Posted by frank_23423 on January 21, 2019, at 20:07:12
Long story short - I have varied between Nardil and Parnate for almost 20 years. Neither has been perfect, but they've given me my life back when all else had failed.
Have been on Nardil at about 60-90 mg for some 5 years straight, which is probably the longest stretch on either med for me.
Over the years, I've hated the weight gain, sexual problems, etc of Nardil and have tried to come off it several times, usually going back on it after hitting rock bottom a few months later. Note that I've never had a problem with restarting either Nardil or Parnate after waiting two weeks or so, and usually I'd ramp up to my effective dosage pretty quickly after a few days of low doses.
About 3 months ago, I decided to taper off Nardil slowly in order to try Cymbalta as it wasn't one of the ones I tried many years ago. I took my last 15 mg mid November, and by that time I was in pretty bad shape - heavy depression, lying in bed all day, ignoring all contact with the outside world, sporadic hours of sleep here and there, isolated, etc. But I wasn't concerned because I knew I could always just go back to Nardil and get better in a few weeks.
Washed out two weeks and took my first 60 mg of Cymbalta. 2 hours later I woke up to the worst panic attack I've had in about 20 years.
Over the next two weeks I tried to take very small amounts of duloxetine, and anytime I'd get up to about 20 mg which is the minimum starting dose, I'd wake up to terrifying delrealization / panic. By this time, I was obviously not only depressed but severely anxious.
Threw in the towel on Cymbalta and decided it was time to go back to Nardil and throw Cymbalta into the ever-growing pile of failed AD drugs.
Waited a week for the last of the Cymbalta to wash out and began Nardil with the plan to work my way up to 75 mg or so over the next two weeks.
About three days at 15 MG, three more days at 30 MG, and then, on the 7th evening, finally worked my way up to 45MG.
Woke up a few hours later with yet another massive panic attack that seemed to drain whatever remaining amount of 'happy chemicals' were left in my brain.
Though I'd been in bed for the past three months nearly 24/7, I now couldn't sit still. I was pacing back and forth, waiting for more panic attacks, couldn't concentrate, watch tv, read a book, racing thoughts, terrified. It is very traumatic even thinking about it over two weeks later.
Went to urgent care and got 3 days of Xanax to get me through till an appointment with my GP who told me to again start taking 30 MG Nardil and 0.5 mg Klonopin "as needed".
I tried to only use the klonopin at night, but every time I went up to 30MG of nardil, I'd get more panic attacks now even during the day, more racing thoughts, awful suicidal thoughts.
Finally got an appointment with a PDOC who I've only met once for an initial consult, and he told me to go back to 15MG of Nardil, take 1.0-1.5 of klonopin as needed to 'get some breathing room' from the panic attacks.
5 Days of 15MG of Nardil and 1.5 MG Klonopin have kept the panic attacks and racing thoughts at bay for now, but the depression is now pretty bad as I feel hopeless. The drug I need the most right now has turned against me, and I'm deathly afraid of now adding a Klonopin addiction to my list of problems by the time I ever get up to the 45-60 MG at a few weeks I'll likely need to (hopefully) no longer need benzos for anxiety. The depression may take longer, but who knows as I was only off of Nardil for a few months and may respond far more quickly than someone who has never used it.
Today I've moved up to 22.5 MG of Nardil along with the 1.5 MG of Klonopin, and we'll go from there in a few days.
I feel I'm at the lowest I've been in 20 years, if not ever.
Any advice would be appreciated. Especially with regard to how much Klonopin is too much, how aggressive I should be in moving up dosages, etc. I feel like my life has literally unraveled in the past three weeks.
poster:frank_23423
thread:1102898
URL: http://www.dr-bob.org/babble/20181024/msgs/1102898.html