A patient with baroreflex failure should avoid certain drugs and foods since they may cause or worsen an episode.
Mechanism: elevation of norepinephrine concentration at synapses
Drugs of abuse:
(1) cocaine
(2) amphetamines
(3) other stimulant drugs
Anti-depressants:
(1) tricyclic antidepressants (blocks the norepinephrine transporter)
(2) monoamine oxidase A inhibitors (MAOI)
Selective serotonin release inhibitors (SSRI) may be a safer alternative if an antidepressant is indicated.
Pressors:
(1) yohimbine (unless being used to treat an episode of hypotension)
Other:
(1) tyramine-rich food or beverages
(2) prednisone
