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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Cass on August 13, 2011, at 15:11:52
My doctor really wants me to try this medication because we've exhausted all other classes of anti-depressants. I've had reservations about it because so many of the things I eat are on the list of counterindicated foods. I've been on Nardil 3 days now. Just this morning, I decided to have a granola bar from Jamba juice. I didn't see anything about it having chocolate chips in it, but it turns out it did. I was hungry having skipped breakfast so I went ahead and ate it. The chocolate chips were small, but I know it was probably risky. I'm a pescavegetarian (vegetarian who eats fish) and I eat avocado a lot. Restricting avocado has proven extremely difficult. I eat it like most people eat meat. I have it in sandwiches all the time. Also, last night I decided to have a Hansen's dark cherry cola. It's decaffeinated and I didn't think there was anything in it that was on the list. Soon afterwards, I had a terrible headache. I don't know why. I feel like I'm playing a game of Russian Roulette, but I also want to give the drug a fair try.
Posted by lifelover on August 13, 2011, at 17:03:36
In reply to New on Nardil, posted by Cass on August 13, 2011, at 15:11:52
The drug is worth having to give up certain foods for, at least for me. The diet is also outdated and their have been many reports of people eating almost whatever they want and being fine, I'm one of them. However everyone's body is different so eat at your own risk. With that said I hope you stick with Nardil its a great med and it saves lives. Feel free to contact me if you have any questions or concerns.
Posted by Phillipa on August 13, 2011, at 19:42:19
In reply to Re: New on Nardil, posted by lifelover on August 13, 2011, at 17:03:36
Cass sure helps it works for you. Phillipa
Posted by emmanuel98 on August 13, 2011, at 20:17:50
In reply to New on Nardil, posted by Cass on August 13, 2011, at 15:11:52
Chocolate is fine in moderation. Avocado is fine if it's not turned brown. The food interactions are not as draconian as some people seem to think. Just avoid aged cheeses, meats, draft beer, red wine and soy products.
Posted by policebox on August 14, 2011, at 0:55:52
In reply to New on Nardil, posted by Cass on August 13, 2011, at 15:11:52
Hello Cass,
I'm sorry to hear you are having a difficult time. I too started taking an MAOi drug during the past few months (Parnate in my case). Like you, I was very much concerned about the food restrictions. Not so much that I would have to give up certain foods, but that I might make a lethal mistake through the accidental intake of a forbidden food.
The good news is, after several months of using Parnate, I haven't experienced any problems when it comes to the restricted diet. Although, as others have mentioned, every individuals' physiology is different, I think it's safe to say that the diet restrictions are fairly conservative (over-cautious).
Caffeine in moderation is okay to have, meaning one soda probably isn't going to cause you a problem. The reason it is contraindicated in large quantities is that Nardil (and other MAOi) can act as a stimulant in the central nervous system (CNS). Caffeine is also a CNS stimulant. Therefore, too many stimulants in your blood stream will cause an increase in your blood pressure, which could result in a hypertensive crisis.
For chocolate, most American chocolate, especially milk chocolate, is also generally safe in small quantities. I'm no expert on this subject, but I think most people say to avoid European chocolates, more expensive, and exotic chocolates. I'm not sure how the formulation is different, perhaps it's the amount of cocoa. For me, I eat a different brand of fiber bars with chocolate chips, and I've never had a problem. I eat Reese's peanut butter cups, chocolate chip cookies, etc. and have never had a problem.
It may be perhaps that the stress and tension you experienced from being afraid of eating the chocolate that caused the headache. Although I've never experienced one for myself, other people have described a hypertensive crisis related headache as one of the worst pains they have ever experienced.
As for avocados, from the description I've read regarding the MAOi diet, the important point is not to eat overripe ones, which contain higher levels of tyramine. If not overripe, it's apparently fine to eat about 1/2 cup of avocado, which I'd guess is about a normal-sized portion.
My suggestion is to take the anxiety of "not knowing" about your blood pressure out of the equation by purchasing a blood pressure/heart rate monitor. They are relatively inexpensive and are an important investment for anyone taking an MAOi.
The general rule is to avoid anything that's been aged, might be overripe, or spoiled. You want to eat fresh foods as much as possible. Even left-overs more than a day or two old can cause a problem for some people. I suggest if you want to eat something you are worried about, then try a small amount and check your blood pressure. If you don't have a reaction, it will probably be okay to eat. However, some people have eaten foods for years and then one day have a spontaneous reaction to them.
So I'd say the larger advice I can give is to not panic. Purchase a blood pressure monitor to reduce your anxiety about not knowing what your blood pressure is. If Nardil is helping with your depressive symptoms and overall improves your quality of life, then with a little caution, you can be confident you'll be alright.
I wish you all the best.
Posted by bleauberry on August 14, 2011, at 8:47:10
In reply to New on Nardil, posted by Cass on August 13, 2011, at 15:11:52
Hey look on the bright side....
At least you are above ground and able to eat.
You can always stop it and go back to eating your old habits any time you want.
There are plenty of foods you will like just as much as the ones you are accustomed to....you just don't know what they are yet. Taste buds will change as your diet changes.
If it ends up working as good as you want it to, the price you have to pay in terms of food choices is almost a steal. You can't get a better deal than that.
At least you aren't gluten intolerant. If you were, your diet would be permanently restricted for the rest of your life. Not a bad thing though. Even normal healthy people feel better when they go gluten free. The wheat of the Bible days is not the same as the wheat of today, which has been horribly contaminated by some pretty serious genetic manipulation. Which reminds me, how do you know you gluten isn't a problem? Have you had the lab test? Ever tried a gluten free diet for a couple weeks to see what happens? I only ask because you would not be the first person who miraculously improved if you tried that and it worked. The time to really start taking a close look at issues such as gluten, toxicity, glutathione, microbial loads, and such, is when a bunch of meds haven't worked out....which basically is logic screaming at us saying we are barking up the wrong tree looking at the wrong stuff.
All that said, Nardil imo has more potential than probably any other meds you've taken. The only ones I am aware of that stand above the crowd include parnate, nardil, prozac/tca, prozac/ritalin, zoloft/tca. I think we could pretty much pretend all the others don't exist and people might be better off because of it. Weird I know. Just an opinion.
Posted by floatingbridge on August 14, 2011, at 15:59:23
In reply to Re: New on Nardil, posted by policebox on August 14, 2011, at 0:55:52
Policebox, glad to hear you are doing o.k. on the parnate.
Good luck Cass!
Posted by Cass on August 15, 2011, at 12:05:45
In reply to Re: New on Nardil, posted by bleauberry on August 14, 2011, at 8:47:10
Thanks for the input, everyone. I feel better about it, not quite so scared. Hey, so far the side effects for me are sleepiness and I feel more emotional than usual. I'm usually on the stoic side, my emotions stay bottled up. On this drug I find myself crying. Anyone else experience this?
This is the end of the thread.
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