Emsam + cold from hell

[weordmyndum]

Okay, I know this is probably one of those "Just call your freakin' doctor" questions, but it's the weekend.

I started Emsam last week, and now I'm having either really bad allergies or the cold from hell, plus the Death Cough I get every fall/winter (sounds like TB but is just an upper respiratory infection.)

I have an appointment with my psychiatrist Wednesday and my GP on Thursday, but I'm pretty miserable right now. I know most cold medicines are a no-no with an MAOI, but is there ANYTHING I can take? I'd really like to sleep without coughing myself awake or feeling like my sinus cavity is going to explode.

[helloheartbreak]

call your pharmacist, or even any 24 hour pharmacy in your area. they usually know better than the prescriber anyhow, I've found.

[notfred]

It is the decongestant in many cold medicines that is a No No with MAOI's. Dextromethorphan, for cough, is OK. Antihistamines and benadryl are OK. The OTC sleep meds are OK. OTC pain relievers are OK.

nf

[weordmyndum]

Hmm. Google tells me Benadryl can cause serotonin syndrome, but it's so hard to know with MAOI's what's actually likely to cause interactions and what's people covering their asses/scare tactics.

[Katyusha]

The risk with antihistamines is really the sedation, I found. MAOIs can make sedatives a lot stronger (much like they make stimulants stronger), i.e. additive CNS depression.

Two Benadryl (50mg) on 9mg Emsam (no Ativan even) and I slept for twelve hours, and felt like I couldn't move the whole next day - felt like it was almost too much effort to breathe. Really, really sucked, and it was kind of scary. If you look up the older oral MAOIs, where the interactions are more fully documented, you'll find an interaction listed with antihistamines - check out aidsmeds.com's Check My Meds.

It may be fine for you (it's not a Major interaction, but a risk), so if you do go for an antihistamine, start at the lowest possible dose, clear your calendar for the next several hours, and see how you do.

Guaifenisin is harmless as long as it's not compounded with other stuff (dextromethorphan, phenylephrine, etc.).

Gargling with salt water (I find snorting it clears the sinuses, mum taught me that one but it's not so tasteful), breathing steam...there are some basic home remedies that work pretty well.

[Moil]

I can't find enough information that isn't completely vague, so I don't want to make any  suggestions besides speaking with a pharmacist on the best meds to use.  I'm fairly sure you can just harass one of the pharmacists at a drug store.

[weordmyndum]

I did get in touch with my doctor early this afternoon. He said guaifenesin and Benadryl are fine. I took both about 5 hours ago, and they are not really helping. Now my ear's hurting, too. I have a feeling I'm going to end up on antibiotics--ugh.

[Moil]

If you haven't already started, water is about the best thing you can do for a cold.  All of that mucus fleeing your body can leave you quite dehydrated.  A state that hampers your ability to fight off the cold.  Another plus is that when you are better hydrated, mucus thins out and feels less like concrete.

I guess I'll stop spouting junk that you probably already know.  I hope you get over this soon.

[weordmyndum]

I've been alternating between ice water and hot herbal tea in an attempt to soothe my sore throat...and running to the restroom constantly. :-) But this crud seems to be getting worse instead of better. I'm supposed to be seeing my new PCP Thursday, but it was intended to be a first visit, and I don't want to suffer that long if I don't have to. Might call my psychiatrist back tomorrow and see if he'd be okay with writing me a scrip for a short course of antibiotics, which always clears this crap up in a few days.

[null0trooper]

The risk with antihistamines is really the sedation, I found. MAOIs can make sedatives a lot stronger (much like they make stimulants stronger), i.e. additive CNS depression.

It's not really the same. Antihistamines work on a neurotransmitter the MAOIs don't directly affect - acetylcholine. The stimulants release, and to an extent inhibit NA/DA reuptake - while MAOIs in general prevent monoamine oxidase from breaking them down once they're pulled back into the nerve cells (there's also variable effects on serotonin release/uptake with the stimulants)

Most common decongestants are sympathomimetics which work on adrenergic receptors - interaction via central and peripheral noradrenaline systems. Dextromethorphan inhibits (or is suspected to) serotonin, so there's a potential interaction there.

I did get in touch with my doctor early this afternoon. He said guaifenesin and Benadryl are fine. I took both about 5 hours ago, and they are not really helping. Now my ear's hurting, too. I have a feeling I'm going to end up on antibiotics--ugh.

Try the children's liquid Benadryl (or equivalent) - it seems to help numb the throat going down, if nothing else. Just don't go overboard on it. Diphenhydramine overdose really sucks (and can be dangerous)

[vanderk]

I'll also encourage the op to call her PCP to make sure this really a cold. Sounds like an unusual amount of misery going on and a throat maybe too sore. Visiting a doc for a suspected cold sounds like overkill, but life on an MAOI can make one have to re-shuffle the lifestyle deck until you really know how you'll react to various things.

Also to the op: I like the snippet from Louise Gluck. I was really drawn to her poetry in my college days. I confess I haven't read any of her poetry since the early 80's. Makes me want to search her.... I hope you're feeling better real soon. I'm a whiney pussy when sick.