Posted by TJ99 on January 26, 2009, at 2:21:30
Hello all,
This is my first post here, but I've been reading for several months now. So let me start by saying "Thank you!" to Dr. Bob and to all the many members who have shared their knowledge and experience.
I have suffered from dysthymia and anxiety for the last 18 years or so, and tried nearly every SSRI with little benefit. I finally found a doctor that was eventually willing to try something besides yet another SSRI in early 2008. I started on Nardil 45 mg back in June of 2008, and gradually increased the dosage to 90 mg in late November/early December (I weigh about 210 lbs). Shortly after moving to 75 mg in August, I had a few days of hypomania (which was quite pleasant) and no anxiety. That ended quickly enough and I was pretty level. Not euphoric, but not thinking about suicide for the first time since, oh, I don't know, Bush 1 maybe? The next few months were ok, but by December I felt like I needed to increase again. Things were going along fairly well at 90 mg until Jan 2, when I started feeling very strange, walked into the kitchen, and passed out. I woke up a few seconds later with my 8 yr old over me, and I asked if she had any idea how I had gotten down there, because I sure didn't.
The ambulance came and my heart rate dropped to around 30 bpm as they were loading me in. I had several instances like that until I was released 4 days later, including two where my heart just stopped for 5-6 seconds. I lost most of my memory of the period starting from a day or two before I went into the hospital up to the day I got out. Maybe 15% wasn't erased.
So my doctor reduced the dosage to 60 mg. It's been twenty-four days now, and I can feel the depression and anxiety starting to come back. I'm trying to figure out what to do. I'm doubting that my doctor will want to go back to 90 mg. He has mentioned augmenting, with lithium in particular. I'm just wondering if it makes sense to augment Nardil when I'm only at about 2/3 the suggested dosage for my weight.
I haven't had any heart issues since I got released. But my head is foggy...hard to concentrate, hard to focus my thoughts. Feel slightly dizzy.
I have a lot of questions at this point...if anyone wants to give me their thoughts I'd be most appreciative:
- Has anyone ever heard of this type of thing happening with Nardil or another MAOI? I thought I had read most everything over the last several months, I don't think I came across anything like this.
- Do you think it is worth even trying to augment with lithium at Nardil 60 mg when 90 mg is what worked for me? Any other augmenting meds you would suggest?
- Is this a risk with ALL MAOIs, or is this just peculiar to Nardil? I'm wondering if it would be worth it to switch to another one. My anxiety is too high to make Parnate attractive, but Marplan sounds like a possibility.
- I was taking 240 mg ginkgo biloba/day because I didn't realize it wasn't recommended for people on MAOIs. I'm wondering if that might have played a role? My prescribing dr and the cardiologist just dismissed it as unimportant.
- On a side note, I'm pretty sure I have some degree of attention deficit disorder. I'm amazed I made it through high school, to say nothing of college. Any suggestions for meds that could be used to address this while I'm on an MAOI? Okay, I admit I'm slacking here, and haven't searched on that topic much yet. I do recall reading someone saying that some of the stimulants could be added in a very careful manner to the MAOIs.
Thanks all!
TJ99
poster:TJ99
thread:876250
URL: http://www.dr-bob.org/babble/20090104/msgs/876250.html