Northward Midget Pole to Pole

MAOI Log

This is a log of what I've put into my body since starting an MAOI. In my case, Tranylcypromine (AKA "Parnate").  MAOI dietary restrictions are notorious, and my hope is that this will help guide those going through the same transition to this class of anti-depressants. The primary "evil" ingredient is tyramine, although there are quite a few other little nasties one is supposed to avoid if following a cautious MAOI diet.

Every damn day

  • Klonopin 0.5mg (morning)
  • Simvastatin (morning)
  • Provigil 300mg (noon)
  • Klonopin 1mg (evening)
  • Coffee (~4 cups)
  • RYO Drum tobacco cigarettes (~6-10)

2/28/2011 Day 1 - 10mg x1

  • S'mores Pop Tarts (x2)
  • Wegmans Bite-Sized Shredded Wheat (several handfuls)
  • Spaghetti and Meatballs (2 servings)
  • Peanut butter sandwich
  • Whole organic milk
  • Apple

3/1/2011 DAY 2 - 10MG x1

  • Strawberry milk
  • S'mores Pop Tarts (x2)
  • Wegmans Bite-Sized Shredded Wheat (several handfuls)
  • Peanut butter sandwich
  • Whole organic milk
  • Wegmans Animal Crackers (handful)

3/2/2011 DAY 3 - 10MG x1

  • Wegmans Homestyle Waffle w/Maple Syrup
  • Wegmans Bite-Sized Shredded Wheat (several handfuls)
  • Grape tomatoes (handful)
  • White seedless graps (handful)
  • Tuna sandwiches (tuna in water, Hellmann's Mayo, Dill pickle relish, Hot Salt, Sriracha, crushed red pepper, black pepper)
  • Homemade Snickerdoodles (a few, no ill effects)

Notably, I skipped Chinese food tonight.  The sick girls wanted dumplings and the sick wife wanted Moo Goo Gai Pan, so I got 'em, but did not touch them for fear of MSG or soy interactions.

3/3/2011 DAY 4 - 10MG X1

  • Homemade Snickerdoodle
  • Wegmans Homestyle Waffle w/Maple Syrup
  • Chipotle chips and hot salsa
  • Peanut butter sandwich
  • Cinnamon toast the littlest didn't finish

I think this will be the last day I log every damn thing I eat or drink.  From now on, only the different things, or things that disturb me.

3/4/2011 Day 5 - 10mg x2

  • Cheese pizza (x4 slices, Muscarella's Pizza, Williamsville, NY)
  • BBQ chicken wings (x2)

So I tried pizza, albeit without pepperoni.  I was afraid to risk even half-pepperoni lest its tyramine bleed into my safe zone.  It's been about an hour, and no ill-effects yet.  I haven't been able to Google the average onset of a hypertensive crisis after ingesting a forbidden food.

3/5/2011 day 6 - 10mg x2

  • Chicken McNuggets (~dozen)
  • Ketchup w/ copious Sriracha sauce
  • McDonalds french fries

3/6/2011 Day 7 - 10mg x2

  • Dutch baby

3/7/2011 Day 8 - 10mg x2

  • Spaghetti w/Wegmans Basil Pesto Sauce (1 bite)

Pesto contained "Grana Panado" cheese.  I chickened out.

3/8/2011 Day 9 - 10mg x3

  • Shrimp in garlic sauce (~20)
  • Brussels sprouts in butter sauce (~20)
  • Morton Hot Salt

Apparently shrimp paste contains loads of tyramine, but no immediate effects from eating plain old shrimp.

3/9/2011 Day 10 - 10mg x3

  • Gumbo?  Jumbalaya?

Contained chicken sausage.  I had one serving, scooping out the sausage.

3/10/2011 Day 11 - 10mg x3

  • Waffles with cinnamon blue agave syrup
  • Eclipse gum (3 pieces)
  • Everything bagel w/garlic cream cheese
  • Soft tacos (~6, skip the cheese)

Cream cheese caused no problems, but it isn't supposed to, so no surprise there.  Maybe if it had been laying unrefrigerated out on the counter longer at work here on "Bagel Thursday."

The Eclipse gum was a test to see if the phenylalanine it contained would cause me any problems.  It didn't.  Phenylalanine is the ingredient you see listed on many diet products with the "Phenylketonurics - contains phenylalanine" warning.  It comes with the aspartame.

I'm thinking the warnings I've Googled apply more to medical phenylalanine supplements and not the amounts occurring "naturally" in off-the-shelf products.

3/11/2011 Day 12 - 10mg x3

  • Pepsi Max
  • Great Northern cheese pizza (1 slice)
  • Great Northern BBQ wings (x3)

Pepsi Max contains both phenylalanine and panax ginseng.  There are spotty references to ginseng being on an MAOI restricted list, but at least one reputable page purports it "may cause manic-like symptoms when combined with MAOIs."  I'm all for mania!

Anyhoo, I had a bottle over the course of three hours this afternoon and no ill effects as of yet.  Yahoo!  I usually drink two of them during my bi-weekly role-playing sessions, so hopefully I don't go into hypertensive crisis tomorrow night as we're battling a Hutt or something.

Any mania experienced is the same I used to get when taking my afternoon Provigil dosage with a Pepsi Max.  Nothing special.

3/12/2011 Day 13 - 10mg x3

  • Pepsi Max (x2 in succession)
  • Eclipse gum (x1)
  • McDonald's hamburgers (x2)

Two bottles of Pepsi Max in a row and no ill effects, so I guess it's safe in the maximum amount I consume.

3/13/2011 DAY 14 - 10MG X3

  • Pastitsio (2 servings)

My considerate wife made a separate batch for me, sans any cheese.

3/14/2011 DAY 15 - 10MG X3

Nothing new to report today.  Back on Pepsi Max daily around noon with my 10mg of Parnate (the MAOI) and 300mg Provigil.

3/16/2011 DAY 17 - 10MG X3

  • Oatmeal (w/brown sugar and honey)

3/17/2011 DAY 18 - 10MG X3

  • Spanakopita (3 squares)

Spanakopita is a Greek spinach pie.  Of those ingredients questionable for a low-tyramine diet it contains spinach, feta cheese, and yogurt.  My wife followed the Cook's Illustrated recipe (registration required); Greek yogurt may not be a standard ingredient.  It's a flaky, tasty dish.

Anyhoo, nothing bad happened, even after eating some refrigerated leftovers a few days later.

3/20/2011 DAY 21 - 10MG X3

  • Wegman's meatballs and spaghetti

These apparently contain "2% or less" of Romano, but no effect with one serving of about four meatballs.

Nothing's had any bad effect thus far, making this "restrictive diet" far less daunting, practically, than it had seemed in the beginning.  After all, it's not nearly as bad as being a diabetic or even having that phenylketonuria thing.

3/23/2011 DAY 24 - 10MG X4

  • Chicken stir-fry with oyster sauce (no soy sauce)

Today my doc upped me to four a day.  I took two between 8pm and 9pm before putting the girls to bed.  I fell asleep with the eldest, rolled out of bed at 11pm for a snack, and almost fainted several times.  Ended up spilling half our milk all over the kitchen.

So, gonna hold off on two-in-the-morning and two-at-night for now.  I'll have a main blog entry about it soon.

Anyway, oyster sauce seems fine.

3/24/2011 DAY 25 - 10MG X3

Back to three daily for today.  Nothing newly notable noshed.

3/25/2011 DAY 26 - 10MG X4

  • Subway tuna on plain Italian (lettuce, tomato, onions, banana peppers, jalapeño, Chipotle Southwest sauce)

Back to the upped dosage of 40MG.  The last 10MG was taken after 11PM, and I didn't wake up until morning, so any light-headedness probably would have gone un-noticed.

4/6/2011 DAY 38 - 10MG X4

Still on four daily.  Haven't tried two at night and two after work.  I thought I was feeling better, but had a fuck of a morning.

Nothing new on the food front.  Still no hypertensive crises.  I probably would have blogged about that.

4/10/2011 DAY 42 - 10MG X4

Fresh?

  • Wegmans Mild Italian Pork Sausage (1 link)

According to my wife, this is "fresh" sausage, so I tried it, because fresh sausage is supposed to be OK for those on an MAOI.  The package is to the right.  No crisis after about two hours.

 

4/23/2011 DAY 55 - 10MG X4

Easter Sunday brunch was at Como at the Airport in Niagara Falls, because the wife's paternal side is all Italian.  The special was an apropos ham dinner, but I didn't like the looks of the sweet potato.  So, I ordered gnocchi, thinking that would be safe, as it didn't mention any inclusion of cheese.

Well, like everything Italian, it had cheese sprinkled on it.  Probably Parmesan.  I don't know my cheeses.  I ate it, anyway, and no ill effects.

4/30/2011 DAY 62 - 10MG X4

I took the girls to a school rummage sale, then some thrift shopping.  Quizno's was nearby, so we stopped there for lunch.  Every goddamned thing has cheese on it by default.  I got the "Roadhouse Steak Sammie" because it didn't, but it did have roast beef, and I could neither remember nor expeditiously google whether or not that was acceptable.  So, I ordered it, at it, and everything was fine.

Then I got a tuna melt without the cheddar, which was far more satisfying.

This is turning out to be a really boring log.  Oh!  I almost forgot the most important part of this day -- the end.  I had two Yuengling lagers and three or four Crown and Cokes at a neighbor's bonfire while the kids played and played and played until 10:30PM.  Slight buzz, but no lightheadedness or other physical ill-effects whatsoever.  In fact, mentally, it made me feel better, as alcohol usual does.

5/11/2011 DAY 73 - 10MG X5

My psychiatrist raised my dosage to five daily on May 2nd.  He was going to go six, but changed his mind because of my relation of the milk-spilling incident.  I told him things were a little worse, but that could be situational.  I wanted to go all the way to six.

Now I'm taking two in the morning, one around noon, and two at night.  A little light-headed now and again, but mostly OK.

I've lost a dozen pounds and some change.  Not sure what accounts for that.  My daily comestibles are a pop tart when I arrive at work, shredded wheat through the day, then whatever the wife has for dinner.

Still no hypertensive episodes.

9/8/2011 DAY ?? - From Nardil to Parnate

Psych switched me to Parnate/Phenelzine.  It's still an MAOI, but a different class (hydrazine), of which most of its fellow drugs have been recalled.  He said there's no need to washout or titrate, so I went straight to the same six-a-day dosage I'd been on Nardil/Tranylcypromine.

So far, it's not so good.  I feel sleepy/high most of the day, and am more prone to bouts of "depressive flashbacks".  We'll see where it goes.

12/5/2011 DAY ?? - Torn and Patched

Parnate gave me sexual "issues" of various unsavory flavors. Or maybe it's the excessive drinking. In any case, switched to the 9mg Emsam patch to give MAOI one last try before washing it out and diving back into the mainstream. See the doc tomorrow, and will ask he do so. These aren't giving me any better results than what I've taken before, so I'd rather go back to something with less restrictions and side effects.

Oh, and I tried a Sausage McGriddle. No hypertensive crisis. I'm gonna call it safe. Your results may vary.

1/17/2012 DAY ?? - It Is Finished

Off the Emsam for a week and a few days now. The dread Washout. It's not nearly as bad as with the SSRI and SNRI. Only an occasional "brain zap." In fact, it's so "not bad" that I'm considering going off anti-depressants altogether. Not because I'm "better", but because if the last episode of crushing anxiety following my cold-turkey withdrawal was more a result of coming off the drug than baring myself to the Empty, then why bother with the drug?

(I'll keep the Provigil and Klonopin, thanks.)

So, yes, I am sliding off the final "patch" of this stint with MAOI. Soon I will be greeting my old friends pepperoni and cheddar.

In conclusion? Well, it didn't do much for me. Nothing more than any of the other drugs. Do any of these drugs help? Do they even give me the safety net I'd assumed -- do they catch me before falling into that abyss that ever-yawns for me?

Next up is "Viibryd". That's a fuck of a name, huh?

Likely more of the same. I am not hopeful. There is no magic bullet for me.

Except those of a certain gauge or calibre, of which I am too cowardly to partake.

Or, of a certain proof. Candy's dandy, but liquor's quicker.

Best of luck to anyone trying MAOI. Whether true or placebo, if they work for you, I am sincerely happy. Nobody should live with this. Nobody.