Posted by SLS on December 21, 2015, at 7:21:26
In reply to Re: Nardil washout and then restart, posted by john locke on December 20, 2015, at 20:56:55
> > My GUESS is that being on Nardil for only two weeks would not set you up for what is called "drug-induced drug-refractoriness" (not responding a second time to the same drug).
>
> Say I wanted to see if I could treat my depression without medication after being on Nardil for a while. Could I just drop the dose of Nardil down to,say, 15mg a day so that it has no therapeutic effect but still stays in my system?Do you think this would guard against the "drug-induced drug-refractoriness"?That's an excellent thought. However, I wouldn't go into Nardil treatment with that plan in mind. If Nardil does work, you would be taking a chance of losing the full therapeutic effect by reducing the dosage so low for an extended period of time. What you are proposing is untested, and I don't think it is worth the gamble.
I think you should first consider the course of your illness in your decision making process. How often do you get depressed? Have you been moderately-severely depressed more than three times in your lifetime? How long has your most recent episode lasted for? If your depression is recurrent or chronic, I would consider indefinite treatment. Social anxiety is a somewhat different story. It may be possible to reduce its severity using psychotherapeutic tools. Even if there is no "reason" for your social anxiety, CBT or DBT can be helpful. It is hard to predict how successful such therapies would be, but it wouldn't hurt to try. Anxiety and depression can reinforce each other. It is possible that reducing one will improve the other.
> > What are your concerns with taking Nardil?
> Mainly poop out and sexual dysfunction
Which drugs are you considering that do not have the potential to exhibit these things?
I don't think Nardil poop-out would affect the potential for other drugs to work. In other words, I doubt there is the same sort of cross-tolerance as might be seen between SSRIs. Therefore, poop-out should not be a concern. Many people, including myself, have lost the ability to achieve orgasm when starting Nardil treatment, only to see it resolve after a few months. It might take longer to orgasm, but pleasurable sensations are not reduced. Just keep trying.
> > What drugs have you already tried?
> lexapro and zoloft. I didn't really give either an honest go because I really just wanted the NArdil scriptMy impression is that you feel that you should try other drugs first. This is logical, especially since you have not given a single antidepressant or anxiolytic a chance to work. I would consider trying Effexor first. In my estimation, it is more effective than the SSRIs for treating depression, and more effective than most for treating anxiety disorders. Effexor is also less likely to poop-out and produce sexual side effects from what I can see. It can be more difficult to discontinue than most of the SSRIs (which can also be difficult), but if it does work, you won't have to worry about this. I have discontinued Effexor 300 mg/day three times using a flexible taper. I didn't suffer. Everyone is different in so many ways when it comes to neurobiology. My taper method might not work for anyone else but me for all I know.
What do you think?
You will still have to wait two weeks from your last dose of Nardil before you can start a serotonin reuptake inhibitor, including Effexor. Nardil stays in the system longer than Parnate, so I would wait the full 14 days. You should be able to taper the dosage and discontinue Nardil within a week. Perhaps you can reduce the dosage by 15 mg every two or three days.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1084766
URL: http://www.dr-bob.org/babble/20151119/msgs/1084830.html