Symptoms of hypertensive crises include:
- heart palpitation,
- chest pain,
- increased or decreased heart rate,
- neck stiffness or soreness,
- sweating, and
- dilated pupils.
Bleeding in the brain also may occur. Patients should be aware of signs and symptoms of hypertensive crisis and should seek immediate medical treatment if these signs or symptoms are present. Hypertensive crisis may be managed with nitroprusside (Nitropress), labetalol (Normodyne, Trandate), or phentolamine.
Orthostatic hypotension (feeling faint upon standing due to decreased blood flow to the brain) also occurs. Patients should rise slowly from a sitting position to reduce the effect of orthostatic hypotension. Orthostatic hypotension may be treated with steroids.
Some patients may experience peripheral edema (swelling of the lower legs and ankles) which can be improved by wearing support stockings.
Weight gain also occurs during MAOI therapy, and tranylcypromine (Parnate) causes more weight gain than other MAOIs. MAOIs also are associated with sexual side effects such as decreased sexual drive, erectile dysfunction, difficulty ejaculating or reaching orgasm. Sexual side effects may diminish with time or a reduction in dose.
What drug interactions may occur with MAOIs?
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