Posted by ed_uk on May 10, 2006, at 10:17:37
In reply to Re: MAOIs » Jost, posted by Don_Bristol on May 10, 2006, at 10:10:32
>But to live with severe brain damage is a living death and is an even more frightening prospect to me than death.
I agree. I hope you weren't offended by my last post to you. MAOIs can be frightening. Do you carry a nifedipine capsule yourself?
Ed
Posted by ed_uk on May 10, 2006, at 10:19:21
In reply to Re: MAOIs and everything else » Phillipa, posted by yxibow on May 9, 2006, at 23:49:45
Hi J
Please reply in private if you wish. I don't want to talk on the board anymore. Thank you.
Regards
Ed
Posted by yxibow on May 10, 2006, at 12:38:18
In reply to Re: MAOIs and everything else » yxibow, posted by ed_uk on May 10, 2006, at 10:19:21
> Hi J
>
> Please reply in private if you wish. I don't want to talk on the board anymore. Thank you.
>
> Regards
>
> Ed
>Good idea, I just did. And let's all be civil -- actually I think I have been fairly so.
Evening, sweetness.
Posted by Don_Bristol on May 10, 2006, at 14:34:30
In reply to Re: MAOIs » Don_Bristol, posted by ed_uk on May 10, 2006, at 10:17:37
> But to live with severe brain damage is a
> living death and is an even more frightening
> prospect to me than death.
>
> I agree. I hope you weren't offended by my last
> post to you. MAOIs can be frightening. Do you
> carry a nifedipine capsule yourself?
>
> Ed------------
You have given no offense at all. Not even faintly.
AIUI, Nifedapine is contra-indicated for a hypertensive crisis.
"The Dangers of Immediate-Release Nifedipine for Hypertensive Crises"
<http://www.ptcommunity.com/ptjournal/fulltext/27/7/PTJ2707362.pdf>;"Alternatives to Nifedipine in the Oral Treatment of Hypertensive Urgencies"
<http://www.rxfiles.ca/acrobat/nifed-hu.pdf>;I used to carry Captopril but now I don't usually bother.
best wishes
Don
Posted by gardenergirl on May 10, 2006, at 15:48:04
In reply to Re: MAOIs » ed_uk, posted by Don_Bristol on May 10, 2006, at 14:34:30
My pdoc did not give me nifidepine. I do wear a medical alert bracelet which states I take an MAOI, and cautions about food and drug interactions. It also points out the risk of hypertensive crisis. I am hopeful that in the unlikely and unfortunate event that I am in an ER unconscious, someone will use this to make informed diagnosis and treatment decisions.
gg
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