Posted by Chairman_MAO on March 8, 2006, at 11:32:26
In reply to Re: Trying MAOI for first time, posted by Gregor on March 8, 2006, at 8:11:17
Nardil is a very unique drug. It has, for better or for worse, an astounding array of varied effects. Keep in mind the following:
--For most people, the ideal therapeutic dose is 1mg per kilogram of bodyweight in divided doses (ideally three equal doses, perhaps four). I believe a lot of people's problems with this drug are a result of inadequate dosage and/or only once or twice daily administration.
--It will take many months for your body--brain and otherwise--and mind to adjust. Initially, I had a severe constellation of side effects (edema, orthostatic hypotension, constipation, urinary retention, the "Nardil nod" (especially in the afternoons), myoclonic jerks that interfered with sleep and scared my girlfriend, impotence, difficulty achieving orgasm, and marked insomnia. I gained some weight, but I went to the gym so I put it to good use. After four months, 3/4 or more of the side effects had waned. After seven months, the orgasm issue suddenly got markedly better. Side effects that went away completely were: constipation, urinary retention, "Nardil nod", orthostatic hypotension. The only one that never improved was insomnia, which I deal with using 10-15mg Ambien or 3-6mg Lunesta nightly.
--The monograph's assertion that there is a lower "maintenance dose" seems incorrect to me.
--A lot of what you think may be weight gain might instead be merely water retention. Hydrochlorothiazide 25-100mg every other day or every day works well for this. I believe I have retained up to 10+lbs of water at times (possibly 15).
--Testosterone plus a dopaminergic drug, with or without a PDE5 inhibitor (Viagra/Cialis/Levitra) is the best treatment I have found for the sexual dysfunction. Testosterone is very safe to use intermittently for BOTH MEN AND WOMEN (women use a lower dose obviously, as little as 1mg, whereas men use 5-10mg+). Androgel 1% testosterone gel comes in a dispenser that gives 1.25g per pump. Thus, even women can benefit from this treatment.
I have taken testosterone in very large doses via intramuscular injection as well. Again, if used INTERMITTENTLY, e.g. two to three times per week, it is virtually harmless in most people.
--D-amphetamine is a great agent to use for fatigue, sexual dysfunction, the "foggy" feeling that you may get (GABA-T inhibition probably), etc. 2.5-20mg two to three times daily.
--Get an updated MAOI diet; the food list included with the monograph is woefully incorrect and needlessly restrictive. The only things I make sure to eat as little as possible of are: fermented soy products, fava beans (l-dopa content), the brine in pickled herring (blech), spoiled bananas/meats/etc (yuck), banana peels (haha), heavily aged cheeses (processed cheeses are OK, so is goat cheese, mozz., any provolone I've had, and frankly most cheese, air-dried/cured sausages/meats. I have eaten all of these by accident or on purpose now and then, and only got "the headache" ONCE (it was not as bad as a hangover) while on Parnate after eating some soy-based sauce by mistake. I took some clonidine and it went away.Best of luck!
poster:Chairman_MAO
thread:617008
URL: http://www.dr-bob.org/babble/20060304/msgs/617463.html