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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by don_bristol on August 11, 2004, at 9:36:01
Does anyone else get a *rise* in blood pressure after taking Parnate?
I get about a 20 point rise in my systolic reading and about a 5 point rise in my diastolic. This lasts for a couple of hours.
Each day I take 40 mg of Parnate. I take it as follows: 20mg at about 8am, 10mg at about midday, 10mg at about 4pm.
Parnate seems to lower my "waking" blood pressure from what it would otherwise have been. I have always taken reading 30 minutes after waking. With Parnate (last dose taken at about 4pm the day before) I get a reading of about 128/84. Before I was taking Parnate it would have been 140/95.
But now approximately 60 to 90 minutes after taking Parnate I typically get readings of 148/91.
Does anyone else get this sort of rise in blood pressure after taking Parnate?
BACKGROUND NOTE:
For my blood pressure readings, all other factors seem to be constant. Food is not a factor as I don't drink coffee or eat anything until the late afternoon. Temperature, stress, emotions, physical activity, pulse rate are all essentially the same.
Blood pressure is a very volitile thing so I make sure I get good figures by taking several readings but not so close together that I get congestion in my arm from the previous reading. I am confident I am using a good technique and I am using a reliable measuring machine.
Posted by King Vultan on August 11, 2004, at 12:22:44
In reply to Parnate RAISES my blood pressure (without food) !, posted by don_bristol on August 11, 2004, at 9:36:01
From what I have read, the spike in BP is very common. The reason for it is the stimulant effect of the Parnate and associated release of norepinephrine, which can raise blood pressure in the short term after taking a dose of it. However, at other times of the day, particularly when it has been a long time since you've had a dose of Parnate--as when you wake up in the morning--it is common to see a decrease in your natural BP at those times. Here, what is at work is the the Parnate's MAOI effect, the exact mechanism by which it lowers BP being exceedingly complicated and not particularly well understood. Keep in mind that the Parnate is really two drugs in one--a stimulant + an MAOI--and they do have different effects.
Todd
Posted by Piquet on August 11, 2004, at 18:25:38
In reply to Parnate RAISES my blood pressure (without food) !, posted by don_bristol on August 11, 2004, at 9:36:01
> Does anyone else get a *rise* in blood pressure after taking Parnate?
I don't have the means to measure my b.p., but I do occasionally notice that my heart rate increases after taking Parnate (30 mg a.m./10 mg midday). As this increase has never approached the level associated with a hypertensive episode, I'm not inclined to worry too much about it. I'm more attentive when it increases after I've eaten, although so far (6 weeks) I haven't had any significant tyramine reactions.
Piquet.
Posted by Sad Panda on August 12, 2004, at 18:09:52
In reply to Parnate RAISES my blood pressure (without food) !, posted by don_bristol on August 11, 2004, at 9:36:01
Hi Don,
Hopefully you will build tolerance to it & have your BP subside. As KV says, it is a stimulant, very similiar to amphetamine. Selegeline is similiar & does actually metabolise into methamphetamine. The other MAOI's, Nardil & Marplan are more like Benzos.
Cheers,
Panda.
Posted by don_bristol on August 13, 2004, at 13:12:23
In reply to Re: Parnate RAISES my blood pressure (without food) !, posted by King Vultan on August 11, 2004, at 12:22:44
Todd wrote:
>> Keep in mind that the Parnate is really two drugs in one--a stimulant + an MAOI--and they do have different effects. <<
Todd, I thought that Parnate's stimulant action came from Parnate being an MAOI. Of course other MAOI's (like Nardil) do not act as a stimulant. But I thought that Parnate was only an MAOI. Can you say more about the stimulant action of Parnate please?I recently looked into Medline for "tranylcypromine and amphetamine" and saw there had been some debate about what exactly did happen to parnate when it was metabolised. But I found the entries were inconclusive - probably because I did not have a big picture of what the debate had concluded.
This 1999 entry says "There is considerable debate about whether or not it is metabolized to amphetamine, with most of studies in the literature indicating that this does not occur." http://tinyurl.com/5c8pm
And this entry http://tinyurl.com/6y4uv asks "Is tranylcypromine really metabolized to amphetamine?" but no text is given.
Also " This lends strong evidence against amphetamine being a metabolite of tranylcypromine"
http://tinyurl.com/5tjg3Thanks for any further info.
Posted by King Vultan on August 13, 2004, at 19:27:13
In reply to Re: Parnate RAISES my blood pressure (without food) ! » King Vultan, posted by don_bristol on August 13, 2004, at 13:12:23
People have been debating for decades whether or not tranylcypromine is metabolized into amphetamine in the body. As the evidence you cite suggests, the answer is probably no. From the standpoint of chemical structure, tranylcypromine and amphetamine are uncanningly similar and really only differ in that tranylcypromine contains a cyclopropane ring, while amphetamine contains a propane chain. The active NH2 group is in the same relative position on both molecules (on the middle carbon of the propyl group). It seems reasonable to conclude that if the stimulant effects of tranylcypromine are not due to it being metabolized into amphetamine, than they must just be due to the molecule's close resemblance to amphetamine.
Nardil, OTOH, superficially looks vaguely like amphetamine, but it really does not seem to have any kind of direct stimulant effect related to its chemical structure. Any stimulant effect that a Nardil user might experience would only be due to its action as an MAOI in increasing the availability of serotonin, norepinephrine, and dopamine. I frankly never noticed any kind of real stimulant effect while on Nardil myself, as I found the stuff to be rather neutral; although, it could be somewhat sedating at times, particularly when I first started taking it.
Todd
Posted by gardenergirl on August 13, 2004, at 23:20:52
In reply to Re: Parnate RAISES my blood pressure (without food) ! » don_bristol, posted by King Vultan on August 13, 2004, at 19:27:13
Nardil has been quite stimulating for me once I raised the dose, as I posted in my prior thread. Now that I lowered it by half a tab, it's calmed down. But I can't have any caffeine anymore. At least not right now.
I have also had it be sedating, often in the early evening. Although not yet. It's just all up right now. sigh
Existing on four hours sleep...
gg
Posted by Ken Blades on August 15, 2004, at 4:27:49
In reply to Parnate RAISES my blood pressure (without food) !, posted by don_bristol on August 11, 2004, at 9:36:01
Hi Don~
I've been taking 70mg. of Parnate a day for about six years for SP. My blood pressure has been elevated ostensibly from the Parnate, as I was normal before starting it. Unfortunately I have gained a lot of weight in the ensuing years which contributed to the hypertension to the point where my internist has me on metoprolol[beta blocker] which works quite well.
When I knew I was going to have my BP checked, I would postpone my next dose of Parnate until after the reading was done; most of the time my BP was closer to a normal level in those cases.
I resisted taking any antihypertensive meds for the past five years[fearing some influence on the "Parnate effect"], but when my readings had begun to run into the 160's/90's range, I thought it dangerous to resist any longer[into my 50's as I am!].I certainly do not want to stop Parnate as it is the only med I have taken that works so well for SP; I have tried dozens!
I'm sure if I lost weight[extremely difficult for me], my blood pressure would drop quite a bit, so I can't blame Parnate for it all.
I do recall that in the first few years after I began taking Parnate, I would have a noticeable increase in heart rate shortly after taking my noon dose of 30mg. It was disturbing; if I still have it I do not notice it anymore.
> Does anyone else get a *rise* in blood pressure after taking Parnate?
>
> I get about a 20 point rise in my systolic reading and about a 5 point rise in my diastolic. This lasts for a couple of hours.
>
> Each day I take 40 mg of Parnate. I take it as follows: 20mg at about 8am, 10mg at about midday, 10mg at about 4pm.
>
> Parnate seems to lower my "waking" blood pressure from what it would otherwise have been. I have always taken reading 30 minutes after waking. With Parnate (last dose taken at about 4pm the day before) I get a reading of about 128/84. Before I was taking Parnate it would have been 140/95.
>
> But now approximately 60 to 90 minutes after taking Parnate I typically get readings of 148/91.
>
> Does anyone else get this sort of rise in blood pressure after taking Parnate?
>
>
>
> BACKGROUND NOTE:
>
> For my blood pressure readings, all other factors seem to be constant. Food is not a factor as I don't drink coffee or eat anything until the late afternoon. Temperature, stress, emotions, physical activity, pulse rate are all essentially the same.
>
> Blood pressure is a very volitile thing so I make sure I get good figures by taking several readings but not so close together that I get congestion in my arm from the previous reading. I am confident I am using a good technique and I am using a reliable measuring machine.
>
>
This is the end of the thread.
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