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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Scott L. Schofield on January 19, 2000, at 7:27:02
Q: How many people have had Nardil stop working for them?Q: How long did it Nardil work before suffering a relapse?
Q: What treatment was found to work afterwards?
I'm beginning to feel scared and demoralized. I think I will be revisiting Nardil (phenelzine), but adding several mood stabilizers this time. By process of elimination, it seems to me that Nardil is the only antidepressant that has any chance to work. My doctor and I have spent nearly ten years trying to find an answer.
I have been looking for something that would get me well so that I could live happily ever-after
I see many posts of people for whom Nardil has "pooped-out" (stopped working), and needing to find something else. For me, there is no something else. Why the hell have I been investing so much time, pain, and effort - using all of what little energy I have - just to get relief for a few months or a few years? I can't make any reasonable plans for a future because I can't count on being well for that long. It has been my expectation of finding a successful treatment that will work indefinitely that has helped convince me to stick around and wait for it.
Please don't be concerned that I might end up taking an unscheduled one-way trip to the great beyond based on the answers to the questions I've asked. I need to have facts so that I can form realistic expectations and thus ways to deal with them as I go along.
Thank-you all for any contribution and sharing of experiences.
Sincerely,
Scott
Posted by Elizabeth on January 19, 2000, at 8:33:33
In reply to Nardil "poop-out" - relapse, posted by Scott L. Schofield on January 19, 2000, at 7:27:02
> Q: How many people have had Nardil stop working for them?
*raises hand*
> Q: How long did it Nardil work before suffering a relapse?
About 8 months. It wasn't just a relapse; it resembled the MAOI withdrawal syndrome, actually.
> Q: What treatment was found to work afterwards?
When I stopped the Nardil for a couple months and then started it again, it worked again, but it pooped out a second time (again after around 8 months). Parnate worked also, once the withdrawal-like symptoms had stopped (they persisted for a very long time, though).
> I'm beginning to feel scared and demoralized. I think I will be revisiting Nardil (phenelzine), but adding several mood stabilizers this time.
I tried adding Depakote and later Lamictal after it pooped out; no effect.
> By process of elimination, it seems to me that Nardil is the only antidepressant that has any chance to work. My doctor and I have spent nearly ten years trying to find an answer.
Tried Marplan?
> I have been looking for something that would get me well so that I could live happily ever-after
> I can't make any reasonable plans for a future because I can't count on being well for that long.
I know that feeling well...right now everything feels so uncertain for me.
Posted by Noa on January 19, 2000, at 18:42:43
In reply to Re: Nardil "poop-out" - relapse, posted by Elizabeth on January 19, 2000, at 8:33:33
I know that feeling too. Traipsing through the land of medications, searching for the combo that will provide relief, it is a tiring and extremely discouraging process.
At the moment I am in a hopeful place, but along the edges of my consciousness lurks the terrifying spectre of "what if this combo poops out?" It makes it hard to enjoy the current progress, becuase if I buy into the idea that my improving state will stick, my feared loss is that much greater.
During one of my most recent discouraging phases, I was ready to check out. I felt I had just had enough, and had no more strength in me to pursue the quest for effective treatment, and I believed it didn't exist.
Now I feel I have to believe there are other things out there to try. Even if you have exhausted all current medication combos, there are trials of new forms of treatment. It seems we live in a time when we are on the brink of completely new ways of addressing psychiatric disorders.
Hang in there. Maybe if you list every combo you have tried, why you stopped them, etc., some of the whiz kids on this board will help you figure out a new avenue to explore.
Posted by Kim on January 22, 2000, at 6:01:36
In reply to Re: Nardil "poop-out" - relapse-Scott, Elizabeth, posted by Noa on January 19, 2000, at 18:42:43
I was on Nardil for about a year, felt so good I quit taking it. When I crashed several months later, it didn't work. I've been on Parnate for 2 years now; but it's pooping out. The two MAOI's are the only ADs that have worked at all so far, so I'm feeling desperate about the Parnate quitting. Are there any other MAOI's out there?
Kim
Posted by Scott L. Schofield on January 22, 2000, at 9:52:34
In reply to Re: Nardil "poop-out"--Parnate, too, posted by Kim on January 22, 2000, at 6:01:36
Hi Kim.
> I was on Nardil for about a year, felt so good I quit taking it. When I crashed several months later, it didn't work.See: http://www.dr-bob.org/babble/20000112/msgs/19064.html
> I've been on Parnate for 2 years now; but it's pooping out. The two MAOI's are the only ADs that have worked at all so far, so I'm feeling desperate about the Parnate quitting. Are there any other MAOI's out there?
In the United States, I believe that there are four MAOIs (Monoamine oxidase inhibitor) currently available, all of which are considered to be "irreversible". The term irreversible is used to describe the property of these drugs to stick to the MAO enzyme permanently (or nearly so), so that it can no longer perform its function of breaking-down an excess of neurotransmitter molecules. Elsewhere in the world, RIMAs (reversible inhibitors of monoamine oxidase) are available as antidepressants. Because they are reversible, it is generally accepted that there is no need to adhere to the dietary restrictions required for the irreversible ones.
Irreversible MAOIs1. Nardil (phenelzine)
2. Parnate (tranylcypramine)
3. Marplan (isocarboxazid)
4. Eldepryl (selegiline, l-deprenyl)
Reversible MAOIs1. moclobemide
2. brofaromine- Other RIMAs are pretty far along in the approval process in Europe, however, I haven't looked into whether any are being looked at for marketing in the U.S.
In your case, I think it makes sense to add another drug (augment) to the Parnate. There's are lots to choose from. They can be *very* effective, however, I don't think the majority of psychiatrists would feel comfortable with many of these.
Possible augmenting agents (off the top of my head):1. Wellbutrin
2. Cylert
3. Amphetamine
4. Tricyclics
5. Lithium
6. Pindolol
7. Ritalin
8. Zyprexa
9. Thyroid hormone
10. Psychotherapy
*** NOT: SSRIs (Prozac, Zoloft, Paxil, Celexa, Luvox) or Effexor (which also blocks the reuptake of serotonin).
I know how hard it is to make these decisions. I often second-guess my own choice and those of my doctor. "Just get it right the first time".I have received partial releif from a combination of Parnate and Norpramin (desipramine).
Good luck.
- Scott
Posted by lc on January 24, 2000, at 11:48:49
In reply to Re: Nardil "poop-out" - relapse, posted by Elizabeth on January 19, 2000, at 8:33:33
> Tried Marplan?
>
I have a friend who is interested in taking Marplan. What has your
expereince been with it? He is currently on Nardil and it has stopped working.
Posted by Kim on January 24, 2000, at 23:48:16
In reply to Re: Nardil "poop-out"--Parnate, too, posted by Scott L. Schofield on January 22, 2000, at 9:52:34
> In your case, I think it makes sense to add another drug (augment) to the Parnate. There's are lots to choose from. They can be *very* effective, however, I don't think the majority of psychiatrists would feel comfortable with many of these.
>
>
> Possible augmenting agents (off the top of my head):
>
> 1. Wellbutrin
> 2. Cylert
> 3. Amphetamine
> 4. Tricyclics
> 5. Lithium
> 6. Pindolol
> 7. Ritalin
> 8. Zyprexa
> 9. Thyroid hormone
> 10. Psychotherapy
>
Thanks, Scott. I've tried augmenting w/Cylert, Lithium, Pindolol, Ritalin, and Dexedrine. (Plus ongoing Psychotherapy.) When I moved, new Pdoc went berserk that I was taking Parnate, Dexedrine, Visken & Temazepam & wants me off them. I will take this list to next appointment and hope for something that helps!
Kim
Posted by Kyle Dettmers on May 5, 2001, at 13:52:01
In reply to Nardil , posted by Scott L. Schofield on January 19, 2000, at 7:27:02
>
> Q: How many people have had Nardil stop working for them?
>
> Q: How long did it Nardil work before suffering a relapse?
>
> Q: What treatment was found to work afterwards?
>
>
>
> I'm beginning to feel scared and demoralized. I think I will be revisiting Nardil (phenelzine), but adding several mood stabilizers this time. By process of elimination, it seems to me that Nardil is the only antidepressant that has any chance to work. My doctor and I have spent nearly ten years trying to find an answer.
>
> I have been looking for something that would get me well so that I could live happily ever-after
>
> I see many posts of people for whom Nardil has "pooped-out" (stopped working), and needing to find something else. For me, there is no something else. Why the hell have I been investing so much time, pain, and effort - using all of what little energy I have - just to get relief for a few months or a few years? I can't make any reasonable plans for a future because I can't count on being well for that long. It has been my expectation of finding a successful treatment that will work indefinitely that has helped convince me to stick around and wait for it.
>
> Please don't be concerned that I might end up taking an unscheduled one-way trip to the great beyond based on the answers to the questions I've asked. I need to have facts so that I can form realistic expectations and thus ways to deal with them as I go along.
>
> Thank-you all for any contribution and sharing of experiences.
>
>
> Sincerely,
> Scott
Scott,I have been on Nardil for most of the past 20 years with good therapeutic effect.
Trials with numerous non-MAOI AD's during this period provided no therapeutic effect.I was on a dose of 75 mg/day of Nardil for the first two years but then it started
having less effect, so it was increased to 90 mg/day. I have since had to increase
the dose by about 15 mg/day (1 pill/day) every year and now require 240 mg/day
(16 pills/day)to maintain the same therapeutic effect.You probably only need to increase the dose to get the same therapeutic effect you
had previously.Send me an e-mail for more info.
Posted by Elizabeth on May 10, 2001, at 8:37:30
In reply to Re: Nardil poop-out-relapse- Just increase dose!, posted by Kyle Dettmers on May 5, 2001, at 13:52:01
I tried increasing the dose (from 60 to 75 and then to 90) when I relapsed on Nardil. It didn't work for me; the only thing that helped was stopping the drug altogether for a couple months. Not a very effective long-term strategy.
This is the end of the thread.
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