MAOI and diet restrictions

[drownouttheworld]

Hey everyone. Here goes my first post here...

I have in my possession a prescription for the MAOI patch, Emsam. If I decide that I want to go ahead and use it, I can start on it in two weeks. I’d be starting at 6mg, so I wouldn’t have to worry about the diet restrictions, but if I needed to go any higher then it would come into play. Here’s my deal, truth be told, I highly doubt I’d follow the rules. I don’t think I’ve specifically go out a break them in a self harm kind of way, but I know that I’m not really all that concerned about my safety right now that and won’t make the effort to go out of my way to restrict my diet because of a medication.

I’m not really looking for people to chime in on if they think I should or should not start this drug under these conditions (but if you want to, go for it, I can’t stop you anyways). But I am looking to see if anymore has knowledge or experience on fudging with the MAIO diet and what it feels like?

Thanks.

[SashaSue]

Fudging the MAOI diet is a very, very, bad idea. Potentially lethal kind of bad.

[bpladybug]

Hey everyone. Here goes my first post here...

I have in my possession a prescription for the MAOI patch, Emsam. If I decide that I want to go ahead and use it, I can start on it in two weeks. I’d be starting at 6mg, so I wouldn’t have to worry about the diet restrictions, but if I needed to go any higher then it would come into play. Here’s my deal, truth be told, I highly doubt I’d follow the rules. I don’t think I’ve specifically go out a break them in a self harm kind of way, but I know that I’m not really all that concerned about my safety right now that and won’t make the effort to go out of my way to restrict my diet because of a medication.

I’m not really looking for people to chime in on if they think I should or should not start this drug under these conditions (but if you want to, go for it, I can’t stop you anyways). But I am looking to see if anymore has knowledge or experience on fudging with the MAIO diet and what it feels like?

Thanks.

What does it feel like? You must mean what does it feel like to have a stroke. Gee, it strikes without warning. Don't you know that high blood pressure is called the silent killer? And it can be worse than death. You can be trapped in a body that will not respond, or unable to speak, or unable to dress yourself, feed yourself. Or even have chronic central nerve pain that makes depression look like a walk in the park. Have you ever seen anyone after a stroke who could not move one half of their body? I encourage you to do more research and think, really think about your decision. Your blithe attitude that you would not change your diet. That is why high blood pressure is taken so seriously by doctors. I have already had one friend have a serious stroke. He was a smart and clever IT guy. When I visited him in the hospital he could not speak intelligible words. Just murmur mush that was incomprehensible. He was under 40.

[Katyusha]

You might come across patients on the Web who say "I'm on [any MAOI] and I don't really follow the diet and I've been fine".

This is dangerous territory.

Hypertensive crises are not 100% predictable; getting away with it once doesn't mean the second or third time will be safe at all.

Plus, the same type of food can vary somewhat in tyramine content across different sources/samples.

So could someone "fudge the diet" and not end up in the ER the first few times? It's possible.

But...

Is it worth risking death, neurological damage, vascular problems, and 'the worst headache of your life' (as I've heard it described) for a piece of cheese or some soy sauce with your sushi? Is it worth all that to avoid asking the waitress "what's in the sauce?" Fuck no.

Should you try Emsam? I can't say.

The diet is only recommended at the 9mg/24h and 12mg/24h patches, as you know, but drug interactions still have to be followed at the lowest-dose patch (6mg/24h).

So I would ask yourself if you feel you can follow those restrictions, too.

(Drug interactions should pose somewhat less of a risk at 6mg than at the higher doses, but we're talking about interactions that could be fatal, so the risks are still not so pretty.)

What you might do is try the 6mg/24h patch for 3-4 weeks and see how you feel. If you feel some improvement, maybe it will motivate you to learn about the diet and try it out for a week to see how you do.

It doesn't take a huge amount of planning after studying it at first, you just learn vigilance - it becomes a reflex.

And if you're trying Emsam, it means you've probably had several failed antidepressant trials, and not a lot of options left among the newer antidepressants. So I'm guessing you have some desperation at this point. If it starts to look promising at the lowest dose, you might just re-examine your feelings about the diet.

Ultimately if you do consider going up to the higher-dose patches, you have to talk with your doctor about the realistic chances of you following the diet.

MAOIs can be amazing drugs for the treatment-resistant. But they demand a lot of patient compliance. Many, if not most doctors are reluctant to prescribe them because of this.

I ultimately found it worthwhile to live with the restrictions.

[AirMarshall]

I would encourage you to give the Emsam patch a try, and follow whatever directions apply to it.

As I understand, it doesn't really have any dietary restrictions due to the low dosage level. However, I would NOT tempt fate by doing something reckless like going out on the town to a food festival with draft beer, aged cheese and salamis, vintage wine and kippers and sauerkraut!

Extreme high blood pressure might have symptoms like headache, unwellness, dizziness, nose bleed, but it may not, and the only symptom might be a stroke, fatal or not.

I agree that I would have a hard time complying with the MAOI diet.

The up side is that MAOI's have helped many a number of members who have had little luck with the more common meds.

Let us know how it works out. a.m.

[drownouttheworld]

Thanks for the responses. I’m still debating if I am going to fill the prescription.

Like Katyusha guessed, I’ve tried a ton of other antidepressants, without success. My psychiatrist has even brought up the possibly of ECT or vagus nerve stimulation (um….no on both counts).

I do appreciate what everyone has said I am taking everything into consideration. Believe it or not, I’m a bit “scared straight” by what bpladybug said. The way I was thinking was if I die on this drug, I die. But not really considering all the possibilities short of death. I’m not at all concerned about the drug interactions with MAOI’s, because I don’t ever take anything over the counter and I always get my meds at the same pharmacy. (the only caveat with drug interactions would be knowing enough to be dangerous in committing suicide, but one would hope that wouldn’t be an issue).

Another thing that is causing me pause is that I’ve felt GOOD for six day IN.A.ROW. I sure as hell don’t want to take this medicine if I don’t need it, but I highly doubt a stint of six days could really be considered remission, especially consideration I couldn’t leave my house last weekend because I felt so bad. Not sure I want to have to get to the point where I feel I need it to start taking it and than have to wait for it to kick it (if it’s going to work).

I realize you all know next to nothing about me but I would appreciate any thoughts, opinions, advice from anyone. At this point I really don’t know what to do.

[Guest Vapourware]

Glad that you have been feeling better and that you're reconsidering your original plan of not completely following the MAOI diet. I guess it's not so much the risk of death that is problematic [although dying is not good]; ending up living with permanent physical issues over something which could have been avoided is, IMO, nearly as bad.

Six days is probably not long enough to determine whether you're in remission. I can't offer any explanations to your lift in mood but there's always a possibility that you will crash again. ADs - when working - will lift your baseline mood up so even on down days, you wouldn't crash into the bottom of the abyss. Whether or not you take the Emsam in the end is up to you, though.

I'm not sure if you are seeing a therapist but it might also be an idea to see one. They can help you with coping strategies and sometimes, just having someone to talk to about issues is really beneficial.