MAOIs, a little about them

WinnieNinnyPoo had stated on my last post the very truthful statement that just because a side effect can happen doesn't mean it will.  And that made me realize that I may never have talked much about MAOIs and the restrictions and the difference from a side effect.  And people in general don't know, and therefore they get insulted sometimes when I can't eat ________ or they don't believe I can't and that I am being picky.

MAOIs work differently than other antidepressants.  Instead of affecting serotonin and/or norepinephrine they block chemicals called monoamines (the I stands for inhibitors).  When these meds are in the body they can interact with an amino acid called tyramine.  Tyramine is mostly found in soy products, aged foods (cheese, alcohol, aged meats, sauerkraut) or foods that have spoiled even slightly (and other things I don't care about and didn't learn, although I do know many products and brands that use soybean oil as a main ingredient)`, and I assume in a lot of meds (it might also be that any med can potentially trigger the same side effects the MAOI has is contraindicated.).  If you eat tyramine or have a reaction to a med your blood pressure can skyrocket and kill you.

Obviously this means that starting an MAOI is a commitment to watching out for interactions.  The foods I pretty much have down although I've messed up slightly a few times without issues (I've never had more than a tiny amount of what is off limits).  The meds are too many to memorize, especially since I also have a list of meds that I can't take with lithium and a list of meds I'm allergic to.   I also don't want to memorize them and have anyone rely on me to know them as I do with lithium because a mistake could be literally fatal if it's the wrong mistake.

That's why I was upset last night.  It's not a side effect, it's totally contraindicated and inappropriate for me to have that med.  It's like my doctor having me eat a huge chunk of cheese.  At this point in my life side effects are nothing; put me on a med, pick about 5 of the worst side effects and you've got my life.  I don't care about side effects and I deal with a lot of them.  I do care about dying or having a stroke though and that is where the problem lays.  Even though my blood pressure was fine when I checked it doesn't mean that I had I taken another dose or two it would have been fine.

Last year I got severely dehydrated and the patch was new to me and I didn't know I had to remove it if I was dehydrated.  The contents of it concentrated in my blood stream putting way more than was safe out there.  When you're really dehydrated your blood pressure should be low; due to the patch concentrating it was quite high for me.  That's all it takes; MAOIs are volatile meds and that's why they are very rarely used (you have to fail on basically every antidepressant out there to wind up on one of these usually) even though they are extremely effective.

And there's your  psychopharmalogy lesson for the day...