If taken with foods that contain very high levels of tyramine ( e . g ., mature cheese, cured meats, or yeast extracts ), they may cause a potentially lethal hypertensive crisis.
22.
The diagnosis of a hypertensive emergency is not based solely on an absolute level of blood pressure, but also on the typical blood pressure level of the patient before the hypertensive crisis occurs.
23.
Adrenergic storms are not provoked often from MAOI-tyramine interactions; hypertensive crisis alone does not diagnose adrenergic storm, although there will always be hypertension in an adrenergic storm, along with tachycardia and rapid, shallow breathing.
24.
This means that the risk of a hypertensive crisis, a dangerous high blood pressure crisis from eating tyramine-rich foods such as cheese, is likely lower with harmaline than with irreversible MAOIs such as phenelzine.
25.
There is a risk of psychosis or bizarre behavior if rasagiline is used with dextromethorphan and there is a risk of non-selective MAO inhibition and hypertensive crisis if rasagiline is used with other MAO inhibitors.
26.
Unless there is a compelling reason, such as immediate heart failure or hypertensive crisis, it is better to wait and allow a washout of the drug, even if the blood pressure goes a little higher,
27.
However, because of the Reversible inhibitors of monoamine oxidase subtype A ( RIMAs ) such as the drug moclobemide, bind reversibly to the MAO-A enzyme, greatly reducing the risk of hypertensive crisis with dietary tyramine intake.
28.
The problem with MAOIs is that they have many potentially dangerous side-effects such as hypotension, and there is a risk of food and drug interactions that can result in potentially fatal serotonin syndrome or a hypertensive crisis.
29.
This could lead to loss of MAO-B selectivity, with inhibition of both MAO-A and MAO-B, which would make patients susceptible to the usual risks of unselective MAOIs such as tyramine-induced hypertensive crisis and serotonin toxicity when combined with serotonergics such as SSRIs.
30.
Severely elevated blood pressure ( equal to or greater than a systolic 180 or diastolic of 110 sometimes termed malignant or accelerated hypertension ) is referred to as a " hypertensive crisis ", as blood pressure at this level confers a high risk of complications.
