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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by UgottaHaveHope on April 26, 2007, at 2:58:08
Im in the midst of my fourth week on 45mg, and yes I feel a little better. Or maybe Im so sedated I think I feel better. Do any of you longtime NARDILians remember how long (estimate) it took for you to really feel it? Thanks Michael
Posted by Declan on April 26, 2007, at 3:33:25
In reply to How LONG does it take for NARDIL to kick in???????, posted by UgottaHaveHope on April 26, 2007, at 2:58:08
Michael, I'm curious.
At this point are you getting a better effect from Nardil than from Emsam?
Can you compare them?
Posted by UgottaHaveHope on April 26, 2007, at 11:58:59
In reply to Re: How LONG does it take for NARDIL to kick in??? » UgottaHaveHope, posted by Declan on April 26, 2007, at 3:33:25
I hate to go off topic because I want my other q answered, but since it is you, I will. For starters, you must know that I am trying these MAOIs for anxiety first, and then any possible depression. Here is where both stand after FOUR WEEKS:
EMSAM (6mg patch): Felt more energy the first day I put it on, trouble sleeping but Seroquel was finally helping and getting about 7 hours per night, still had hours of midrange anxiety each day or every other day, could eat anything I want and no other side effects.
NARDIL (45 mg): Felt drugged like being shot by an elephant dart but daytime sedation seems to lessen over time, still have trouble sleeping and get 4-5 hours per night, had maybe three days with a few hours of midrange anxiety and one day with a few hours of high anxiety in the 28 days which is great for me, also have some insomnia, constipation and oh yeah blackouts when standing up quickly. You know what's weird about Nardil? When I dont get my sleep, it sends me into an absolute panic mode. But with Nardil, the lack of sleep just makes me feel really tired but takes away the anxiety therefore I dont panic.
IN SUMMARY: Nardil didn't really kick in for me until week 7. At that point, I rated it a 6 on a scale of 1-10. The only reason I am trying Nardil is because others I know hit 9 or 10 with Nardil. With my job slowing down for the summer, this was the perfect time to give this med a trial for 8-12 weeks, once and for all.
Declan, thanks for your insight many of my posts. I appreciate your care, concern and interest. Feel free to ask me anything anytime.
Posted by UgottaHaveHope on April 26, 2007, at 12:05:29
In reply to Re: How LONG does it take for NARDIL to kick in??? » UgottaHaveHope, posted by Declan on April 26, 2007, at 3:33:25
nm
Posted by nutjob on April 26, 2007, at 14:39:17
In reply to Hmmmm ... Nardil vs. Emsam after four weeks » Declan, posted by UgottaHaveHope on April 26, 2007, at 11:58:59
Why have you stayed at 45 mgs for so long? From everything I've read about Nardil and from what others have reported 45 mgs is seldom effective. 60 mgs is usually required before any improvements are made.
I've been on Nardil now for two weeks. I started out at 30 mgs/day. I increased the dose to 45 mgs after 4 days, and then 60 mgs after another 4 days had passed. When I upped the dose to 60 mgs my anxiety was virtually gone after two days. And I'm not exaggerating. I've now been at 60 mgs for 5 days and I cannot believe how much relief this drug is giving me.
--job
Posted by Declan on April 26, 2007, at 16:11:03
In reply to Re: Hmmmm ... Nardil vs. Emsam after four weeks » UgottaHaveHope, posted by nutjob on April 26, 2007, at 14:39:17
So nutjob, your anxiety has (just about) gone from being on 60mg/d.
What about your mood? Depression affected too?
I like the sound of low dose Nardil, but don't suppose it's feasible.
Posted by nutjob on April 26, 2007, at 18:49:55
In reply to Re: Hmmmm ... Nardil vs. Emsam after four weeks » nutjob, posted by Declan on April 26, 2007, at 16:11:03
> So nutjob, your anxiety has (just about) gone from being on 60mg/d.
>
> What about your mood? Depression affected too?
>
> I like the sound of low dose Nardil, but don't suppose it's feasible.My mood has improved drastically. Where before I had to drink alcohol and smoke marijuana to kill the unbearable emotional suffering I endured each day, now I have absolutely no desire to drink and am better able to resist the urge to smoke. I simply have no need for these cruder medicines. Nardil is clearly the superior treatment.
Unfortunately low-dose Nardil isn't feasible. Controlled studies have consistently shown low dose Nardil (below 60 mgs) to be of little therapeutic value in the way of treating phobic depressive states; and if you browse through the archives here at psychobabble you'll find plenty of examples to further substantiate this.
--job
Posted by UgottaHaveHope on April 26, 2007, at 19:02:35
In reply to Re: Hmmmm ... Nardil vs. Emsam after four weeks, posted by nutjob on April 26, 2007, at 18:49:55
NJ:
For the record, despite controlled studies, I know plenty of people who get a theraputic effect of Nardil at 45 and even at 37.5 mgs. Every med affects everybody differently, but on a whole yes I agree from following posts on here it takes at least 60 to hit the mark.I appreciate you sharing your experiences and I was wondering if I could ask you some questions:
1. What is your primary diagnosis? (Mine is GAD)
2. How did Nardil affect your anxiety at 45 compared to 60?
3. Have you had ANY episodes of anxiety at all (even for a few minutes) at 60?
4. What made you go up to 60? Your own instincts or pdoc's advice?
5. Do you take any other meds with Nardil?
Again, thanks for sharing. It encourages me to read 60 took away your anxiety. Thanks for the hope. Michael
Posted by UgottaHaveHope on April 26, 2007, at 19:06:44
In reply to Re: Hmmmm ... Nardil vs. Emsam after four weeks, posted by nutjob on April 26, 2007, at 18:49:55
My pdoc ran a blood test before I started Nardil.
Then after my third week at 45mg, he ran another one. He said the test was good news, that a "theraputic level" of Nardil was making it to my bloodstream, therefore he would keep me at 45.
However, the X factor in all of this is I don't think anyone knows for sure if a certain level of Nardil in your blood means it is operating at a certain level of effectiveness.
Oh, yeah, one more Q: How many days after 60 did you feel the difference from 45? As in no anxiety? Thanks, Michael
Posted by FredPotter on April 26, 2007, at 19:40:38
In reply to Re: Hmmmm ... Nardil vs. Emsam after four weeks, posted by nutjob on April 26, 2007, at 18:49:55
Someone said you should titrate up to a dose of 1mg/kg body weight. Good grief that means I should take 95mg. One question : when you up the dose do you have to wait 8 weeks to see how the increase has worked? If so I think I'll be dead by the time my trial finishes Fred
Posted by Declan on April 26, 2007, at 21:44:25
In reply to Re: Hmmmm ... Nardil vs. Emsam after four weeks » nutjob, posted by FredPotter on April 26, 2007, at 19:40:38
People do talk about high doses of MAOIs sometimes.
I've been depressed but there is no way IMO that 80mg/d Parnate was going to do anything right for me.
If I got a therapeutic effect from a drug I would *try* not to be greedy and spin it out so that it lasted as long as it could, although of course it might not poop out.
With tianeptine I slowly feel my baseline shift so that the med becomes progressively less useful, unless I raise the dose.
Posted by nutjob on April 26, 2007, at 22:15:23
In reply to Very interested to hear more details of your story » nutjob, posted by UgottaHaveHope on April 26, 2007, at 19:02:35
Michael,
I have social anxiety. At 45 mgs I got absolutely no relief. Though I only took 45 mgs for 4 days. But after increasing the dose to 60 mgs the anxiolytic effect was almost immediately apparent. Granted, I might have had a response at 45 mgs if I had waited longer--but quite honestly I was too impatient to wait around and find out when the chances were far greater that at least 60 mgs would be required. Why suffer needlessly for any longer? If at some point I back down to 45 mgs and I find that 45 is all that I require, then what I will have lost by having gone up to 60 so rapidly? I guess the side effects might be worse. But sexual dysfunction and a little fatigue are nothing compared to the suffering I've endured on a daily basis for so many years.
My psychiatrist doesn't even know about my decision to go up to 60 mgs. As far as she knows I've just increased my dose from 30 to 45 as of three days ago. Unfortunately I've had to take matters into my own hands, because after 11 years of trying virtually every treatment available, I've yet to encounter a psychiatrist who actually knows what the f*#$ they're talking about.
I'm still quiet and withdrawn in social situations. I guess part of my problem is that I don't enjoy engaging in trivial conversation as much as most people do. But suddenly I don't feel overwhelmed when I have to interact with people. I can speak up when I need to.
I take no other meds, although I've tried a good number of other meds in various combinations over the years, including SSRI's, antipsychotics, benzodiazepines, and psychostimulants. And of course I've relied on alcohol and marijuana a great deal. But the effect of Nardil is so unlike anything I've ever experienced that I find it difficult to draw comparisons.
After I've been on Nardil for a while longer and had more time to gauge my response I will try to elaborate more on my experience with the drug.
--job
> NJ:
> For the record, despite controlled studies, I know plenty of people who get a theraputic effect of Nardil at 45 and even at 37.5 mgs. Every med affects everybody differently, but on a whole yes I agree from following posts on here it takes at least 60 to hit the mark.
>
> I appreciate you sharing your experiences and I was wondering if I could ask you some questions:
>
> 1. What is your primary diagnosis? (Mine is GAD)
>
> 2. How did Nardil affect your anxiety at 45 compared to 60?
>
> 3. Have you had ANY episodes of anxiety at all (even for a few minutes) at 60?
>
> 4. What made you go up to 60? Your own instincts or pdoc's advice?
>
> 5. Do you take any other meds with Nardil?
>
> Again, thanks for sharing. It encourages me to read 60 took away your anxiety. Thanks for the hope. Michael
Posted by football on April 27, 2007, at 14:09:26
In reply to How LONG does it take for NARDIL to kick in???????, posted by UgottaHaveHope on April 26, 2007, at 2:58:08
> Im in the midst of my fourth week on 45mg, and yes I feel a little better. Or maybe Im so sedated I think I feel better. Do any of you longtime NARDILians remember how long (estimate) it took for you to really feel it? Thanks Michael
Increase your dose!!! I found the side-effects to be no worse at 75 MG (what I'm on right now) then 45 MG. The only difference is 45 MG did nothing for more, while 75 MG has been great!
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