![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by n_wolfie on February 25, 2009, at 10:39:01
I've been on 30 mg of Nardil for about 2 weeks, and my mood is marginally better, but I'm so tired I can barely function. I have to take a nap about an hour after I wake. then another around 5, then I'm exhausted again by 11pm, and then I don't sleep that well. Is this is temporary side effect? Are there any augmentation strategies to keep me awake? Even though my mood is slightly better, I'm just as dysfunctional as when I was severely depressed.
Posted by myco on February 25, 2009, at 11:08:56
In reply to Nardil exhaustion, so tired, posted by n_wolfie on February 25, 2009, at 10:39:01
Hey...2 weeks at 30. It's a good time to raise the dose. Ideally, unless the good effect is very good, you want to get up to 60mg within the first month (the lowest therapeutic dose by average...effective dose range is 60 to 90). 30 probably wont be that effective for very long if at all.
Unfortunately this 'worn out' tired feeling you are having probably wont totally clear until youve reached your 'effective' dose and stayed there for some time.
Many people find nardil 'activating' at a higher dose...means more energy. For me I had many times of intense energy to the point of 'i wanna dance' lol. The stimulation was great. All sides except insomnia and a little weight will go away (for me anyway). I dont even feel the med physically now (3 months in - my dose is 75)...all I get is a little stimulation in my leg muscles about an hour after dosing each time. No tiredness other than the tiredness I get from a night of little sleep (enter a good sleep med). All the good effect now is subtleI pay close attention to how I react to situations and notice wow Im differentI never normally reacted this way, this is much better.
So while you are ramping up and playing around with your dosing to find the best dose for you, you can probably expect to feel those sides (tired, dizzy etc) until you spend weeks on your best dose. Nardil theory states 1mg/kg of body weight (some people think this is bollocks but it worked for me) to be effective. That puts most people in the 75mg area.
Don't chase augments yet, great idea to think about them and ask questions etc in preparation for that time though. I'm constantly keeping my options open but dont get to serious yet until youve stabilized and properly determined how the med is working then there are options to minimizing the lethargy (if you have any left which likely you wont) but it can be tricky and many dr's are not cooperative with this (i.e. often means addition of stimulant which scare many drs). Try some coffee, I find the combo of nardil and a good amount of very good fresh ground coffee done in a french press (much better kick to it than percd) gives me a nice little hypomanic energetic buzz for a few hours until it crashes.
Hang in there though, nardil will get better
myco
> I've been on 30 mg of Nardil for about 2 weeks, and my mood is marginally better, but I'm so tired I can barely function. I have to take a nap about an hour after I wake. then another around 5, then I'm exhausted again by 11pm, and then I don't sleep that well. Is this is temporary side effect? Are there any augmentation strategies to keep me awake? Even though my mood is slightly better, I'm just as dysfunctional as when I was severely depressed.
Posted by softheprairie on February 25, 2009, at 23:49:10
In reply to Nardil exhaustion, so tired, posted by n_wolfie on February 25, 2009, at 10:39:01
I don't know if your doctor is cooperative and open to this, but I love a certain article that I think is relevant, and you might be able to use it to ask for the augmenters it recommends. It is from doctors affiliated with McLean Hospital and Harvard Medical School. I've quoted this before.
It is
MAO inhibitors: An option worth trying in treatment-resistant cases. JO Cole, JA Bodkin. Current Psychiatry, V. 1, No. 6, June 2002. The original is not available for free from the publisher, but it is copied onto another dr's personal website at http://www.drtonyromack.com/MAOIs.htmIt states "[a]n altered diurnal sleep cycle is another MAOI-related side effect. Some patients get extremely drowsy in the late afternoon but then may have insomnia at night. 26 Attempts to alter this odd cycle by changing the timing of administration have generally not helped." The authors offer these patients on MAOIs a low dose of a stimulant for the afternoon and a sleep agent (such as trazodone) for the insomnia.
> I've been on 30 mg of Nardil for about 2 weeks, and my mood is marginally better, but I'm so tired I can barely function. I have to take a nap about an hour after I wake. then another around 5, then I'm exhausted again by 11pm, and then I don't sleep that well. Is this is temporary side effect? Are there any augmentation strategies to keep me awake? Even though my mood is slightly better, I'm just as dysfunctional as when I was severely depressed.
Posted by g_g_g_unit on February 26, 2009, at 7:08:24
In reply to Nardil exhaustion, so tired, posted by n_wolfie on February 25, 2009, at 10:39:01
> I've been on 30 mg of Nardil for about 2 weeks, and my mood is marginally better, but I'm so tired I can barely function. I have to take a nap about an hour after I wake. then another around 5, then I'm exhausted again by 11pm, and then I don't sleep that well. Is this is temporary side effect? Are there any augmentation strategies to keep me awake? Even though my mood is slightly better, I'm just as dysfunctional as when I was severely depressed.
hang in there. how are you planning on titrating? i added one table a week until i reached 60mg. around 45mg a day the debilitating tiredness went away. are you working at the moment? i have a very light schedule / part-time job and have been able to set aside most important responsibilities in order to give the nardil time. i am no pro but i feel that patience is absolutely crucial.
also, how is your sleep? if anyone is reading this, i did not want to start a new thread, so please excuse me posting this here: my sleep is currently horrendous. if i do not take a sleeping aid, i get ZERO hours sleep. i am taking zopiclone, but it is not strong enough and i still find myself waking up after a couple of hours, so tonight switched to Temazepam. what is the most sensible way to avoid tolerance? i was taking every 4th night off but it's difficult - like hey, do i feel like literally staying awake all night tonight and feeling dead to the world tomorrow? Still, i am scared of sleeping pills and do not need to add benzo withdrawal to my problems. is 3 nights on, 4th night off, or can i possibly stretch this to maybe 6nights on, 7th night off?
Posted by mav27 on February 26, 2009, at 8:36:26
In reply to Re: Nardil exhaustion, so tired + Nardil Insomnia, posted by g_g_g_unit on February 26, 2009, at 7:08:24
> also, how is your sleep? if anyone is reading this, i did not want to start a new thread, so please excuse me posting this here: my sleep is currently horrendous. if i do not take a sleeping aid, i get ZERO hours sleep. i am taking zopiclone, but it is not strong enough and i still find myself waking up after a couple of hours, so tonight switched to Temazepam. what is the most sensible way to avoid tolerance? i was taking every 4th night off but it's difficult - like hey, do i feel like literally staying awake all night tonight and feeling dead to the world tomorrow? Still, i am scared of sleeping pills and do not need to add benzo withdrawal to my problems. is 3 nights on, 4th night off, or can i possibly stretch this to maybe 6nights on, 7th night off?
>For me the only thing that could get me a good nights sleep whilst on nardil was a small dose of seroquel.
Posted by myco on February 26, 2009, at 9:51:50
In reply to Re: Nardil exhaustion, so tired + Nardil Insomnia, posted by g_g_g_unit on February 26, 2009, at 7:08:24
hey g_g_g_unit
Dont overly worry about temazepam and valium in terms of tolerance. Like I mentioned before on other threads, those two benzo's are the least likely to develop tolerence...study and patient support for this. Don't be carefree with them either though...they are still benzo's so they will still morph into a physical addiction after awhile that is less than pleasant to break...so the question of how often do I take temazepam to get addicted is more legitimate. --> I did twice a week from dr suggestion. He also said he would not approve for me temazepam at any more than 4 nights a week...In my opinion dont use it for years at more than 2-4nights a week. Add additional things to the mix (wasn't sure if you said you tried trazodone or seroquel - both effective sleep aids). Some herbs work...check this out...I added a herbal tincture (a liquid) at night called "scullcap" and it worked so well for me that I discontinued temazepam and use only this now with my seroquel. I too am on nardil and sleep like sh*t unless I have sleep meds. Scullcap is worth a try man...its cheap, effective, and you dont have to fight a dr for it...works on benzo sites like rx meds.
myco
>... so tonight switched to Temazepam. what is the most sensible way to avoid tolerance? i was taking every 4th night off but it's difficult - like hey, do i feel like literally staying awake all night tonight and feeling dead to the world tomorrow? Still, i am scared of sleeping pills and do not need to add benzo withdrawal to my problems. is 3 nights on, 4th night off, or can i possibly stretch this to maybe 6nights on, 7th night off?
>
Posted by n_wolfie on February 27, 2009, at 21:05:24
In reply to Re: Nardil exhaustion, so tired + Nardil Insomnia, posted by g_g_g_unit on February 26, 2009, at 7:08:24
My doctor doesn't want to go up too fast, because in the past it made me a little manic, which i liked. I'm also on the lamictal, which prevents me from sinking as far as I did, and having disproportionate reactions. The Lamictal potentiates the Nardil, so he wants to be careful, but my patience is wearing very, very thin. Every week I can't function because I'm waiting for side effects too subside, being cautious, is another week of my life that passes me by. I've basically lost my 20's to depression. And I'm way beyond others in life skills, finances, relationships, career. I'm the biggest underachiever you've ever seen, and it's sad.
> > I've been on 30 mg of Nardil for about 2 weeks, and my mood is marginally better, but I'm so tired I can barely function. I have to take a nap about an hour after I wake. then another around 5, then I'm exhausted again by 11pm, and then I don't sleep that well. Is this is temporary side effect? Are there any augmentation strategies to keep me awake? Even though my mood is slightly better, I'm just as dysfunctional as when I was severely depressed.
>
> hang in there. how are you planning on titrating? i added one table a week until i reached 60mg. around 45mg a day the debilitating tiredness went away. are you working at the moment? i have a very light schedule / part-time job and have been able to set aside most important responsibilities in order to give the nardil time. i am no pro but i feel that patience is absolutely crucial.
>
> also, how is your sleep? if anyone is reading this, i did not want to start a new thread, so please excuse me posting this here: my sleep is currently horrendous. if i do not take a sleeping aid, i get ZERO hours sleep. i am taking zopiclone, but it is not strong enough and i still find myself waking up after a couple of hours, so tonight switched to Temazepam. what is the most sensible way to avoid tolerance? i was taking every 4th night off but it's difficult - like hey, do i feel like literally staying awake all night tonight and feeling dead to the world tomorrow? Still, i am scared of sleeping pills and do not need to add benzo withdrawal to my problems. is 3 nights on, 4th night off, or can i possibly stretch this to maybe 6nights on, 7th night off?
>
Posted by n_wolfie on February 27, 2009, at 21:07:13
In reply to Re: Nardil exhaustion, so tired + Nardil Insomnia, posted by n_wolfie on February 27, 2009, at 21:05:24
oh, as far as the sleep. i'm on 50 mg trazadone, which works very well, but don't take it too late because it can leave you with a temporary hangover. When i was on a higher dosage of nardil i needed 100mg, but i'd need to take it by 10, or the hangover would be pretty bad. I'd have to force myself out of bed, but once I did it cleared up.
> My doctor doesn't want to go up too fast, because in the past it made me a little manic, which i liked. I'm also on the lamictal, which prevents me from sinking as far as I did, and having disproportionate reactions. The Lamictal potentiates the Nardil, so he wants to be careful, but my patience is wearing very, very thin. Every week I can't function because I'm waiting for side effects too subside, being cautious, is another week of my life that passes me by. I've basically lost my 20's to depression. And I'm way beyond others in life skills, finances, relationships, career. I'm the biggest underachiever you've ever seen, and it's sad.
>
> > > I've been on 30 mg of Nardil for about 2 weeks, and my mood is marginally better, but I'm so tired I can barely function. I have to take a nap about an hour after I wake. then another around 5, then I'm exhausted again by 11pm, and then I don't sleep that well. Is this is temporary side effect? Are there any augmentation strategies to keep me awake? Even though my mood is slightly better, I'm just as dysfunctional as when I was severely depressed.
> >
> > hang in there. how are you planning on titrating? i added one table a week until i reached 60mg. around 45mg a day the debilitating tiredness went away. are you working at the moment? i have a very light schedule / part-time job and have been able to set aside most important responsibilities in order to give the nardil time. i am no pro but i feel that patience is absolutely crucial.
> >
> > also, how is your sleep? if anyone is reading this, i did not want to start a new thread, so please excuse me posting this here: my sleep is currently horrendous. if i do not take a sleeping aid, i get ZERO hours sleep. i am taking zopiclone, but it is not strong enough and i still find myself waking up after a couple of hours, so tonight switched to Temazepam. what is the most sensible way to avoid tolerance? i was taking every 4th night off but it's difficult - like hey, do i feel like literally staying awake all night tonight and feeling dead to the world tomorrow? Still, i am scared of sleeping pills and do not need to add benzo withdrawal to my problems. is 3 nights on, 4th night off, or can i possibly stretch this to maybe 6nights on, 7th night off?
> >
>
>
Posted by g_g_g_unit on February 27, 2009, at 23:09:21
In reply to Re: Nardil exhaustion, so tired + Nardil Insomnia » g_g_g_unit, posted by myco on February 26, 2009, at 9:51:50
> hey g_g_g_unit
>
> Dont overly worry about temazepam and valium in terms of tolerance. Like I mentioned before on other threads, those two benzo's are the least likely to develop tolerence...study and patient support for this. Don't be carefree with them either though...they are still benzo's so they will still morph into a physical addiction after awhile that is less than pleasant to break...so the question of how often do I take temazepam to get addicted is more legitimate. --> I did twice a week from dr suggestion. He also said he would not approve for me temazepam at any more than 4 nights a week...In my opinion dont use it for years at more than 2-4nights a week. Add additional things to the mix (wasn't sure if you said you tried trazodone or seroquel - both effective sleep aids).i haven't tried trazodone or seroquel. to be honest if i require indefinite use of a sleep med then i will not stay on nardil. just a personal choice. right now though, even 2-4 nights use of temazepam is not enough. like i said, ANY night i don't take a benzo, i am up ALL night. i took two zopiclone two nights ago and even that didn't keep me asleep for more than 2 hours. so i will give it a couple days break. interestingly, i tried melatonin last night which worked pretty well. it kept me asleep for about 2 hours, then i took another and was able to sleep for 2 hours more. i will look into skullcap. one naturopath actually recommended it to me but i turned it down because i didn't have much faith
Posted by g_g_g_unit on February 27, 2009, at 23:19:12
In reply to Re: Nardil exhaustion, so tired + Nardil Insomnia, posted by n_wolfie on February 27, 2009, at 21:05:24
hey - don't be so hard on yourself. are you in therapy? exercising regularly? i have just begun and am finding both are the best things i've looked into so far. around last novemeber i had a small breakdown and lost my girlfriend, job, life etc. at the moment i am a little drugged out on the nardil and finding it a relief to just let go of everything :) now i am taking life in baby steps. just getting to the gym each day at the moment provides some sense of accomplishment that is sticking with me. i understand your situation is more severe and imagine you have looked into a lot of treatments. i am also sorry to hear you've lost so much time to depression, and realise that words from a stranger can only provide so much comfort. but hang in there
> My doctor doesn't want to go up too fast, because in the past it made me a little manic, which i liked. I'm also on the lamictal, which prevents me from sinking as far as I did, and having disproportionate reactions. The Lamictal potentiates the Nardil, so he wants to be careful, but my patience is wearing very, very thin. Every week I can't function because I'm waiting for side effects too subside, being cautious, is another week of my life that passes me by. I've basically lost my 20's to depression. And I'm way beyond others in life skills, finances, relationships, career. I'm the biggest underachiever you've ever seen, and it's sad.
Posted by DavidLA on March 1, 2009, at 22:41:54
In reply to Re: Nardil exhaustion, so tired + Nardil Insomnia, posted by g_g_g_unit on February 27, 2009, at 23:19:12
Try a low-dose of Trazadone or Ambien for sleep. Trazadone has a slight hangover effect.
I've been on Nardil for 10+ years and without one of these two options I would have never slept.
Good luck.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.