Posted by Adam on December 8, 1999, at 0:22:55
In reply to Re: Ask a silly question..., posted by Adam on December 7, 1999, at 0:38:30
Check it out:
J Affect Disord 1985 Sep;9(2):137-41Attempts to attenuate the 'cheese effect'. Combined drug therapy in depressive illness.
Pare CM, Al Mousawi M, Sandler M, Glover V
Although earlier results, employing intravenous tyramine challenge, had indicated that a tricyclic antidepressant plus monoamine oxidase inhibitor drug
combination might be free from the 'cheese effect', the experiments reported here, involving oral tyramine challenge during the combined therapy, showed
that relaxation of a tyramine-free diet during such a drug regimen might be unsafe. Preliminary observations indicated that combined (-)-deprenyl plus
nonselective monoamine oxidase inhibitor therapy might lead to an unacceptable degree of orthostatic hypotension without reduction in tyramine sensitivity.PMID: 2932486, UI: 86034975
Looks like somebody has tried my idea 15 years ago (not for tranylcypromine-associated spontaneous hypertension specifically, but the use of
selegiline as an antidote to hypertension in combination with non-selective irreversible MAOIs). It would seem the adverse effect was hypotension.
Here's another interesting abstract:Acta Physiol Hung 1990;75(4):321-36
The effect of various monoamine oxidase (MAO) inhibitors on the response of blood
pressure of rats and cats to tyramine.Abdo-Rubo A
Department of Pharmacology, Semmelweis University of Medicine, Budapest, Hungary.
The "cheese effect" is the clinically most important side effect of structurally different MAO inhibitors. It occurs mainly as a result of the interaction of
MAO inhibitor with tyramine in foodstuffs. Anaesthetised rats and cats were used in order to investigate and compare the influence of the effect of
tyramine by selective MAO type-B inhibitors with that produced by non-selective and A-selective MAO inhibitors on the one hand, and on the other hand,
different MAO-B inhibitors with (-)deprenyl. (-)Deprenyl was the only one which inhibited the effect of tyramine in the experimental animals used, while
other MAO inhibitors potentiated the tyramine effect. Therefore this study indicates that not only non-selective and A-selective inhibitors potentiate the
effect of tyramine but selective inhibitors of B-type MAO as well. The inhibition of tyramine uptake by (-)deprenyl is a remarkable exception from the
rule.
Appears selegiline really is an antipressor drug. Maybe the combined effects of MAO-A inhibition and tyramine overwhelm its sympatholytic properties,
and that's why high-dose selegiline and low-dose selegiline+MAOI aren't protective against the "cheese effect". But maybe it might work for less potent
sympathomimetic stimuli. Perhaps Parnate+low dose selegiline as an antidote isn't completely out of the question.Just a thought.
poster:Adam
thread:16095
URL: http://www.dr-bob.org/babble/19991123/msgs/16407.html