Post Azilect administration, b/p bumps up for a few hrs

Despite considerable searching through my diet and supplements for sources of substances known to interact with Azilect causing hypertension I still experience a mild rise in b/p for 5-6 hours. For example, in the am before any meds or food my b/p can be 115 to 125. Then I take Azilect with water and no food and starting in about an hour and a half my b/p begins to rise but not so much as to be alarming just to the upper 130s and lower 140s. The b/p peaks in about 3 hrs then gradually returns to normal. Before I removed green tea's theanine substance from my routine my b/p was rising to way over 150. Now I believe I could live with taking Azilect on an empty stomach and with no other meds or food for 6 hrs. but I'd rather have a more normal morning so I am going to make a gradual change in the time of day for Azilect to bedtime, which is also when I take an aspiring for blood thinner. I hope this works out because I feel that Azilect has helped control my PD and I've only taken it for a couple months.

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  • I was put on Azilect when i was first DX and i never knew if it worked or not i was also put on Requip at the same time. II continued to take it for 9 years. I was having major problems in the evening. I would get depressed, cry about every thing, get anxious, mad, my emotions were going crazy. So i stopped taking all my meds and started them back 1 at a time but did not include Azilect and now i have no problems with my emotions.

  • Emotional breaks are the last thing I need. I have a huge responsibility, caring for my spouse an MS patient. A stable mind is needed. Thanks for that info.

  • I'm doing OK on it as far as emotional stability. But then I also take Zoloft and that helps me a lot!

  • You take Zoloft and you take Azilect? Aren't there any warnings you have been given to read about not mixing those? Does the doctor know it? Please? reference.medscape.com/drug...

  • Yes.... The doctor insisted it was fine to take the two of them and actually wrote that on my prescription for Azilect. I also was taking Trazodone which is another SSRI but I have weaned off of that.

    My doctor says this a selctive MAO-b inhibitor has no negative reaction with SSRI's like the old MAOI's do. The FDA forced the warning on the product even though there was never a case of any problems just because of the old you can't mix MAOI's with SSRI's.

    My brother's son happens to be a drug rep for this product in New York and he confirmed what the Neuro told me.

  • Thanks for posting, I was worried.

  • Buzz, I have only taken it a few months but I believe it has helped by giving me more energy. Frankly though I wish I had more energy. Bailey I don't notice any negatives regarding emotions. It is overall positive and I believe it has helped my tremor though I also started exercising so I think it is a combined benefit. Buzz, what kind of improvement have you seen?

  • No decrease to speak of in the resting tremor that I would credit to Azilect, I wish! Since using Azilect I do note decreasing foot shuffle, increased stamina for walking and recovery of ability to do things with my dominant hand, for example, things that required a good pincer grasp with the thumb and forefinger that were hard like buttons, shoe laces...etc. However in the interest of full disclosure, I started (I know some think this is nuts) using fire ant "therapy" about a week or so before beginning my Azilect Rx. So I cannot be sure which of those things or if its a combo of them that is helping to recover failing hand/finger abilities. Nutty fire ant "therapy" is easy, I allow a couple of fire ant bites to my effected hand every few days, no big deal. Easy to find fire ants around here. If you have not read my prior post on fire ant venom's piperidine substance, please give me the benefit of the doubt and type search terms, fire ant, piperidine, parkinson's, budipine and the like to learn about Lundbeck pharmaceutical's Parkensan product and the research behind it.

  • Hi Buzz, fire ants, now you surprised me with that one; I am glad you see improvement. I asked because it seems that the comments regarding improvement from azilect are a little vague. More energy is important to me and if it is slowing progress of PD of course that is important. I agree that it is smart to monitor that and I still take a nibble of bleu cheese now and then. Are you exercising? I have had to lay off now for almost a week (other issues) and I really miss the boost from exercising. It also makes me feel a lot better in terms of my frame of mind.

  • Oh yes I exercise almost 2 or 3 times every day even when it is hot outside because warming up seems to be helpful. Especially, warming up is helpful for me because my poor MSer spouse benefits from chilling the ambient temp down into the 60s and I get cold, honestly. So, I go out and walk pushing myself to walk as fast as I can without appearing like a drunk in a hurry :) What exercises did you enjoy?

  • I failed to note you think I was vague in describing improvements. Aah, what's vague in writing that my pincer grip for buttoning has gotten better? I don't know? But if you'd like specifics, my wife who is dependent on me for my help with dressing noticed it also, noticing how much quicker my hand is working at buttoning and zipping and tying her shoe laces. Specific enough for you?:) I am reticent to use the word recovery as it isn't supposed to occur, but that is what appears to be occurring. Maybe that is why I wrote vaguely, I do not wish to be encouraging people to go out and find fire ant mounds just because I have a nutty experiment going on.

  • Buzz, oh sorry I just meant that I find comments about azilect generally vague and I am guilty of this too. Perhaps it is because I can only report generally feeling better and more energetic ... I walk/ run with my husband early AM ... Not a natural runner like he is so I get a real workout, 3-4 miles each morning. I like yoga and think it is important to stretch. It also builds strength.

  • You are so blessed to still be able to run. Now I am envious of you. I remember being capable of fluid movement, jumping over bushes, running the stands at the football stadium. Good times.

  • Buzz you know I am grateful and I tell myself that every time I get out there even though it is grueling sometimes

    I am glad that you are getting out there too.

  • This is very interesting. I have never heard of fire ant therapy. Please keep us posted on this treatment.

  • Hi Buzz. I am not an expert but can pass on the information I have received from reliable sources.

    Azilect and all other MAO-b inhibitors inhibit the natural breakdown of dopamine. They also inhibit the breakdown of a substace called Tyramine. Tyramine is the cause of the rising B/p, so you shoud avoid eating food that contains tyramine. Look on Google for all the foods containing tyramine. From memory, the foods containing the most tyramine are warmed-up food, Jerky, mature cheese, and anything that has been standing around a long time before being eaten. Warming up yesterday's dinner is not the way to go when you take MAO,b inhibitors.

  • Thanks John

  • John, I just love potato salad and cole slaw, which might have been consumed by me the next day, I'm not saying. But I'll do an experiment on it one day after I get a normal b/p. I'll eat some of my favorites from the tub they come in from the grocery wait a couple hrs. and see what the b/p did. I knew about tyrosine by reading the instruction from the MD and from the internet info on Azilect warnings and I do no longer to my knowledge eat fermented/aged foods. I did enjoy balsamic vinagrette on a salad but on the possibility it contains tyrosine I threw it out when I got Azilect. There was no other fermented food in my kitchen or refrigerator or on my common diet. BTW on the off chance you thought I confused theanine with tyrosine, look it up and you will find that tyrosine is not the only food substance beginning with t and ending with ine that causes a significant rise in b/p when taking Azilect. :)

    reference.medscape.com/drug...

  • Hi Buzz. The chemical that MAO-b medication inhibits the breakdown of is TYRAMINE, not tyrosine.

  • "MAO-B inhibitors help to block the breakdown of dopamine in the brain. This makes more dopamine available and reduces some of the motor symptoms of PD."

    "Taking some MAO-B inhibitors with the heavy consumption of aged cheeses or wines high in tyramine carries a risk of raising blood pressure to dangerous levels, but this "cheese effect" has not been found in selegiline and rasagiline. The FDA has relaxed food restrictions related to MAO-B inhibitors."

    parkinson.org/understanding...

    Non-selective MAO inhibitors, which inhibit both MAO A + B, cause high blood pressure:

    'The major side effect with the use of first generation of non selective monoamine oxidase (MAO) inhibitors as neuropsychiatric drugs was what became known as the "cheese reaction". Namely, potentiation of sympathomimetic activity of ingested tyramine present in cheese and other food stuff, resulting from its ability to release noradrenaline, when prevented from metabolism by MAO. The identification of two forms of MAO, termed types A and B and their selective irreversible inhibitors resolved some of this problems. However irreversible MAO-A inhibitors continue to induce a cheese reaction, whereas MAO-B inhibitors at their selective dosage did not and led to introduction of L-deprenyl (selegiline) as an anti-Parkinson drug, since dopamine is equally well metabolized by both enzyme forms. "

    ncbi.nlm.nih.gov/pubmed/146...

  • You know that goes over my head

  • What the above means is selective MAO-b inhibitors prevent the breakdown of striatal dopamine (and not tyramine) when taken at prescribed doses. Consequently, drugs like selegiline and rasagiline (Azilect) will not cause high blood pressure even if someone eats food like cheese and wine which contain tyramine. If selegiline and rasagiline are taken either with anothe (irreversible) MAO-b inhibitor or in a larger than prescribed dose, then high blood pressure will result when a person eats tyramine containing food.

    It also means that MAO inhibitors which selectively and irreversibly target MAO-a (or are non-selective, meaning they target both MAO-a and b), will raise blood pressure when a person eats tyramine containing foods like cheese and wine.

    So taking more than 1 MAO inhibitor is a dangerous affair and caution should be taken to make sure multiple MAO-Is are not taken in addition to the prescribed drug. Herbal MAO-i are many and they include: EGCG (B), quercetin (A), St. John's Wort (B), Polygonum multiflorum (B), Kava kava (B), piperine (B), resveratrol (B)...etc.... The difference between herbal and most drug MAO-Is is herbal inhibitors are reversible and not likely to raise blood pressure even when coupled with other herbal MAO-Is. The perfect example is the combination of curcumin with piperine. Curcumin is a reversible MAO-a inhibitor and piperine, a reversible MAO-b inhibitor. 20 mg of piperine has been shown to potentiate the absorption of curcumin by 2,000% and if there have been no cases of tryamine induced high blood pressure by people taking this supplement.

    Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers.

    ncbi.nlm.nih.gov/pubmed/961...

    Newer pharmaceutical MAO-Is are reversible and thus are more safe and highly unlikely to cause high blood pressure. The MAO-s xadago is reversible and a HU participant posted a thread about its efficacy in his therapy:

    healthunlocked.com/parkinso...

    In so many words, pharmaceutical MAO-Is are finally catching up with natural MAO-Is in safety and effectiveness. So if anyone reads this thread and wants to take a good MAO-i (safely) curcumin and piperine is a good idea:

    amazon.com/gp/search?ie=UTF...

  • Basically, tyramine is a product of tyrosine and, in large enough quantities, tyramine is a releasing agent for certain catecholamines which include noradrenaline and adrenaline. The MAO-a enzyme catabolizes, breaks down, tyramine and when MAO-a is irreversibly inhibited it prevents the break down of tyramine thus releasing noradrenaline and adrenaline which raise blood pressure. This is why I think the tyrosine and not the theanine caused your blood pressure spikes. Especially when tyrosine is accompanied with piperine. Piperine makes CoQ10 30% more bioavailable; Vitamin C 50% more bioavailable; curcumin 2,000% more bioavailable; resveratrol 1,544% more bioavailable; rifampicin, a TB antibiotic, 44% more bioavailable.

  • whoosh:)

  • Wow! black pepper does all of that? Good thing it's a spice found in all the grocery stores. Just think if it had only just been discovered by a big pharma and they had a proprietary grip on distribution how much a little black pepper would cost.

  • right tyramine, not what I typed :)

  • John, i remembered to experiment, using my left overs, using tubs of left over potato salad and coleslaw from the grocery store that have been in the fridge for a week. Living dangerously?! :) I ate my lunch before the football game today, Sunday, having hot, fresh, rotisserie chicken, the old potato salad and coleslaw with a nice cup of iced tea. I followed it up with a couple of bromelain/quercetin caps for metabolizing the chicken protein because I hope that helps to maintain sinemet efficacy despite the protein consumption. I don't know I'm just optimistic. After half an hour awhile I took my b/p and it was still normal 110/72. Yay!

  • Hi Buzz. You really do live dangerously!

  • Buzz I meant to add, if I follow this regimen, I stay fairly energetic and upbeat so this is a good formula for me right now. I have been unable to work out for the past week due to a completely different issue and definitely feel the difference. My husband and I live in Florida and we run out doors so it is very hot that is why I would get up so early. Cold weather is much worse for me too. I have been considering exercising in the gym.

  • Oh yes, exercising in a gym with company to talk to and find support with. That would be great for me too. Twenty years ago I used to work part-time assisting at a gym after my regular job. It is a positive environment. Lifts one up I miss the optimism and spirits of people doing group activity, working out to be better at their sport or just to improve appearance.

  • I like a gym for air conditioning! Wow, living in Florida, AC is a beautiful thing. Also the variety is nice. Running or fast walking outside is also nice though. This morning we stumbled on a pretty botanical park. While I complain about the heat, the water is beautiful.

  • This morning my waking b/p was 118/78 so I know that the movement of the Azilect to a wee hour time has worked. And, as an experiment that I planned, I have restarted taking decaffeinated EGCG, which I assume has little theanine in it after the decaffeinating process. Hope I am right and EGCG decaffeinated does not adversely effect my b/p because EGCG was helping my dry eye issue and I think my visual acuity for my hobby, target shooting.

  • Well I have learned that even decaffeinated EGCG must contain a significant amount of something that will cause hypertension interacting with Azilect. At 11 am b/p was 137/90 and now 11:40 it is 148/97. Anyone want some unopened decaffeinated EGCG?

  • I'm taking my Azilect before bedtime and knock on wood have had no increase in BP. I just saw the doctor yesterday and it was 124/84 when the nurse took it.

    I didn't ask when I was suppose to take it when it was prescribed to me but since I think I read it could cause drowsiness I figure night time would be best.

  • Theresa I ran a thread recently titled Azilect, what time to take, morning or evening? You may find it helpful. I now take it in the morning.

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