Posted by kregpark@yahoo.com on May 6, 2002, at 15:09:29
In reply to Re: guys help me with the anorgasmia from Nardil, posted by Seamus2 on May 6, 2002, at 1:43:38
Hey Ross -
I took high dose Nardil (by itself) for 2 years. I was extremely productive at that time, and eventually switched over to low Nardil + Klonopin. However, the high Nardil was good, and I would not change that course of events even if I could go back.
I had the same initial side effects as you. My Dr. reassurred me to be patient. He was right. After a few months all side effects were gone (including the difficulty starting urination), except delayed orgasm which started out as anorgasmia when I got the dose pretty high. The difficulty with urination is an anticholinergic effect I believe which you get also with tricyclics and other drugs. Bechanechol is indicated for that but that should go away in time. Any occasional dizziness on standing, etc. will go away. In my case the initial anorgasmia had me very scared. Luckily my Dr. kept reassurring me, and after a few months at the high dose thing were suddenly improved. Once you adjust then on a 2nd retrial you will quickly adapt to Nardil, and also it may not take as long as 3 months to adjust the first trial.
You can try Parnate also. Although if you are doing well with Nardil and you probably have tried other stuff which is why you are trying Nardil - it is worth staying with it, just annoying to wait out the side effects initially for some people.
After adjusting I had retained efficacy and I did have sexual side effects, and while they were annoying they were no worse than I experienced with 50 Zoloft or 30 Paxil. And everything else was far better so it was an easy call.
You might try bechanechol, or prostigmin if your Dr. is ok with those. The cholinergic meds are probably good since some of the initial side effects are due to anticholinergic effects.
If you want to aggressively treat sexual side effects in the early adjusting perior you can and Dr's vary. Cautious trials of very low Ritalin and even Serzone with or without Ritalin for example. Both of those drugs might be considered dangerous to combine though. Personally I would not since you are getting the most potent Nardil effect right now. I would go with cholinergics at first (Viagra has similar effects to a cholinergic also).
If you add a stimulant, ritilin will promote libido, decrease delay, improve erection, etc. (How is that for clinical talk?) You should try only extremely tiny doses at first and measure BP changes if you do that - check PDR and ask Dr though. Serzone may have a similar effect. When I added Serzone to 75mg Nardil I felt as though I were taking Parnate (not good for social phobia). But there was an obvious prosexual effect. I tried that only because I had taken 300 Serzone with Zoloft 50 previously also to combat sexual side effects as well as fatigue and improve socialbility.
Which reminds me - as for Parnate I would say it is worth trying. However do keep in mind that most people with significant social phobia do much better with Nardil than with Parnate. Parnate taken alone was of little use to me - in fact it may have caused me trouble at work.
Still - occasionally people to get good results for SP from Parnate.
Good luck.
BTW, Seamus - what do/did you use Parnate for? Did it work well all by itself?
poster:kregpark@yahoo.com
thread:105146
URL: http://www.dr-bob.org/babble/20020503/msgs/105300.html