![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 31. This is the beginning of the thread.
Posted by Nardilstarted2007 on November 19, 2007, at 6:13:32
Hi!(bit of a long post sorry) I have been so pleased to read all your posts and its time for me to contribute and get help from you guys. I'm sure I'll be with you all for a long time. I'm 22 and a 3rd year college student Taking Conservation Enforcement Degree and I live in Canada, I just joined last week. I started Nardil Oct 10th 2007, 5 weeks ago. I have severe SAD and Panic Disorder since I was probably very young (under 10 for SAD), it leads to depression if I don’t do anything about it.
I have tried Paxil(first med I tried in early 1994), Lexapro, Clexa, wellbutrin (on its own and as a combo), Effexor, Zoloft, Ativan, and zanax (Benzo's alone and in conjunction with the AD's.Paxil worked Great for 4 months with CBT, then I weaned down to 10mgs in hopes of getting my sex life back so I could take it a step further with some girls I knew. We would kiss, spoon, and get all into it, but when it came to where I would be expected to "finish" I would have to stop and come up with an excuse. Paxil stopped working and never worked again. Then I tried Celexa, which almost worked but didn't, Lexapro made me sleep 20 hrs a day and didn’t work, Zoloft did nothing, Wellbutrin gave me awesome sexual functioning and super interest in everything but made My anxiety and Panic the worst of all time, Effexor did nothing unless I drank which made me a hypomanic and crazy which was good at parties or the bars only! But never worked otherwise. The Benzo’s are ok but don’t help with my SAD, they just calm me down.
I tried going on paxil again this summer but it didn’t work unless I was drinking, for some reason it totally worked when I was drunk. So I became a drunk for a whole summer and lost a job. When these meds don’t work I get agoraphobia and paranoia so bad I run away or go somewhere and just drink in combination with benzo's to stop the inferno of anxiety. That’s all I Could Do Or die (I’m not suicidal and never was) I turned to alcohol and zanax and abused them every day to free my mind that was being crushed to the point of loosing sanity completely (I would cry and walk around like a mad man looking up asking WHYYYY! WHY MEE). I quit Paxil/ssris for good at the end of august 2007. I was fine for 2 weeks after because of an ssri discontinuation induced hypomania, WHOO HOOO, it was great, Like Being On a Great antidepressant with no anxiety and felt like ACE most of the time. That last 2 weeks then I dropped into my severe state of SAD, PD, and then finally depression. This was the worst of all time and just a little over a month ago. I drove home for thanks giving Oct 8 2007 (that’s when it is in Canada and had the worst time ever). I didn’t attend dinner or see my family I was too paranoid and having panic attacks) so I just left back to school without telling any one Oct 10th and stopped 2 hrs away and went into a walk in clinic and said I needed a refill of Nardil because I was going to Alberta and my insurance only covers meds in BC. So he said OK here's a script for 170nardil. OK, thanks, I said, and got into my vehicle and popped one in my mouth immediately and began my trip back to Alberta (10 hour drive) I decided to do 60mgs my first day starting exactly then ( I was still feeling so horrible as I drove for the journey with tears coming out of my eyes). When I got to Alberta I started my second day. 75mg/day exactly recommended for my weight. I said f*ck titrating I need it to kick in as SOON as possible or I’m going to fail school and run away. I wasn't going to waste time titrating for 80% maoi inhibition I wanted it by day seven so I could start waiting the 1- 8 weeks starting with full maoi inhibition. I DO NOT THINK ANYONE SHOULD EVER GO UP THAT FAST BUT I WAS DESPERATE AND DIDN"T CARE ANYMORE. Anyway I was agoraphobic for another week. Then by week two I knew I hit the target of 80% (anorgasmia, urin retention , insomnia, blurred vision, heavy arms and legs) But I would tolerate this until it worked dammit (I said) to myself. at 3.5 weeks I felt it kicking in!, By week 4 I was doing great with euphoria and the side effects were subsiding AND my social phobia was gone and depression and panic, all gone. It was GREAT with euphoria too. Now I’m at week 5 and I still have anorgasmia and constipation and insomnia. The euphoria from week 3.5 - to the end of week 4 is gone. I have much less anxiety and I’m not depressed. I’m a little unmotivated right now since the euphoria is gone. I hope it starts kicking in a bit better in the next few weeks or I might try 90mgs a day. I have a psychiatrist now so that is good. He didn’t approve of me starting right away at 75mgs but said if the side effects are ok then he’s onboard with me. Although the Nardil is working good I need a bit more to get through this semester so I’m going back to augmenting with zanax .5, 3 x a day till I’m done this semester, and I’ll use a beta blocker when I give my presentations.
That’s my story I hope you know me a bit better now. I’m a research fanatic about this stuff so I hope I can be helpful to you guys.
Thanks for listening; I’m going to have some new posts up here soon with some issues I’m dealing with on Nardil
Yours truly.
NardilStarter2007
Posted by medweirdo on November 19, 2007, at 8:06:34
In reply to Nardil! my story, im new, please get to know me, posted by Nardilstarted2007 on November 19, 2007, at 6:13:32
I'm glad to hear you've gotten some relief from the depression and hope you'll get more benefits from it.
I'm STARTING NARDIL as well in a few days after years of waiting for it.
Have tried so many medications that gave me unbearble SE or just didn't work for me.
since I'm so sensitive to meds, my p.d decided me to start with 7.5mg/day and titrat it up slowly by half a pill. but I think it's over exaggerating and prefer more SE than waiting more time for it to kick in.
Posted by Nardilstarted2007 on November 19, 2007, at 8:50:21
In reply to Re: Nardil! my story, im new, please get to know m, posted by medweirdo on November 19, 2007, at 8:06:34
> I'm glad to hear you've gotten some relief from the depression and hope you'll get more benefits from it.
>
> I'm STARTING NARDIL as well in a few days after years of waiting for it.
> Have tried so many medications that gave me unbearble SE or just didn't work for me.
> since I'm so sensitive to meds, my p.d decided me to start with 7.5mg/day and titrat it up slowly by half a pill. but I think it's over exaggerating and prefer more SE than waiting more time for it to kick in.Hi Med weirdo, good to have you abord. Your doc may be a very cautious person. starting at 15 would be a better option so if you can tolerate 7.5mgs for a short while, go for the 15, and if that works I hope you can move up quickly with tolerable SE's. Its not till you hit 80%is maoi inhibition until the clock starts ticking for it to work. But I believe the titration time it takes you to get to your optimal dosage will get some nardil working in your system so this should cut off a bit of the waiting time for the med to work once you hit your optimal dose (usually 1mg/kg of body weight per day) if you can handel it but some people get benefits fom 30 - 60mgs/day if their lucky. I do 1mg/kg of wieght so im 170 lbs devided by 2.2 = 77mg/day of nardil for me.
Keep me updated on your SE's as you go along and progress, I hope you have the courage to wait until your dose gets theraputic, RegardsNardilStarter2007
Posted by medweirdo on November 19, 2007, at 11:12:23
In reply to Re: Nardil! my story, im new, please get to know m » medweirdo, posted by Nardilstarted2007 on November 19, 2007, at 8:50:21
yea I think I'll be better to start with 15/d.
7.5 is nothing - more like eating a candy.lol, the main problem now is that becuase of defi cency the pharmacy isn't having it right now (it took me 2 weeks to cleanse myself of Paxil and now that's what they have to tell me dam*it) they'll just do everything to make me feel despair consedering that I'd already felt it anyway.
I'm hoping it'll take for no more than few days (It took me 2 years to get Nardil).
Posted by Phillipa on November 19, 2007, at 12:45:36
In reply to Re: Nardil! my story, im new, please get to know m » Nardilstarted2007, posted by medweirdo on November 19, 2007, at 11:12:23
Good luck to you and go slow. Love Phillipa
Posted by medweirdo on November 19, 2007, at 13:42:57
In reply to Re: Nardil! my story, im new, please get to know m » medweirdo, posted by Phillipa on November 19, 2007, at 12:45:36
Thank you Phillipa.
I attend to post my progress in the future whoever is interested.
Posted by Nardilstarted2007 on November 19, 2007, at 14:12:53
In reply to Re: Nardil! my story, im new, please get to know m » Phillipa, posted by medweirdo on November 19, 2007, at 13:42:57
> Thank you Phillipa.
> I attend to post my progress in the future whoever is interested.Hi, So are you saying your going to start nardil in 3 days once your pharmacy gets Nardil? And you dont have it yet? And that when you do get it you will start at 7.5mgs/day? I'm wondering if cutting the pill in half will alter the way its absorbed... does anybody know if the pills still work properly if cut in half? Where are you from Medweirdo?
NardilSatrted2007 Thanks!
Posted by medweirdo on November 19, 2007, at 15:11:14
In reply to Re: Nardil! my story, im new, please get to know m » medweirdo, posted by Nardilstarted2007 on November 19, 2007, at 14:12:53
> > Thank you Phillipa.
> > I attend to post my progress in the future whoever is interested.
>
> Hi, So are you saying your going to start nardil in 3 days once your pharmacy gets Nardil? And you dont have it yet? And that when you do get it you will start at 7.5mgs/day? I'm wondering if cutting the pill in half will alter the way its absorbed... does anybody know if the pills still work properly if cut in half? Where are you from Medweirdo?
>
> NardilSatrted2007 Thanks!
>
>
Yes, I hope the pharmacy'll get it as soon as possible my guess is a matter of days.
I more like thinking to start with 15mg/d, 7.5mg is just very low dose.
I think cutting the pills doesn't make any changes to it, that's why you have the little line on it in case like me(I guess).
As for your question I live in Israel(another big problem too).
Posted by Nardilstarted2007 on November 19, 2007, at 16:40:19
In reply to Re: Nardil! my story, im new, please get to know m, posted by medweirdo on November 19, 2007, at 15:11:14
> > > Thank you Phillipa.
> > > I attend to post my progress in the future whoever is interested.
> >
> > Hi, So are you saying your going to start nardil in 3 days once your pharmacy gets Nardil? And you dont have it yet? And that when you do get it you will start at 7.5mgs/day? I'm wondering if cutting the pill in half will alter the way its absorbed... does anybody know if the pills still work properly if cut in half? Where are you from Medweirdo?
> >
> > NardilSatrted2007 Thanks!
> >
> >
>
>
> Yes, I hope the pharmacy'll get it as soon as possible my guess is a matter of days.
> I more like thinking to start with 15mg/d, 7.5mg is just very low dose.
> I think cutting the pills doesn't make any changes to it, that's why you have the little line on it in case like me(I guess).
> As for your question I live in Israel(another big problem too).Isreal eh! wow! I hope I can travel there one day for a trip and so many other places. My Nardil Doesn't have a line on it. On my pill it's engraved "PD 270". My pills are made by Phizer, the new verson as of 2003 when they changed Nardils colour, taste and texture and excipient ingredients. People say this New Versin doesn't work as well as the old Phizer version of Nardil. I'll never know because I never got to try the old standard Nardil, I wonder who manufactures yours for Isreal, do you know?
Yes I believe very much that you should start at 15mgs. The directions still say to take 3 pills 45mgs/day to start. The Companies have not changed that even though they changed the pill ingredients a little bit in 2003. I bet your safe with 15. and from there I hope you dont have many bad side effects and can keep increasing your dosage! Good luck, Let me know when you get the pills and start!
NardilStarted2007
Posted by mav27 on November 19, 2007, at 22:39:17
In reply to Re: Nardil! my story, im new, please get to know m, posted by medweirdo on November 19, 2007, at 8:06:34
> since I'm so sensitive to meds, my p.d decided me to start with 7.5mg/day and titrat it up slowly by half a pill. but I think it's over exaggerating and prefer more SE than waiting more time for it to kick in.
>
I know it's tempting to start at a higher dose, especially since you may not feel any side effects but be carefull. I did the same thing, went up to 60mg after a couple days because i had no side effects... after just over 3 weeks i was in hospital from the side effects.. it dropped my blood pressure to 70/60 and i was fainting 10 times a day. Thing with Nardil is it feels normal at first and then just switches on overnight after a period of time and ytou may end up with side effects galore that you will regret.I've restarted the nardil this time at only 30mg and it still feels like it's working as well after 3 weeks but without the side effects of the 60mg from bfore.
Posted by medweirdo on November 20, 2007, at 2:26:02
In reply to Re: Nardil! my story, im new, please get to know m » medweirdo, posted by mav27 on November 19, 2007, at 22:39:17
> > since I'm so sensitive to meds, my p.d decided me to start with 7.5mg/day and titrat it up slowly by half a pill. but I think it's over exaggerating and prefer more SE than waiting more time for it to kick in.
> >
> I know it's tempting to start at a higher dose, especially since you may not feel any side effects but be carefull. I did the same thing, went up to 60mg after a couple days because i had no side effects... after just over 3 weeks i was in hospital from the side effects.. it dropped my blood pressure to 70/60 and i was fainting 10 times a day. Thing with Nardil is it feels normal at first and then just switches on overnight after a period of time and ytou may end up with side effects galore that you will regret.
>
> I've restarted the nardil this time at only 30mg and it still feels like it's working as well after 3 weeks but without the side effects of the 60mg from bfore.
>I have always sensation my heart is beating hard and fast , especially when I wake up in the morning maybe the BP thing will actually help me. I hope!.
Posted by medweirdo on November 20, 2007, at 2:29:40
In reply to Re: Nardil! my story, im new, please get to know m » medweirdo, posted by Nardilstarted2007 on November 19, 2007, at 16:40:19
I know a person here who takes it and said it's EFRAs. but they switched it once it was of Pfizer's.
Posted by Nardilstarted2007 on November 20, 2007, at 5:34:10
In reply to Re: Nardil! my story, im new, please get to know m » mav27, posted by medweirdo on November 20, 2007, at 2:26:02
> > > since I'm so sensitive to meds, my p.d decided me to start with 7.5mg/day and titrat it up slowly by half a pill. but I think it's over exaggerating and prefer more SE than waiting more time for it to kick in.
> > >
> > I know it's tempting to start at a higher dose, especially since you may not feel any side effects but be carefull. I did the same thing, went up to 60mg after a couple days because i had no side effects... after just over 3 weeks i was in hospital from the side effects.. it dropped my blood pressure to 70/60 and i was fainting 10 times a day. Thing with Nardil is it feels normal at first and then just switches on overnight after a period of time and ytou may end up with side effects galore that you will regret.
> >
> > I've restarted the nardil this time at only 30mg and it still feels like it's working as well after 3 weeks but without the side effects of the 60mg from bfore.
> >
>
> I have always sensation my heart is beating hard and fast , especially when I wake up in the morning maybe the BP thing will actually help me. I hope!.
>My BP has gone up since I started nardil, from 120/70 (normal for me) and now on nardil im 140/90
Posted by UGottaHaveHOPE on November 23, 2007, at 20:11:00
In reply to Nardil! my story, im new, please get to know me, posted by Nardilstarted2007 on November 19, 2007, at 6:13:32
It's great that you are giving Nardil a trial, as some say it is the No. 1 med for SAD. I am concerned that you took so much so quickly, but I really dont see that hurting you, other than maybe some freaky side effects, which should eventually go away.
Even if you start up Nardil under the correct dosage, you will have a lot of nasty side effects the first 6-8 weeks, most of which go away. These side effects are a major reason why many ppl quit the drug, which is a shame because it can be a miracle drug for some.
Many ppl would say that 6-8 weeks is a fair trial on Nardil. For me, it took 8-10 weeks for a response, and 12 for it really to kick in. Keep posting your thoughts and experiences. Michael
Posted by Nardilstarted2007 on November 23, 2007, at 20:54:43
In reply to Re: Some would rank Nardil No. 1 for SAD » Nardilstarted2007, posted by UGottaHaveHOPE on November 23, 2007, at 20:11:00
> It's great that you are giving Nardil a trial, as some say it is the No. 1 med for SAD. I am concerned that you took so much so quickly, but I really dont see that hurting you, other than maybe some freaky side effects, which should eventually go away.
>
> Even if you start up Nardil under the correct dosage, you will have a lot of nasty side effects the first 6-8 weeks, most of which go away. These side effects are a major reason why many ppl quit the drug, which is a shame because it can be a miracle drug for some.
>
> Many ppl would say that 6-8 weeks is a fair trial on Nardil. For me, it took 8-10 weeks for a response, and 12 for it really to kick in. Keep posting your thoughts and experiences. MichaelHi Michael, I sure did start at a high dose but I was so deperate for it to kick in. As I drove towards the clinic to get Nardil I was also thinking of driving off some little side trail where I knew there was a hidden lake with 2 small cabins. I just wanted to squat in one for the winter and never deal with SAD again. Im a pretty good bush man as I was a trapper for a year. But I gripped my stearing wheel and went for the Nardil and back to college for one last try (I know some Doc's dont like to perscribe it if they dont know you, but if you know what to say then they'll give it to you [probably not a good talent]). I'm one lucky guy to have been able to tolerate starting at 75 and thats the dosage im still on. I think that starting at that dose gave me the therapeutic effect alot faster (because I would have inhibited mao 80% roughly by week 1) then those who titrate (I felt it kick in at 3.5 weks). I hope it kicks in more because I sure could use a bit more boost to speak in classes and GIVE A PRESENTATION!!!!!!! my worst fear of all. Dont worry Im not letting the med do all the work I just went to my first toastmasters too.
I'll kepp you posted. Ps. I's Id love to hear your experience and where your at these days with the Nardil.
NardilStarted
Posted by medweirdo on November 24, 2007, at 11:49:54
In reply to Re: Some would rank Nardil No. 1 for SAD » Nardilstarted2007, posted by UGottaHaveHOPE on November 23, 2007, at 20:11:00
> It's great that you are giving Nardil a trial, as some say it is the No. 1 med for SAD. I am concerned that you took so much so quickly, but I really dont see that hurting you, other than maybe some freaky side effects, which should eventually go away.
>
> Even if you start up Nardil under the correct dosage, you will have a lot of nasty side effects the first 6-8 weeks, most of which go away. These side effects are a major reason why many ppl quit the drug, which is a shame because it can be a miracle drug for some.
>
> Many ppl would say that 6-8 weeks is a fair trial on Nardil. For me, it took 8-10 weeks for a response, and 12 for it really to kick in. Keep posting your thoughts and experiences. MichaelI ain't intend to hijack the thread but I would like to know how is the best way to titrate up Nardil? I'm very impatient as to getting it to work as soon as possible?.
I've already started with 15mg/d, although I think I noticed a little change in the last few days I started it(a kind of sensation which haven't felf before) with my SP/SA, but want it to fully kick in b/c my anxiety (not SP) is still high and I get very hard time studing and concentrating during exams.
Posted by Nardilstarted2007 on November 24, 2007, at 14:04:34
In reply to Re: Some would rank Nardil No. 1 for SAD » UGottaHaveHOPE, posted by medweirdo on November 24, 2007, at 11:49:54
Medweirdo, Most often when using Nardil you want to get to your theraputic dosage as soon as possible. BUT without uping the dose so quickly that your body cant adapt and you get intolerable side effects. I'd say if you've been on 15mg for a week and the side effects arent too bad, go up to 30 and see how that feels for a week. You said your really sensitive to meds and side effects so doing slow titration may be the way for you. Side effects are something you must live with at the beginning but they get better as time goes on (much better) . see how fast you can titrate up to 45 mg's per day (1 pill three times a day) If you can tolerate the side effects then GREAT! Thwn just keep slowly upping your dose if no theriputic responce is felt after a week or two. If the side effects are too bothersome then lower the dose back to the previous dose you were on and stay there a little while longer before adding another 15 mgs. The target dose is 1mg/kg of body weight, Thats an old rule of thumb but stil works. you may feel better at just 30 mgs/day or 45 or 60. some people go up to 90. I was soo desperate I didn;t listen to my doctor and thru away the dose paper. I just started at 75mgs/day and have been there for 6 weeks. I dont suggest anyone ever do that especially you if your sensitive to drugs, but just to say steadily increase your dose as long as you can tolerate the side effects. 60mgs/day is usually where people get the theraputic effect - it doest really matter when you take your pills, but most people do half in the morning and half in the afternoon, or many variations. I take 2 in the morning, 2 in theafter noon and one during the evening.
I dont know why I blabbled on for so long!! seems like that message is saying the same thing 3x in a row.. well im foggy this morning because I had to take a sleeping pill last night due to nardil induced insomnia.
Good Luck, Keep asking Questions, Others will be here soon with more input.
NardilStarted
Posted by medweirdo on November 24, 2007, at 15:01:44
In reply to Re: Some would rank Nardil No. 1 for SAD » medweirdo, posted by Nardilstarted2007 on November 24, 2007, at 14:04:34
> Medweirdo, Most often when using Nardil you want to get to your theraputic dosage as soon as possible. BUT without uping the dose so quickly that your body cant adapt and you get intolerable side effects. I'd say if you've been on 15mg for a week and the side effects arent too bad, go up to 30 and see how that feels for a week. You said your really sensitive to meds and side effects so doing slow titration may be the way for you. Side effects are something you must live with at the beginning but they get better as time goes on (much better) . see how fast you can titrate up to 45 mg's per day (1 pill three times a day) If you can tolerate the side effects then GREAT! Thwn just keep slowly upping your dose if no theriputic responce is felt after a week or two. If the side effects are too bothersome then lower the dose back to the previous dose you were on and stay there a little while longer before adding another 15 mgs. The target dose is 1mg/kg of body weight, Thats an old rule of thumb but stil works. you may feel better at just 30 mgs/day or 45 or 60. some people go up to 90. I was soo desperate I didn;t listen to my doctor and thru away the dose paper. I just started at 75mgs/day and have been there for 6 weeks. I dont suggest anyone ever do that especially you if your sensitive to drugs, but just to say steadily increase your dose as long as you can tolerate the side effects. 60mgs/day is usually where people get the theraputic effect - it doest really matter when you take your pills, but most people do half in the morning and half in the afternoon, or many variations. I take 2 in the morning, 2 in theafter noon and one during the evening.
>
> I dont know why I blabbled on for so long!! seems like that message is saying the same thing 3x in a row.. well im foggy this morning because I had to take a sleeping pill last night due to nardil induced insomnia.
>
> Good Luck, Keep asking Questions, Others will be here soon with more input.
>
> NardilStartedThank you Nardilstarted. the case is that I've been on 15mg for 4 days without any SE. are there people who gets the SE right after 1 or 2 dose?
Do you think I can up my dose to 30mg a day and see how I respond after being on 15mg for 4 days?
Posted by medweirdo on November 24, 2007, at 15:03:31
In reply to Re: Some would rank Nardil No. 1 for SAD » medweirdo, posted by Nardilstarted2007 on November 24, 2007, at 14:04:34
> Medweirdo, Most often when using Nardil you want to get to your theraputic dosage as soon as possible. BUT without uping the dose so quickly that your body cant adapt and you get intolerable side effects. I'd say if you've been on 15mg for a week and the side effects arent too bad, go up to 30 and see how that feels for a week. You said your really sensitive to meds and side effects so doing slow titration may be the way for you. Side effects are something you must live with at the beginning but they get better as time goes on (much better) . see how fast you can titrate up to 45 mg's per day (1 pill three times a day) If you can tolerate the side effects then GREAT! Thwn just keep slowly upping your dose if no theriputic responce is felt after a week or two. If the side effects are too bothersome then lower the dose back to the previous dose you were on and stay there a little while longer before adding another 15 mgs. The target dose is 1mg/kg of body weight, Thats an old rule of thumb but stil works. you may feel better at just 30 mgs/day or 45 or 60. some people go up to 90. I was soo desperate I didn;t listen to my doctor and thru away the dose paper. I just started at 75mgs/day and have been there for 6 weeks. I dont suggest anyone ever do that especially you if your sensitive to drugs, but just to say steadily increase your dose as long as you can tolerate the side effects. 60mgs/day is usually where people get the theraputic effect - it doest really matter when you take your pills, but most people do half in the morning and half in the afternoon, or many variations. I take 2 in the morning, 2 in theafter noon and one during the evening.
>
> I dont know why I blabbled on for so long!! seems like that message is saying the same thing 3x in a row.. well im foggy this morning because I had to take a sleeping pill last night due to nardil induced insomnia.
>
> Good Luck, Keep asking Questions, Others will be here soon with more input.
>
> NardilStartedThank you Nardilstarted. the case is that I've been on 15mg for 4 days without any SE. are there people who gets the SE right after 1 or 2 dose?
Do you think I can up my dose to 30mg a day and see how I respond after being on 15mg for 4 days?
Posted by Justherself54 on November 24, 2007, at 18:01:44
In reply to Re: Some would rank Nardil No. 1 for SAD » Nardilstarted2007, posted by medweirdo on November 24, 2007, at 15:03:31
It took me 3 weeks to hit 45 mg and I almost stopped it as I felt pretty horrible but then it started to work, so I'm glad I stuck with it.
Posted by Nardilstarted2007 on November 24, 2007, at 21:15:59
In reply to Re: Some would rank Nardil No. 1 for SAD » Nardilstarted2007, posted by medweirdo on November 24, 2007, at 15:03:31
> > Medweirdo, Most often when using Nardil you want to get to your theraputic dosage as soon as possible. BUT without uping the dose so quickly that your body cant adapt and you get intolerable side effects. I'd say if you've been on 15mg for a week and the side effects arent too bad, go up to 30 and see how that feels for a week. You said your really sensitive to meds and side effects so doing slow titration may be the way for you. Side effects are something you must live with at the beginning but they get better as time goes on (much better) . see how fast you can titrate up to 45 mg's per day (1 pill three times a day) If you can tolerate the side effects then GREAT! Thwn just keep slowly upping your dose if no theriputic responce is felt after a week or two. If the side effects are too bothersome then lower the dose back to the previous dose you were on and stay there a little while longer before adding another 15 mgs. The target dose is 1mg/kg of body weight, Thats an old rule of thumb but stil works. you may feel better at just 30 mgs/day or 45 or 60. some people go up to 90. I was soo desperate I didn;t listen to my doctor and thru away the dose paper. I just started at 75mgs/day and have been there for 6 weeks. I dont suggest anyone ever do that especially you if your sensitive to drugs, but just to say steadily increase your dose as long as you can tolerate the side effects. 60mgs/day is usually where people get the theraputic effect - it doest really matter when you take your pills, but most people do half in the morning and half in the afternoon, or many variations. I take 2 in the morning, 2 in theafter noon and one during the evening.
> >
> > I dont know why I blabbled on for so long!! seems like that message is saying the same thing 3x in a row.. well im foggy this morning because I had to take a sleeping pill last night due to nardil induced insomnia.
> >
> > Good Luck, Keep asking Questions, Others will be here soon with more input.
> >
> > NardilStarted
>
> Thank you Nardilstarted. the case is that I've been on 15mg for 4 days without any SE. are there people who gets the SE right after 1 or 2 dose?
>
> Do you think I can up my dose to 30mg a day and see how I respond after being on 15mg for 4 days?Hello Medweirdo, I've read so so much about nardil and other maoi's that I'm very glad to share what I've learned. I did so much studying on them because i was at the end of my rope and was obsessed to find the med that would work, Nardil is probably No. 1 for SP, Phobias and OCD and maybe depression. I take it for SP. I think you should be just fine to go to 30mgs for a week. If you get side effects that are untolerable go back to 15mg's for another week before trying 30 again. And Yes I you can feel some side effects after just a day or two just from the chemical itself. The other thing that gives you side effects is when Nardil really starts to inhibit mao. So the chemical = side effect and mao inhibition = side effects. Nardil usually takes a week before it inhibits mao to the max for whatever dosage your on (I bet 15 mgs/day wont inhibit very much, maybe 30% mao). Some people feel really bad right away just from the chemical, some dont. Some start to feel bad SE after a couple weeks once the Nardil has inhibited enough mao so that there is an increas in seratonin, Norepinepherine and Dopamine because this will alter many functions in your body. At a dosage of 1mg/kg of body weight per day, nardil should inhibit about 80% mao. AND thats where some serious side effects can kick in because you have so much DA (dop) NE (norepineph) and 5-HT (seratonin) then usual. This is what you want to acheive to get the therapeutic effect. SE's vary alot between individuals. I felt very sluggish for the first 2 weeks and heavy, poor cognative skill and a weird dizzyness which all went away by week 3.5 I knew that after one weeek at 75mgs I had achieved about 80% mao inhibition as I could feel the effects of increased neurotransmitters. but it took 2 weeks after that for it to work. And my SE's have changed to insomnia, anorgasmia and I have to follow the dietary restrictions to a point, Thats how I knew I hit good mao inhibition. For the first week I could ejaculate just fine and eat anything and sleep which ment it took 1 week to get the inhibition to 80% ish at 75mgs/day. Just because you hit enough mao inhibition doesn't mean youll start feeling better right away, it takes a few weeks for it to kick in even if you are at 80% mao inhibition. since I started at 75mg's per day I had fully enough mao ihibition after week 1 but felt no respoce till two weeks after that, making a total of three weeks. If you titrate slowly it takes a lot longer to work because you have to achieve the mao inhibition you need, then wait for it to kick in.
I think your safe to try 30 for a week 1 pill in morning, one around noon. Then if you can try 45mgs for a week or two, 1 pill in morning one at noon and one at evening. If no goodness is felt there and you can tolerate 60 mgs then try 60 mgs for another couple weeks. Who knows how much you'll need just keep ramping it up if you can tolerate it until you feel it kick in then wait there and it should do its magic. I hear it gets even better with time once you hit your magic dose, But im going to ask that on another post. If I don't get more responce in another few weeks I might try 90mgs/day.. Side effects for me are getting much better except insomnia.
I know this was a long post, ces't la vie. I'll try and get better at doing shorter posts.
NardilStarter
Posted by stargazer2 on November 25, 2007, at 0:01:08
In reply to Re: Nardil start up, posted by Justherself54 on November 24, 2007, at 18:01:44
JH54...so happy it started to work for you. It seems you have to really persevere through the side effects and the lack of response but when you do, it can really start to work better than many other meds. I had results at 30, then at 45 and now I'm at 60 and this dose feels right to me.
Wishing you continued good success with it!
Stargazer
Posted by Jedi on November 25, 2007, at 2:44:41
In reply to Re: Some would rank Nardil No. 1 for SAD » medweirdo, posted by Nardilstarted2007 on November 24, 2007, at 21:15:59
Hi,
I've been taking Nardil at 90mg for most of eleven years. I have come off four times to try newer combinations of meds. Mainly this is because of the weight gain, delayed orgasm, insomnia, and daytime sleepiness. I have tried more than forty different combinations of antidepressants and augmentors. Nothing works like Nardil for my symptoms. Each time I've been off Nardil my major depression has returned.I currently use 90mg of Nardil, 2mg of clonazepam and 25mg of Seroquel. My diagnosis is treatment resistant atypical depression with social anxiety disorder and dysthymia(double depression). IMHO I believe that Nardil is the best med for atypical depression and the combination of Nardil and clonazepam is the best for Social Anxiety Disorder. I believe that Nardil should be a 2nd tier trial if the SSRIs fail for atypical depression. Many psychiatrists use it as a last resort, even after ECT. Some won't use it at all. The med really isn't as dangerous as some of the old research implies. When was the last time you heard of someone dying from a MAOI.
I use the very low dose of Seroquel for the Nardil induced insomnia. So far it has worked better than any other med for this.
Take care,
JediReference:
Ann Pharmacother. 2006 Mar;40(3):567-70. Epub 2006 Feb 14. Quetiapine for insomnia associated with refractory depression exacerbated by phenelzine. Sokolski KN, Brown BJ.
Mood Disorders Clinic, Veterans Affairs Long Beach Healthcare System, Long Beach, CA 90822, USA. kenneth.sokolski@med.va.govOBJECTIVE: To report the successful treatment of phenelzine-associated insomnia with low-dose quetiapine in a patient with refractory depression. CASE SUMMARY: A 42-year-old white man with severe major depression unresponsive to selective serotonin-reuptake inhibitors, bupropion, and tricyclic antidepressants improved following treatment with the monoamine oxidase inhibitor (MAOI) phenelzine. Insomnia, present to a moderate degree prior to antidepressant therapy, worsened markedly following phenelzine treatment and failed to respond to diphenhydramine, temazepam, triazolam, clonazepam, zolpidem, or trazodone given at high therapeutic doses. Sleep disturbance resolved with low-dose (50 mg) adjunctive quetiapine, with no adverse effects. DISCUSSION: Major depression refractory to standard therapy is a common and serious condition. Some cases respond to MAOIs; however, orthostatic hypotension and insomnia frequently occur. Potentially serious MAOI interactions with psychotropic drugs have raised concerns about combining these agents. In this case, a failure of a number of other medications known to treat MAOI-associated insomnia safely prompted a trial of quetiapine. Despite the possibility that enhanced serotonergic activity might have resulted in serotonin syndrome, no adverse interactions between phenelzine and quetiapine were noted. The use of low-dose, once-daily quetiapine, along with its unique binding properties, may account for its increased safety in combination with phenelzine. CONCLUSIONS: This case illustrates that low-dose quetiapine may be an alternative treatment for phenelzine-associated insomnia. Further case reports are needed to establish the safety and effectiveness of combining these agents.
PMID: 16478812 [PubMed - indexed for MEDLINE]
Posted by Nardilstarted2007 on November 25, 2007, at 3:23:03
In reply to Re: Some would rank Nardil No. 1 for SAD » Nardilstarted2007, posted by Jedi on November 25, 2007, at 2:44:41
> Hi,
> I've been taking Nardil at 90mg for most of eleven years. I have come off four times to try newer combinations of meds. Mainly this is because of the weight gain, delayed orgasm, insomnia, and daytime sleepiness. I have tried more than forty different combinations of antidepressants and augmentors. Nothing works like Nardil for my symptoms. Each time I've been off Nardil my major depression has returned.
>
> I currently use 90mg of Nardil, 2mg of clonazepam and 25mg of Seroquel. My diagnosis is treatment resistant atypical depression with social anxiety disorder and dysthymia(double depression). IMHO I believe that Nardil is the best med for atypical depression and the combination of Nardil and clonazepam is the best for Social Anxiety Disorder. I believe that Nardil should be a 2nd tier trial if the SSRIs fail for atypical depression. Many psychiatrists use it as a last resort, even after ECT. Some won't use it at all. The med really isn't as dangerous as some of the old research implies. When was the last time you heard of someone dying from a MAOI.
>
> I use the very low dose of Seroquel for the Nardil induced insomnia. So far it has worked better than any other med for this.
> Take care,
> Jedi
>
> Reference:
> Ann Pharmacother. 2006 Mar;40(3):567-70. Epub 2006 Feb 14. Quetiapine for insomnia associated with refractory depression exacerbated by phenelzine. Sokolski KN, Brown BJ.
> Mood Disorders Clinic, Veterans Affairs Long Beach Healthcare System, Long Beach, CA 90822, USA. kenneth.sokolski@med.va.gov
>
> OBJECTIVE: To report the successful treatment of phenelzine-associated insomnia with low-dose quetiapine in a patient with refractory depression. CASE SUMMARY: A 42-year-old white man with severe major depression unresponsive to selective serotonin-reuptake inhibitors, bupropion, and tricyclic antidepressants improved following treatment with the monoamine oxidase inhibitor (MAOI) phenelzine. Insomnia, present to a moderate degree prior to antidepressant therapy, worsened markedly following phenelzine treatment and failed to respond to diphenhydramine, temazepam, triazolam, clonazepam, zolpidem, or trazodone given at high therapeutic doses. Sleep disturbance resolved with low-dose (50 mg) adjunctive quetiapine, with no adverse effects. DISCUSSION: Major depression refractory to standard therapy is a common and serious condition. Some cases respond to MAOIs; however, orthostatic hypotension and insomnia frequently occur. Potentially serious MAOI interactions with psychotropic drugs have raised concerns about combining these agents. In this case, a failure of a number of other medications known to treat MAOI-associated insomnia safely prompted a trial of quetiapine. Despite the possibility that enhanced serotonergic activity might have resulted in serotonin syndrome, no adverse interactions between phenelzine and quetiapine were noted. The use of low-dose, once-daily quetiapine, along with its unique binding properties, may account for its increased safety in combination with phenelzine. CONCLUSIONS: This case illustrates that low-dose quetiapine may be an alternative treatment for phenelzine-associated insomnia. Further case reports are needed to establish the safety and effectiveness of combining these agents.
>
> PMID: 16478812 [PubMed - indexed for MEDLINE]
>
>
>
Hi Jedi, Thats some good information. My insomnia is the sh**s to say the least. (I take 75mgs of nardil/day and .5 zanax 4x a day) That med combo is very similar to yours except you use clonazepam instead of zanax, I dont know which is better but my doc is a fan of the zanax, I know zanax has some downfalls but It says its better for depression and clonazepam may make depession worse, thats probably just a very small population that had that happen I bet. I have tried Tamazapam, clonazepam, Zopiclone and Trazodone. All at high doses too, Zopiclone and Temazepam just make me feel drunk, not tired. I just wasted 70 bucks on the Zopiclone I tried it for 5 days titrating up to 37.gmgs and maybe more one night. I have an appt. with my psychiatrist on thursday and I will surly ask about seroquel. I didn't before because It is a antipsychotic, and that kinda scared be because I thought it might interact with my AD or it would change me, or id get hooked on it like AD's or it would have different theraputic effects that I dont need. I have heard of people using this more often then sleeping pills with maoi's but I never looked into it (still haven't). I just figured that if I need sleep I need a strong hypnotic sleep aid. But if seroquel is the one, I will be so happy. AND me tooo I am going to gain massive weight unless I can battle the food craving nardil has given me and I'll seriously have to get back to the gym. its only been 6 weeks but I can see alredy I have put on what looks like almost 10 pounds, Im normally 160, now im 170. If I dont fight the nardil food cravings at night now I will become very heavy very fast!Nardilstarted
Posted by Justherself54 on November 25, 2007, at 9:58:17
In reply to Re: Some would rank Nardil No. 1 for SAD » Jedi, posted by Nardilstarted2007 on November 25, 2007, at 3:23:03
I also have fibromyalgia which causes it's own sleep problems. I was terrified to try seroquel at first but my nightly dose of clonazapam and zopiclone weren't helping me. Adding .25 mg of seroquel has really helped me get restorative sleep (most nights).
As for Nardil and SAD, I wasn't sure it was going to work for me, however, this past weekend I was able to go away to the city for a weekend, shopped in strange crowded stores, ate in restaurants and even took a crowded city bus by myself just cause I felt I could do it. I didn't have to take the bus, I could have taken a taxi, but I was prepared to "challenge myself" with something that would have put me over the edge a short while back. I felt no anxiety AT ALL. From the woman who could barely leave the house, this is pretty remarkable. Even though I don't feel "on top of the world" yet, I'm sure seeing some very positive changes happening.
I'm trying not to get my hopes up too high..right now I'm just scared it will poop out on me. Every SSRI in various combinations with boosters has done that..so cross your fingers for me fellow Nardilites that it keeps on working.
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