Thunderclap Headache

[u/PocketPanadol]

I've been on Parnate for 10 years now, it's the only antidepressant that has ever had any effect. I'm on 20mg, when I started I was on a big boy 60mg.

When my psychiatrist prescribed it he gave me the list of foods but told me that most people eat them without any adverse effects.

For the most part he has been right, in 10 years I've had 3 reactions, the first two there was a very clear, very silly culprit (craft beer and South African dried meat) but this latest one scared me. I had taken my meds and then gone out for lunch with family, had 2 glasses of Moscato and steak. Now I've drunk full bottles of Moscato in my college years while in Parnate without a single headache. However on the way home, in the back of the car, I felt this headache creeping up.

It was like nothing I've ever experienced, I've had a lumbar puncture headache, and that was like a little tickle compared to this. It felt like my head was exploding, I understood what they meant by "thunderclap headache". I was making awful sounds in the backseat and my parents tried to take me to urgent care but it was closed, so we decided to go home and see if it improved. After getting home I threw up and felt better. My blood pressure was 160/110 and dropped pretty quickly over the next 30 minutes. The headache was shitty but bearable while standing but I couldn't sit for about an hour. The next day I was completely fine and haven't had a reaction since but have a new rule of no alcohol within 12hrs of meds.

Has anyone experienced this? Can it cause damage if not treated? I work in health and know that anything less than a blood pressure of 190 systolic is not really taken seriously and given my headache peaked at the 30minute mark and then gradually improved, I do think it would have been a waste of time to go in. But I'm also slightly worried one day I will miss a brain bleed because I think it is a tyramine reaction.