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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by laima on August 22, 2006, at 15:41:16
Has this happened to anyone here? If it does happen, due to dietary indiscretion or snafu, is it really true that you would know immediately? And why do doctors not recommend benzodiazapines to calm it down if it does happen?This is hypothetical- it's never happened to me and I do try to be careful with what I eat, even though I'm using Emsam- but the possibility is always in the back of my mind. Any experiences or comments? Thanks
Posted by silvercoin on August 22, 2006, at 16:26:25
In reply to maoi/hypertensive crisis question, posted by laima on August 22, 2006, at 15:41:16
>
> Has this happened to anyone here? If it does happen, due to dietary indiscretion or snafu, is it really true that you would know immediately? And why do doctors not recommend benzodiazapines to calm it down if it does happen?
>
> This is hypothetical- it's never happened to me and I do try to be careful with what I eat, even though I'm using Emsam- but the possibility is always in the back of my mind. Any experiences or comments? Thanks
Benzos are a treatment I've read of for serotonin syndrome, but I don't believe they will do anything for a hypertensive crisis. For that, you need an anti-hypertensive such as nifedipine. No, I've never experienced a hypertensive crisis, or any type of BP rise that I've been able to detect, and I've taken Nardil, Parnate, and Marplan.Todd
Posted by laima on August 22, 2006, at 16:32:53
In reply to Re: maoi/hypertensive crisis question, posted by silvercoin on August 22, 2006, at 16:26:25
Oh really? And here my doctor especially warned about seratonin crisises, saying that there is just about nothing that could be done for a severe one, other than monitoring. I wonder if he was trying to really scare me into complying, or what. Thanks for your input. (I'll still do all possible to avoid either type of crisis!)> >
> > Has this happened to anyone here? If it does happen, due to dietary indiscretion or snafu, is it really true that you would know immediately? And why do doctors not recommend benzodiazapines to calm it down if it does happen?
> >
> > This is hypothetical- it's never happened to me and I do try to be careful with what I eat, even though I'm using Emsam- but the possibility is always in the back of my mind. Any experiences or comments? Thanks
>
>
> Benzos are a treatment I've read of for serotonin syndrome, but I don't believe they will do anything for a hypertensive crisis. For that, you need an anti-hypertensive such as nifedipine. No, I've never experienced a hypertensive crisis, or any type of BP rise that I've been able to detect, and I've taken Nardil, Parnate, and Marplan.
>
> Todd
Posted by Maxime on August 22, 2006, at 16:35:12
In reply to Re: maoi/hypertensive crisis question, posted by silvercoin on August 22, 2006, at 16:26:25
Yes it happened a couple of times to me on Parnate. Once it was soy sauce ... by mistake. The other was home made red wine. I had been able to drink store bought red wine no problem. I took 100 mg of Thorazine when I felt the reaction ... and you do it feel it quickly. I felt it in my head first and then a rapid heartbeat. But I didn't need to go to the hospital. The Thorazine did the trick.
I though you didn't have to worry about a hypertensive crisis on the patch?
Maxime
Posted by laima on August 22, 2006, at 18:27:37
In reply to Re: maoi/hypertensive crisis question » silvercoin, posted by Maxime on August 22, 2006, at 16:35:12
Wow- that must have been scary.
Well, true, a crisis is a much lower risk with the patch, but careful study of the Emsam insert does indicate that they don't have definitive data about food interaction potential or risks with the "9" and "12". They just don't know, and don't make any claims. It's only the "6" that they have tested out for interactions and make the "no food interaction" claim for. I'm using the "9" right now, and my doctor told me it would be very prudent to follow the maoi diet carefully at this dose, just in case.
However, my current problem is dropping blood pressure- last reading was 83 over 60- so I'm off in the other direction, feeling faint and disfunctional. This despite coffee- Though Emsam has been helping me so far, this current condition is not allowing me to DO things, and that in itself is feeling depressing as I see my projects and deadlines sliding away. I have an appointment Friday, and wonder what will happen. Geez, I wish it was tomorrow. I'm tempted to go eat a large hunk of parmeson right now, but was told in advance that that would NOT be the way to remedy low blood pressure responsably... Weirdly, when we had a severe heat spell recently, my blood pressure went way up to 126/90 (high for me) and I was super panicky. I used about 15 mg ritalin at the time (that's not a lot at all), and it was taken away as result. But I think I overall did much better with it, and the only time it caused any panickyness was during the heat. It kept my blood pressure reasonable and fairly stable except during that heat spell. So I'm confused and frustrated. I wonder if other maoi users have felt any odd changes in vital signs during heat spells? If there is a connection?
Thank you for your input.
> Yes it happened a couple of times to me on Parnate. Once it was soy sauce ... by mistake. The other was home made red wine. I had been able to drink store bought red wine no problem. I took 100 mg of Thorazine when I felt the reaction ... and you do it feel it quickly. I felt it in my head first and then a rapid heartbeat. But I didn't need to go to the hospital. The Thorazine did the trick.
>
> I though you didn't have to worry about a hypertensive crisis on the patch?
>
> Maxime
Posted by Phillipa on August 22, 2006, at 19:14:10
In reply to Re: maoi/hypertensive crisis question » Maxime, posted by laima on August 22, 2006, at 18:27:37
Someone just recently posted the same reaction with the heat? And how come so many on EMSAM have such low BP? Love Phillipa
Posted by laima on August 22, 2006, at 19:39:55
In reply to Re: maoi/hypertensive crisis question » laima, posted by Phillipa on August 22, 2006, at 19:14:10
> Someone just recently posted the same reaction with the heat? And how come so many on EMSAM have such low BP? Love Phillipa
Oh? I wonder where- I'll have to look around. thank you.
Is low blood pressure a problem with the other maois?
Posted by Phillipa on August 22, 2006, at 20:31:50
In reply to Re: maoi/hypertensive crisis question » Phillipa, posted by laima on August 22, 2006, at 19:39:55
I don't know why not start a thread and ask? Or google it? Sometimes I feel so stupid!!!!Love Phillipa
Posted by mayzee on August 22, 2006, at 21:03:18
In reply to Re: maoi/hypertensive crisis question » Phillipa, posted by laima on August 22, 2006, at 19:39:55
> Is low blood pressure a problem with the other maois?
Hi Laima,
I was told by pdoc that yes, all MAOIs have the potential side effect of low blood pressure. I guess for some people that is a plus! (not for me)
--mayzee
Posted by laima on August 22, 2006, at 21:08:22
In reply to Re: maoi/hypertensive crisis question » laima, posted by mayzee on August 22, 2006, at 21:03:18
Really? Thanks for info- I'm like you, you know--already low!> > Is low blood pressure a problem with the other maois?
>
> Hi Laima,
>
> I was told by pdoc that yes, all MAOIs have the potential side effect of low blood pressure. I guess for some people that is a plus! (not for me)
>
> --mayzee
Posted by Maxime on August 23, 2006, at 6:07:05
In reply to Re: maoi/hypertensive crisis question » Maxime, posted by laima on August 22, 2006, at 18:27:37
Yes, Parnate made me hypotensive. And also I would overheat on it as well. But again, since it was the only AD to work for me, I put up with it. When you are down to your last option, you tend to put up with more.
Good luck.
Maxime
> Wow- that must have been scary.
>
> Well, true, a crisis is a much lower risk with the patch, but careful study of the Emsam insert does indicate that they don't have definitive data about food interaction potential or risks with the "9" and "12". They just don't know, and don't make any claims. It's only the "6" that they have tested out for interactions and make the "no food interaction" claim for. I'm using the "9" right now, and my doctor told me it would be very prudent to follow the maoi diet carefully at this dose, just in case.
>
> However, my current problem is dropping blood pressure- last reading was 83 over 60- so I'm off in the other direction, feeling faint and disfunctional. This despite coffee- Though Emsam has been helping me so far, this current condition is not allowing me to DO things, and that in itself is feeling depressing as I see my projects and deadlines sliding away. I have an appointment Friday, and wonder what will happen. Geez, I wish it was tomorrow. I'm tempted to go eat a large hunk of parmeson right now, but was told in advance that that would NOT be the way to remedy low blood pressure responsably... Weirdly, when we had a severe heat spell recently, my blood pressure went way up to 126/90 (high for me) and I was super panicky. I used about 15 mg ritalin at the time (that's not a lot at all), and it was taken away as result. But I think I overall did much better with it, and the only time it caused any panickyness was during the heat. It kept my blood pressure reasonable and fairly stable except during that heat spell. So I'm confused and frustrated. I wonder if other maoi users have felt any odd changes in vital signs during heat spells? If there is a connection?
>
> Thank you for your input.
>
>
>
> > Yes it happened a couple of times to me on Parnate. Once it was soy sauce ... by mistake. The other was home made red wine. I had been able to drink store bought red wine no problem. I took 100 mg of Thorazine when I felt the reaction ... and you do it feel it quickly. I felt it in my head first and then a rapid heartbeat. But I didn't need to go to the hospital. The Thorazine did the trick.
> >
> > I though you didn't have to worry about a hypertensive crisis on the patch?
> >
> > Maxime
>
>
Posted by laima on August 23, 2006, at 7:34:21
In reply to Re: maoi/hypertensive crisis question » laima, posted by Maxime on August 23, 2006, at 6:07:05
Thank you, Maxime. Are you still using it, or did it konk out?
> Yes, Parnate made me hypotensive. And also I would overheat on it as well. But again, since it was the only AD to work for me, I put up with it. When you are down to your last option, you tend to put up with more.
>
> Good luck.
>
> Maxime
>
>
>
> > Wow- that must have been scary.
> >
> > Well, true, a crisis is a much lower risk with the patch, but careful study of the Emsam insert does indicate that they don't have definitive data about food interaction potential or risks with the "9" and "12". They just don't know, and don't make any claims. It's only the "6" that they have tested out for interactions and make the "no food interaction" claim for. I'm using the "9" right now, and my doctor told me it would be very prudent to follow the maoi diet carefully at this dose, just in case.
> >
> > However, my current problem is dropping blood pressure- last reading was 83 over 60- so I'm off in the other direction, feeling faint and disfunctional. This despite coffee- Though Emsam has been helping me so far, this current condition is not allowing me to DO things, and that in itself is feeling depressing as I see my projects and deadlines sliding away. I have an appointment Friday, and wonder what will happen. Geez, I wish it was tomorrow. I'm tempted to go eat a large hunk of parmeson right now, but was told in advance that that would NOT be the way to remedy low blood pressure responsably... Weirdly, when we had a severe heat spell recently, my blood pressure went way up to 126/90 (high for me) and I was super panicky. I used about 15 mg ritalin at the time (that's not a lot at all), and it was taken away as result. But I think I overall did much better with it, and the only time it caused any panickyness was during the heat. It kept my blood pressure reasonable and fairly stable except during that heat spell. So I'm confused and frustrated. I wonder if other maoi users have felt any odd changes in vital signs during heat spells? If there is a connection?
> >
> > Thank you for your input.
> >
> >
> >
> > > Yes it happened a couple of times to me on Parnate. Once it was soy sauce ... by mistake. The other was home made red wine. I had been able to drink store bought red wine no problem. I took 100 mg of Thorazine when I felt the reaction ... and you do it feel it quickly. I felt it in my head first and then a rapid heartbeat. But I didn't need to go to the hospital. The Thorazine did the trick.
> > >
> > > I though you didn't have to worry about a hypertensive crisis on the patch?
> > >
> > > Maxime
> >
> >
>
>
Posted by Maxime on August 23, 2006, at 11:40:52
In reply to Re: maoi/hypertensive crisis question » Maxime, posted by laima on August 23, 2006, at 7:34:21
>
> Thank you, Maxime. Are you still using it, or did it konk out?
>
>*cries* It konked out on me! And Nardil did not agree with me. I am now anti-depressant free and it's not a good thing.
Maxime
Posted by laima on August 23, 2006, at 12:05:47
In reply to Re: maoi/hypertensive crisis question » laima, posted by Maxime on August 23, 2006, at 11:40:52
Oh- that's not good news at all. How long did Parnate work for you?How are you coping, are you considering any of those new alternative non-drug, non-substance treatments like the magnet thing or even botox? (I'm not kidding in the least about the botox- there was an amazing Washington Post article last spring, and I saw the researchers involved get interviewed on Good Morning America and was impressed by them and their reported results- they said it was "time to think outside the box" and provided some pretty convincing evidence-even though their initial study was quite small. Worth a try, what's to lose? It only lasts 2-3 months at a time, after all-and I dare say it strikes me that injections of a neutralized toxin into specific muscles is less drastic than swallowing drugs that can affect the whole body-and the botox doesn't really travel outside of its injection areas. Google this if you don't know about it.) Wait, was that you who started the recent ECT thread? I haven't read any of it yet.
Warmest wishes,
Laima
> >
> > Thank you, Maxime. Are you still using it, or did it konk out?
> >
> >
>
> *cries* It konked out on me! And Nardil did not agree with me. I am now anti-depressant free and it's not a good thing.
>
> Maxime
Posted by Maxime on August 23, 2006, at 19:29:38
In reply to Re: maoi/hypertensive crisis question » Maxime, posted by laima on August 23, 2006, at 12:05:47
It lasted a couple of years ... which is the LONGEST any AD has worked for me.
I'm not coping. I'm considering ECT. I'll have to look up the botox for depression ...
I'm considering a lot of things right now ... not all of them good.
Maxime
> Oh- that's not good news at all. How long did Parnate work for you?
>
> How are you coping, are you considering any of those new alternative non-drug, non-substance treatments like the magnet thing or even botox? (I'm not kidding in the least about the botox- there was an amazing Washington Post article last spring, and I saw the researchers involved get interviewed on Good Morning America and was impressed by them and their reported results- they said it was "time to think outside the box" and provided some pretty convincing evidence-even though their initial study was quite small. Worth a try, what's to lose? It only lasts 2-3 months at a time, after all-and I dare say it strikes me that injections of a neutralized toxin into specific muscles is less drastic than swallowing drugs that can affect the whole body-and the botox doesn't really travel outside of its injection areas. Google this if you don't know about it.) Wait, was that you who started the recent ECT thread? I haven't read any of it yet.
>
> Warmest wishes,
>
> Laima
>
>
> > >
> > > Thank you, Maxime. Are you still using it, or did it konk out?
> > >
> > >
> >
> > *cries* It konked out on me! And Nardil did not agree with me. I am now anti-depressant free and it's not a good thing.
> >
> > Maxime
>
>
Posted by jedi on August 26, 2006, at 2:27:03
In reply to maoi/hypertensive crisis question, posted by laima on August 22, 2006, at 15:41:16
>
> Has this happened to anyone here? If it does happen, due to dietary indiscretion or snafu, is it really true that you would know immediately? And why do doctors not recommend benzodiazapines to calm it down if it does happen?
>
> This is hypothetical- it's never happened to me and I do try to be careful with what I eat, even though I'm using Emsam- but the possibility is always in the back of my mind. Any experiences or comments? ThanksHi,
I've been on Nardil for most of ten years. I've had two hypertensive episodes. The first was just a space on my part, eating some white cheese which I thought was mozzarella. It wasn't. The 2nd was when I bought some codeine cough syrup in Canada. Codeine is over the counter there, and has never caused problems for me with MAOIs. The pharmacist said it would be just fine. But in small print was the word pseudoephedrine. I didn't have my reading glasses and I could not even see it. This drug is a big NO-NO with MAOIs and will cause a hypertensive crisis. It did for me.When I first started Nardil I had some orthostatic hypotension. This is when you stand up too fast, your BP goes way down, and you can get light headed and can even faint. After a while this side effect went away. Now Nardil tends to lower my BP a few points, which has actually kept me off of the beta-blockers, since my BP normally runs borderline high.
I used to carry niphedipine for emergencies. My current doctor does not want to risk this, because niphedipine can lower your BP too much, which is very dangerous also. Benzos will not help a hypertensive episode.
When taking the irreversible MAOIs you just have to take a lot of responsibility on yourself. I research every medication I take now and have a handle on all of the foods that affect me.
Take care,
Jedi
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