Posted by ChicagoKat on October 11, 2012, at 12:35:57
In reply to Nardil only working half the time. Appt tommorow., posted by enndub on October 11, 2012, at 11:26:50
> So my Nardil is making me feel mildly bipolar. My anxiety is still significantly better (all the time) than it was before Nardil (but not as good as it had been after about 2 months on Nardil). My dysthimia will go for a few days and then come back for a few days.
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> I was on 60 mg for 10 weeks and have been on 75 mg for 6 weeks.
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> I'm not sure if it's a lack of sleep or stress thing (I've been having trouble keeping up with my school and work due to Nardil fatigue) or if the meds just aren't working. I was on Vyvanse prior to starting Nardil for ADD, but I was thinking that the inattention symptoms were caused by anxiety. Now I'm thinking I just have ADD in addition to atypical dysthimia and social anxiety (maybe generalized? not sure).
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> I had some ideas that I'm hoping to discuss with my psych at my appointment tomorrow, and am looking for some input here since people on this board tend to be pretty knowledgeable about this stuff.
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> 1. Add Nuvigil to hopefully counteract the Nardil fatigue and ADD.
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> 2. Add Lyrica or Baclofen to hopefully take are of the residual anxiety (I get temporary relief from dysthimia after a good social interaction (mood reactivity?) so maybe knocking out my anxiety will knock out the residual dysthimia?)
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> 3. Up the dose to 90 mg, since my side effects are pretty mild and I am dreaming again. Not that I mind dreaming, but I thought you weren't supposed to dream on Nardil?
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> 4. Add Lamictal. Seems like there is a lot of overlap between bipolar II with mixed states and anxiety with atypical dysthimia. I have never been on a mood stabilizer or AP mostly due to fear of anticholinergic side effects (I get bad restless legs/akathisia from ACh antagonists and some antihistamines like mirtazapine) and cognitive side effects.
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> 5. Change meds? I have never tried a TCA or Wellbutrin (but I have been on Strattera + Mirtazapine witch didn't help at all with anything).
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> Sorry for the scattered thoughts and I would appreciate any input anyone here can give me.
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> Thanks!
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> Nick
>Oh Nick, it's funny you should say that, b/c Nardil is making me feel mildly bipolar now too, but I think it's just normal ups and downs at the start of therapy. I've never been the least bipolar after decades of atypical depression. So mood stabilizers - I've tried Lithium and Lamictal - did jack sh*t for me. Unless you are truly thinking you might be bipolar, personally, I'd stay away fromt them cos they both have potentially dangerous side effects.
How long have you been on Nardil? I'm so scared that it will help and then poop out on me after a while like all drugs seem to do. Do you think that might be what's going on with you?
I think Lyrica is a good idea, but I personally think Neurontin is a better one. I admit I am prone to experience side effects often, but Lyrica made my depression worse. And it didn't work very well for me either. Neurontin had no affect on my depression, and it helped with my anxiety much more. The only problem I've had with it is a rapid build up of tolerance, but again, I'm prone to that.
An AP is certainly not a good option; it doesn't mix with an MAOI, and if you get akathisia from even drugs with antihistaminic properties, you are almost guaranteed to get it from an AP.
Hopefully one of the true experts like Scott will chime in with some better recs than I can offer. But I hope I've helped even a little bit. Good luck with the pdoc tomorrow; be sure to let us know how it turns out.
My best,
Kat
poster:ChicagoKat
thread:1028340
URL: http://www.dr-bob.org/babble/20121009/msgs/1028352.html