doxylamine
Greenlighter
- Joined
- Aug 8, 2010
- Messages
- 47
So I won't bore you with too much history but I've been on this medication a while and for an even longer time in the past, more than familiar with it basically.
If you're familiar with it you probably know that is known for being the "safe" user-friendly MAOI being a *Reversible* Inhibitor of Monoamine Oxidase A. Drug interactions are somewhat less likely and you don't have to worry about avoiding high tyramine foods, or so I thought..
I have previously never experienced any sort of adverse effects or noticeable tyramine-mediated pressor response. I ate everything. Aged cheese, red wine, tap beer, tempeh, kimchi, miso, soy sauce, sesame etc. Everything you're advised to avoid eating on an irreversible MAOI I have enjoyed without consequence (except bacon, vegetarian here) and I had concluded the threshold was just too high to be of any practical risk.
Anyway, this Tuesday evening I had made a stirfry with lots of soy sauce and a neighbour had brought over some kind of sweet tart made with tahini (sesame version of peanut butter). I had to rush out of the house quite quickly to help a friend nearby after I plated up for dinner/dessert and simply assumed my partner would put it all away in the fridge while I was gone so I left it all out. I took longer than expected and returned several hours later to the food still on the table but figured there was no meat or dairy so it would probably be fine, how ever bacterial action on tyrosine food can increase tyramine content.
I didn't even think about tyramine though
I never think about tyramine.
5-10 minutes after finishing all the food while sitting on my phone I got the most unbelievable headache unlike anything I've had in my whole life that all came on over the course of 15 seconds, tops. Absolutely splitting, cutting and it felt like my blood vessels were bursting. Quickly followed was the most intense anxiety imaginable. I thought I was going to die and it hadn't even been 60 seconds yet.
I took a Clonidine immediately, partner and I went straight to the ER (down the road) thankfully and I was taken straight through where more symptoms presented and it was determined that I was not only in an obvious hypertensive crisis, but SEROTONIN SYNDROME.
I had clonus, agitation, hypervigilance, confusion, nausea, tremor, auditory hallucinations, shivering yet hyperthermic, hypertension, tachycardia, anxiety, the persisted 'thunderclap' headache as they called it, etc, all of it.
They pretty quickly gave me 20mg of diazepam and a serotonin antagonist. Probably cyproheptadine but I cannot be sure due to a bit of amnesia from the diazepam, I do specifically remember the nurse saying "and this one is one is an antiserotonergic" specifically.
Anyways I basically passed out after that, vaguely remember being CT scanned and then was given a lumbar puncture the next day to make sure I had no bleeding on the brain, which thankfully I did not.
Anyways, I just want people to be aware that Moclobemide isn't necessarily as safe as many users and Doctors claim. It seems there is a reachable threshold where tyramine can be hazardous and I just want people to be careful.
As for the serotonin syndrome, which I definitely had due to the official diagnosis and response to the prescribed course of action, I am still curious as to how that happened... If anyone has any ideas I'd love to know. Too much tryptophan too in my meal perhaps?
If you're familiar with it you probably know that is known for being the "safe" user-friendly MAOI being a *Reversible* Inhibitor of Monoamine Oxidase A. Drug interactions are somewhat less likely and you don't have to worry about avoiding high tyramine foods, or so I thought..
I have previously never experienced any sort of adverse effects or noticeable tyramine-mediated pressor response. I ate everything. Aged cheese, red wine, tap beer, tempeh, kimchi, miso, soy sauce, sesame etc. Everything you're advised to avoid eating on an irreversible MAOI I have enjoyed without consequence (except bacon, vegetarian here) and I had concluded the threshold was just too high to be of any practical risk.
Anyway, this Tuesday evening I had made a stirfry with lots of soy sauce and a neighbour had brought over some kind of sweet tart made with tahini (sesame version of peanut butter). I had to rush out of the house quite quickly to help a friend nearby after I plated up for dinner/dessert and simply assumed my partner would put it all away in the fridge while I was gone so I left it all out. I took longer than expected and returned several hours later to the food still on the table but figured there was no meat or dairy so it would probably be fine, how ever bacterial action on tyrosine food can increase tyramine content.
I didn't even think about tyramine though
I never think about tyramine.
5-10 minutes after finishing all the food while sitting on my phone I got the most unbelievable headache unlike anything I've had in my whole life that all came on over the course of 15 seconds, tops. Absolutely splitting, cutting and it felt like my blood vessels were bursting. Quickly followed was the most intense anxiety imaginable. I thought I was going to die and it hadn't even been 60 seconds yet.
I took a Clonidine immediately, partner and I went straight to the ER (down the road) thankfully and I was taken straight through where more symptoms presented and it was determined that I was not only in an obvious hypertensive crisis, but SEROTONIN SYNDROME.
I had clonus, agitation, hypervigilance, confusion, nausea, tremor, auditory hallucinations, shivering yet hyperthermic, hypertension, tachycardia, anxiety, the persisted 'thunderclap' headache as they called it, etc, all of it.
They pretty quickly gave me 20mg of diazepam and a serotonin antagonist. Probably cyproheptadine but I cannot be sure due to a bit of amnesia from the diazepam, I do specifically remember the nurse saying "and this one is one is an antiserotonergic" specifically.
Anyways I basically passed out after that, vaguely remember being CT scanned and then was given a lumbar puncture the next day to make sure I had no bleeding on the brain, which thankfully I did not.
Anyways, I just want people to be aware that Moclobemide isn't necessarily as safe as many users and Doctors claim. It seems there is a reachable threshold where tyramine can be hazardous and I just want people to be careful.
As for the serotonin syndrome, which I definitely had due to the official diagnosis and response to the prescribed course of action, I am still curious as to how that happened... If anyone has any ideas I'd love to know. Too much tryptophan too in my meal perhaps?