Posted by Tomatheus on April 9, 2013, at 12:46:02
In reply to Re: Nardil brand vs generic?, posted by brynb on April 9, 2013, at 11:20:34
Bryn,
I know that I've written a lot here about the old and new versions of Nardil, and I do think that many were affected by the 2003 formulation change. Unfortunately, the version of Nardil that was available until the fall of 2003 doesn't seem to be available anywhere, and nobody seems to have found a good way to get any of the new versions of Nardil to perform as well as the old version in those who don't seem to respond as well to the new versions. I had some success with putting the contents of my Nardil tablets into enteric capsules, but for reasons that I'm not 100 percent sure of, even this strategy didn't work out for me in the long run. And even when I did seem to be able to get my Nardil to be both more effective and more tolerable by using the enteric capsules, I found that the medication became both less effective and less tolerable the longer I kept my tablets in the pill bottle on my shelf. So for these reasons, even though I'd wish anybody trying the enteric capsule approach luck, I don't actively promote it.
Even though I think that there was something about the formulation change that caused some people taking Nardil to have problems back in 2003, it does seem that not everybody taking the medication was affected by the formulation change. Some have tried to argue that those affected by the change were in the majority, while others have argued that those affected represent a small minority. I don't think it's entirely clear what portion of those taking Nardil were affected by the formulation change as far as either effectiveness or tolerability were concerned, but it does seem clear from what I've read that many people taking Nardil experienced no problems with the medication when the formulation was changed. Because there is a chance that anybody starting Nardil might respond to the medication just fine (or at least in the same way that they would have responded to the "old" Nardil), I think that starting out with regular film-coated Nardil would be the most advisable thing to do.
As far as the "brands" of Nardil are concerned, it's my understanding that there are three versions available in U.S. pharmacies: the Pfizer name-brand Nardil and generics made by Gavis and Greenstone. Greenstone LLC is a subsidiary of Pfizer, and considering that the inactive ingredients in Greenstone's phenelzine are the same as those in Pfizer's Nardil, it would be my guess that the two versions should not differ in any way. The version of phenelzine made by Gavis Pharmaceuticals does differ from the Pfizer and Greenstone versions as far as the inactive ingredients are concerned. I do recall reading one or two online anecdotal reports saying that the Gavis phenelzine seemed to be better in some way than Pfizer's Nardil, but it did seem that the few individuals who were still posting on the Anxiety Community's Nardil forum (which doesn't seem to exist anymore) around the time the Gavis phenelzine came out did not find the Gavis phenelzine to be any better than Pfizer's Nardil.
I think that I should also note that I stopped taking Pfizer's Nardil after I received what very well might have been a bad batch of the medication from my pharmacy. I responded very differently to that batch of Nardil than I did to any version of the medication that I had tried previously, noticing a loss of effectiveness and the emergence of some extreme agitation. That was back in 2006. Others who were affiliated with both the Anxiety Community's Nardil forum and the Nardil Problems Action Committee had reported receiving bad batches around that time. I don't seem to recall reading as many reports of bad batches of Nardil more recently, compared to the reports that I was reading about up to around 2006, but whether that's due to Pfizer actually producing fewer bad batches of Nardil would be difficult to say. As the case was with the formulation change, I think that it's unclear how widespread the problem with bad batches of Nardil was. It doesn't seem that as many people were affected by bad batches of Nardil as were affected by the formulation change, but that's just my observation based on the anecdotal reports that I've read. I haven't read any reports of bad batches from individuals who've taken the Gavis phenelzine, and I might expect the Gavis phenelzine to be less likely to have problems with bad batches than the other version of the medication since it's made by a completely different company, but then again, I haven't read any reports of bad batches from individuals who've taken the Greenstone phenelzine, nor have I read any recent reports of bad batches from those taking Pfizer's Nardil.
So, to give you some feedback, I would say that although none of the versions of Nardil that are currently available in U.S. pharmacies are the same as the "old" Nardil, any one of them would probably be a good place to start. I think that I personally would be inclined to start with the Gavis phenelzine if I were taking the medication for depression and/or anxiety and had a choice as to which version to start out with, but the evidence for any differences between the three versions of Nardil/phenelzine seems to be extremely limited to say the least, and it's entirely anecdotal. Whatever version of Nardil/phenelzine you end up starting out with, assuming that you go ahead with taking the medication, I wish you luck. I know that I've included a lot of information in this post and that it might not necessarily make deciding how to proceed with your Nardil trial any easier, but I hope that it's been of at least some help. Please do feel free to let me know if you have any questions, though.
Tomatheus
Dx: schizoaffective disorder
Treatments: Abilify & Korean ginseng
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