Posted by PeterMartin on December 22, 2015, at 18:53:50
In reply to Re: Nardil washout and then restart, posted by john locke on December 22, 2015, at 17:12:18
> Should I be worried that side effects haven't kicked in yet at day 16? Maybe tiredness is kicking in; I'm not sure. I've read that sides can be a sign that the med is working.
Side effects are definitely a good indicator.
I take Marplan (the most similar MAOI to Nardil) and had to restart it twice this year. Once due to an insurance issue (off Jan through March then restart) and then most recently I stopped taking Marplan from Oct 30th through Nov 17th (over 2wks).
In Sept/October I noticed my blood pressure was elevated (140ish/95ish). I take 4meds total and tried taking less of each for a day or two at a time but was unable to get it to come down. Prior to noticing it elevated in Sept it had been 117/76 in March (at my last Marplan restart) then in July/Aug 100ish/60ish (which I now believe is thanks to Marplan).
When I noticed the elevated bp get to 160/110 late Oct I went to Urgent Care. Of course they assumed it was the Marplan causing a problem as MAOis are most known for potential to cause hypertensive crisis. What I found out later is that originally MAOis were originally prescribed as anti-hypertensives and in general should lower bp (See: http://www.psychotropical.com/maois-and-blood-pressure-anti-hypertensive-effect).
But yea to get to the point after I stopped my bp didn't get worse but it didn't improve either (stayed 140-150 over 95-100 mostly). Meanwhile my mood tanked. I started sleeping from 11pm until 10am when I used to get up before my gf around 6ish to get breakfast and then find something to get into. I was hurting mentally pretty badly.
My doctor let me restart Marplan on Nov 17th. I've journaled everyday since Oct regarding changes to try to narrow down what med was doing what. So due to that I can tell you some date events on this most recent Marplan restart:
Nov 17: Restart (at 30mg which is slighly under recommended dose but what I was on previously from 2011-2014 and then spring/summer 2015)
Nov 24: First earlier wake day. Instead of waking up at 9am this is where I started having a few days getting up ~7am. Which for me is nice. I don't oversleep. So something was happening.
Nov 28: Noted as "First real early wake day". Started getting up at 6:30 read to go out to grab breakfast/etc.
Nov 29: First time I noticed my Blood pressure on my home cuff down a bunch. I got 120/85 but as it turned out it kinda went back up for a while to 135/95.....either way the was some bp affect starting to take place.
Dec 9th: Saw my doctor and he advised to go to 40mg Marplan (recommended dose after a wk per pdr) for a wk then go to 50mg. The max recommended dose of Marplan is 60mg. So now I'd be in the middle of the recommended range rather than 10mg below which I had been in times before.
Dec 15: BP still around 135/95
Dec 16: 130/89 - Marplan to 50mg
Dec 20: 126/90
Dec 21: 117/79
Dec 22 (Today): 98/68
So yea for me it take about a month to notice the side effects. In my case the hypotension side effect is super beneficial as I'd probably need bp meds if it weren't for Marplan. I think when Urgent care took me off it cold turkey I had a bit of rebound hypertension.I also checked my earlier 2015 restart and I startted on 5/13. I measured my bp on 5/17 and was concerned w/ a 150/90 reading. I didn't have a cuff at the time so I just waited it out only checking weekly and the main drop happened around 6/10 (90/70).
Sadly my ability to orgasm has also pretty much gone away the last couple of days but I've had that come and then go away after a period of time. I also noticed when I stopped Marplan in early '15 and also in Nov I started have the opposite of anorgasmia (premature actually)....which was kinda nice. But yea that was another side effect that just started coming around the last few days (about a month) after restarting Marplan on Nov 17th......the increase to a good dose was probably needed and I now believe that is probably why I had elevated bp in Sept/Oct - I actually needed a dose increase on Marplan not a reduction/cesesation.
But yea I would say in my experience stopping and restarting has worked fine. My mood is great and I'm ecstatic that my bp has come around. I'd give it at least a month to 6wks. Watch for the low bp on standing. Watch for libido. Those sorta things.....
Sorry if this reads terrible as I'm writing it stream of thought, I didn't intend to write this much, and I'm not going to proof-read :) That said maybe it'll be insightful and good luck!!
poster:PeterMartin
thread:1084766
URL: http://www.dr-bob.org/babble/20151119/msgs/1084886.html