Posted by King Vultan on June 4, 2004, at 12:39:26
In reply to Any ideas on reducing AD-related hypotension?, posted by Racer on June 4, 2004, at 11:48:02
> A lot of ADs reduce my already low BP even further, and lead to me falling down a lot from a sudden drop. Does anyone know of any ways to improve this, so that I might be able to go on and stay on one of the drugs that does this to me?
>
> Thanks!
I've posted this link beforehttp://www.currentpsychiatry.com/2002_06/06_02_maoi.asp
and this is the relevant passage near the end in regard to orthostatic hypotension:
"Orthostatic hypotension is the most common early side effect of phenelzine and isocarboxazid. Clinically significant hypotension is best managed via dosage adjustment. If that fails, add Na Cl, 1 to 2 grams bid with increased fluids. If that doesn’t work, administer fludrocortisone, 0.1 to 0.4 mg/d. If that fails, administer d-amphetamine, starting with 2.5 to 5 mg/d, and observe carefully for hypertension."
I am having severe problems myself on the 90 mg/day of Nardil I am taking and have been teetering and coming close to blacking out on several occasions. It's not the typical problem where you feel dizzy after standing up quickly (I experienced that sort of thing on tricyclics), but a situation where I start having problems after sitting for a while and then getting up and walking a distance of perhaps 100-200 feet or just climbing some stairs. I had to crouch down and tilt my head forward after walking into a store last night because my legs were shaking and quivering and about to give out, combined with a definite lack of blood flow to my brain. I am not in bad condition: 5-9, 150 lbs, and jog 15-20 miles a week. I guess I am fortunate in this case for my essential hypertension because the problem would probably be exacerbated if I had a low BP as you do (unmedicated BP is 140/90, unmedicated heart rate is 75; with the Nardil, it is about 100/65, with a heart rate of 60). I do not believe I have a solution for my own problem other than to try to be careful and anticipate the dizziness/weakness attack as best I can in order to take precautionary action (crouching down, grabbing support, etc). Perhaps this might be of some benefit in your situation also.Todd
poster:King Vultan
thread:353748
URL: http://www.dr-bob.org/babble/20040602/msgs/353759.html