![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 31. Go back in thread:
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.
Posted by Nardilstarted2007 on November 25, 2007, at 15:10:57
In reply to Re: Some would rank Nardil No. 1 for SAD, posted by Justherself54 on November 25, 2007, at 9:58:17
> 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.
Hey! Thats pretty sweet news. You seem to have made good progress so far on Nardil. I too wa seriously Angoraphobic before I took nardil ( hiding out in my trailer and not leaving my suit. Now im at 6 weeks nardil and All my Social Phobia is Gone! (well pretty much) I can do most all things without being struck by panic and the thought of getting away. Good luck, Hopefully it just keeps getting better. I hear it gets better even after it kicks in!Talk to ya soon JustHerSelf
Posted by cbtcbt on November 30, 2007, at 21:46:33
In reply to Nardil! my story, im new, please get to know me, posted by Nardilstarted2007 on November 19, 2007, at 6:13:32
MY QUESTIONS:
I have been on 60mg for 6 weeks. I sleep really well, and have not had any weight gain (although I am fairly disciplined about diet). Am I just lucky or will these problems come later?
Also, when does the anorgasmia end? After 3rd week to now (6th week), and I have not been able to come (and I have tried very hard).
Thanks for your input.
MY EXPERIENCE:
During first months (approximate)
– intense orgasms (enjoy while this lasts. I am tempted to re-start nardil for this experience)
– Dry mouth
– Feel high and medicated
– Nauseous
– drowsyDuring second month
– Dizzy when getting up or physically exerting myself, even if walking up flight of stairs. (Fortunately, this decreased over time)
– Less interest in sex
– Smoke LOT more. Really crave nicotine.
– Minor muscle twitches (mycloneus)
So far (2 months), I still do not have major weight gain or sleep problems.For optimal sleep, I take 2 before sleep, and 2 in the middle of my sleep. I slept very poorly with SSRIs, so maybe my sleep now is just normal. I do like to take naps at lunch, because Nardil makes me bit drowsy.
I eat lost less than before because Nardil gives me more self control, and I just have less of an appetite. I crave sweets though.
Food restrictions- very minor consideration in deciding if to take Nardil. I have eaten certain foods that have made my heart beat really hard. Suspect it was tyramine reaction.
Now, I enjoy life more, more relaxed, positive outlook. I also have better self-control (ie. anger, food)
Posted by 2learnhelp on May 17, 2009, at 11:51:55
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 see great results from mnay people here on Nardil . I am new to the medication and not to get off subject . Has anyone experienced a counteract effect from drinking alcohol. I can have just 8 beers and then the next two days I am ridden with anxiety,agoraphobia,depression,etc. I am currenlt taking 60 mg a day and I feel it is an unbelievable miracle that my anxiety and depression are subsiding . Yet the alcohol just stops the whole process. anyone who has had this experience please help . I blieve this forum is for the people who know . Doctors can hypothesize yet the people on the medicine nardil only know the answers . Thank you and good luck to all .
john
Posted by ParnateStarted2008 on May 17, 2009, at 18:25:20
In reply to Re: Nardil! my story, im new, please get to know me » Nardilstarted2007, posted by 2learnhelp on May 17, 2009, at 11:51:55
> I see great results from mnay people here on Nardil . I am new to the medication and not to get off subject . Has anyone experienced a counteract effect from drinking alcohol. I can have just 8 beers and then the next two days I am ridden with anxiety,agoraphobia,depression,etc. I am currenlt taking 60 mg a day and I feel it is an unbelievable miracle that my anxiety and depression are subsiding . Yet the alcohol just stops the whole process. anyone who has had this experience please help . I blieve this forum is for the people who know . Doctors can hypothesize yet the people on the medicine nardil only know the answers . Thank you and good luck to all .
> john
Hi John. Im glad to hear Nardil is working! WHen I drink (on any AD and Nardil/Parnate) I become hypomanic and in a social/self euphoria as long as I keep a drinking bender going. I dont notice afer drinking that the AD stops working but personally 95% of the time no AD works good enough for me unless I mix it with booz. Its an unsafe combo. After I stop drinking the next 2 days my nerves are somewhat shot(shaky) and my anxiety is worse, but not by much. Maybe a day or two or three of benzo's after you drink could help until the Nardil effects restore themselves.
Posted by Phillipa on May 17, 2009, at 19:56:04
In reply to Re: Nardil! my story, im new, please get to know me, posted by ParnateStarted2008 on May 17, 2009, at 18:25:20
Hey miss you. Love Phillipa
Posted by Lebrada on May 21, 2009, at 18:50:31
In reply to Re: Nardil! my story, im new, please get to know me » Nardilstarted2007, posted by 2learnhelp on May 17, 2009, at 11:51:55
> I see great results from mnay people here on Nardil . I am new to the medication and not to get off subject . Has anyone experienced a counteract effect from drinking alcohol. I can have just 8 beers and then the next two days I am ridden with anxiety,agoraphobia,depression,etc. I am currenlt taking 60 mg a day and I feel it is an unbelievable miracle that my anxiety and depression are subsiding . Yet the alcohol just stops the whole process. anyone who has had this experience please help . I blieve this forum is for the people who know . Doctors can hypothesize yet the people on the medicine nardil only know the answers . Thank you and good luck to all .
> johnHi, below is my experience, I hope this helps...
I found that Alcohol with Nardil could make me feel very confident, competent, assertive and VERY social (dis-inhibited) - the perfect state which is otherwise never experienced by someone who is strongly affected by 'Generalized Social Anxiety Disorder/SAD') - and perfect for when in social environments).
(Note: nothing else I have tried has ever been able to approach or replicate this state except for maybe Dexamphetamine...and I've tried Nardil, Parnate, Moclobemide, Clonazepam, Xanax, Lexapro, Prozac, Paxil, Amitriptyline, Clomipramine, Remeron, Buspirone, Bupropion, Reboxetine, Ritalin, Dexamphetamine etc (I don't do drugs - only the prescrbed variety ;)
For me, I found the Nardil only really useful when I combined it with Alcohol (this I would only do when out on the town - without alcohol I found Nardil almost redundant bar the early stages/days - a rather hit and miss affair thereafter).There were days in the early stages where I could be quite talkative or pro-social but again this desired affect was not predictable and so not reliable.
With alcohol I found it had a very pro-social effect on me (felt like complete remission - alcohol alone would hardly ever have the same effect on me - note I only drink when out with friends - again I rarely drink otherwise).
Aside from the Nardil-Alcohol combination (i.e. during the day/work etc) I find Nardil rather inconsistant in the early stages/ first few months, before it eventually starts to fade in its effectiveness (aside from the afore-menioned combination).
I find that Nardil can cause rebound anxiety which can at times equate to Paranoia when anxiety levels are heightened (I have experienced this on more than a few occassions - this is VERY problematic and counter-productive - for example if experienced at work etc).
I never experienced any problems with diet (even when having Soya Sauce), however, I did experience weight gain. It also caused loss of Libido and complete ED...only survivable by adding Viagra which makes for a great experience although it can be a mission to come but again this is not the worst.
Would I recommend Nardil for Generalized SAD - not really - paranoia is a Bitch! It can work but is unpredictable and unreliable while also coming with a host of unwanted side-effects.
Good Luck!
This is the end of the thread.
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