![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 43. Go back in thread:
Posted by tecknohed on November 21, 2007, at 5:07:42
In reply to Deplin/Brooke, posted by stargazer2 on November 20, 2007, at 22:27:40
>It seems like I just started this hellish journey, since many of those years i faithfully took what he advised and this is the first year I started to take charge of my depression with requests for second opinions and different medications and so far I feel like it has made a big difference.
>
> Perhaps some of my recent recovery has been from this new role in researching new approaches to depression with vitamins and other less med focused treatment. Just being an active participant in my care rather than a passive one has made me stronger and more confident....My own thoughts exactly! You cant be passive if your somewhat treatment resistant!
>....or has this change been the sole result of Nardil. I think a little bit of both.
Again, I fully agree. Nardil is an excellent med when it works, but you cant just let it do ALL the work!
> I will post my Deplin results as they occur from week to week. Hopefully I will have good results to report.Good luck with it! I look forward to reading your success - fingers crossed!
Posted by stargazer2 on November 21, 2007, at 7:37:19
In reply to Re: Deplin/Brooke » stargazer2, posted by tecknohed on November 21, 2007, at 5:07:42
Posted by quasiloco on November 21, 2007, at 21:13:50
In reply to The 'Nardil Smell' do you have it?, posted by Nardilstarted2007 on November 19, 2007, at 23:56:30
as soon as I started taking nardil, I seem to have become hypersensitive to it's smell.
The pills stank, my urine and feces stank, and maybe BO, but I was just too overwhelmed by the other odors to notice.
the bathroom seemed permeated with that odor.
Posted by Nardilstarted2007 on November 22, 2007, at 1:26:59
In reply to Re: The 'Nardil Smell' do you have it?, posted by quasiloco on November 21, 2007, at 21:13:50
> as soon as I started taking nardil, I seem to have become hypersensitive to it's smell.
>
> The pills stank, my urine and feces stank, and maybe BO, but I was just too overwhelmed by the other odors to notice.
>
> the bathroom seemed permeated with that odor.Yes thats exactly what I'm experiencing. The smell of Nardil coming out of me every where. Quite a embarassing reaction if you ask me. How long have you been on Nardil??? I have a feeling this will go away once our body's adapt. Im at 6weeks of taking nardil for the first time. The smell coming out of me is one of the worst side effects along with insomnia, anorgasmia and poor memory. Those are the only three side effects im dealing with now, the others have subsided. Im interested to hear more about the smell that you have noticed (what brand of nardil are you on? where are you from? do your pills smell potent?) What do you mean by "I was just too overwhelmed by the other odors to notice.." Your one of the first other then me to have spoke of this on this thread. Good luck with your Nardil, let me know more..
Nardilstarted
Posted by tecknohed on November 22, 2007, at 6:45:47
In reply to Re: The 'Nardil Smell' do you have it?, posted by Nardilstarted2007 on November 22, 2007, at 1:26:59
Hi mate!
Has Nardil actually kicked in yet? I ask because it might actually be worth considering cutting back on your dose a bit. Maybe to 60mg or even 45mg. This might help the smell go. Also, the Nardil dose needs to be very precise for it to work - not enough & it wont work, too much & it still might not work. Your own PERFECT dose may be lower than you think. My own most responsive dose was 75mg, & I even went up as far as 120mg at times which seemed counter-productive in the long run. Always ended up coming back to 75mg, though it actually first kicked in at 60mg.
Of course if it has kicked in then it might be best to leave the dosage, though if that is the case then 60mg might still work just as well. Would give you more 'room' for dose adjustment in the future too if you ever needed to increase.
Posted by UGottaHaveHOPE on November 23, 2007, at 20:05:51
In reply to Re: The 'Nardil Smell' do you have it? » Nardilstarted2007, posted by tecknohed on November 22, 2007, at 6:45:47
It means that Nardil is going through your body. Yes, it is a bummer for your bathroom waste to smell like that, but that is simply one of the things that goes along with Nardil. No worries at all.
Posted by Nardilstarted2007 on November 23, 2007, at 20:22:53
In reply to Yes, the Nardil 'smell' is actually a good sign, posted by UGottaHaveHOPE on November 23, 2007, at 20:05:51
> It means that Nardil is going through your body. Yes, it is a bummer for your bathroom waste to smell like that, but that is simply one of the things that goes along with Nardil. No worries at all.
Hi, I'm glad to hear that its not such a bad thing other then the smell. Do you think it will diminish in time? Im at six weeks since starting nardil. It sure has curbed my social phobia but not much antidepressant effect which is good because im not taking it for depression. Taking it for severe SP, PD and just really bad GAD all together. All the SSRI's made me hypomanic and bipolar (they called it ssri induced mania which fluctuated like bipolar). I dont feel this at all on Nardil. I'm liking the fact that I have no SP anymore after just six weeks, but I still dont think I will be able to give a presentation at college without xanax and a beta-blocker or I'd have a Panic Attack still. Did you have the smell of nardil too?
Posted by UGottaHaveHOPE on November 24, 2007, at 2:48:59
In reply to Re: Yes, the Nardil 'smell' is actually a good sign » UGottaHaveHOPE, posted by Nardilstarted2007 on November 23, 2007, at 20:22:53
No, the "bad smell" of Nardil will not go away, but again that is good news because it means the Nardil is flowing through your body, which has to happen for it to work.
Have ever drank a lot of beer? Well, if so, when you urinate, it will smell like beer.
And it is hard to say Nardil has a "bad smell" when urine or human waste in its natural state does not have "good smell." So in essence it really doesn't matter how your human waste smells because it all has a "bad smell."
Im no pdoc, but Ive read bits and peices of your story and I think you may have some characteristics of Bipolar II, most notably the way SSRIs affected you in a hypomanic way. BPII is one of the hardest disorders to diagnose and you have to insist that your pdoc look at it, if your pdoc understands it. After 10 years, my pdoc is finally approaching me as someone with characteristics with BPII. And it was only at my insistence (SSRIs did nothing for me). You remind me of me in a few ways.
The good news is that one of the few AD's that works well for BPII and many, many other disorders is Nardil. Then after that, there are countless combos to try, most involving Lamictal or Seroquel.
Hang in there and I hope you give Nardil a full trial of 10-12 weeks. Michael
Here is a great site to read on BPII and Dr. Phelps will answer emails:
Posted by stargazer2 on November 25, 2007, at 10:46:49
In reply to Now think this out because it's not so bad » Nardilstarted2007, posted by UGottaHaveHOPE on November 24, 2007, at 2:48:59
You speak the truth Michael...
>>and it is hard to say Nardil has a "bad smell" when urine or human waste in its natural state does not have "good smell." So in essence it really doesn't matter how your human waste smells because it all has a "bad smell."
I just got a 3 new bottles of Nardil in it's Pfizer original container with an absorbent "can" or whatever it is called, for the moisture absorption. I sniffed the pills, as I habitually do, and they had absolutely NO SMELL, which is different from other bottles I have gotten.
In the past I have asked for the "can" for any bottle that didn't come with one, as this seemed to reduce the smell of the pills.
But like I said having an original Nardil bottle with a can in it is the first time I have not encounter Nardil pills that smell, so unless they degrade quickly and develop this smell over the next few weeks, that may be something to request from your the pharmacy. At the least ask for the "can " to be placed in a non-original bottle since this did reduce the smell before but not eliminate it entirely.
Just a suggestion...I personally don't notice alot of "nardil" smells coming from my body, so that may be what is reducing the problem for me.
That and bathing alot...only kidding you guys,
although since I have been feeling better on Nardil my bathing schedule has picked up. I'm back to a bit of obsessiveness, which can be a good thing when for so long this was not considered a high priority.Stargazer
Posted by tecknohed on November 25, 2007, at 17:35:42
In reply to Now think this out because it's not so bad » Nardilstarted2007, posted by UGottaHaveHOPE on November 24, 2007, at 2:48:59
> No, the "bad smell" of Nardil will not go away, but again that is good news because it means the Nardil is flowing through your body, which has to happen for it to work.
I found the smell went eventually, & so did EVERY other side effect (lack of energy got worse but I put that down to lack of efficacy rather than a side effect - when Nardil first worked I had more energy than ever). Nardil's side effects just take a long time to fade. Even the anorgasmia goes eventually.
Posted by Nardilstarted2007 on November 25, 2007, at 19:44:26
In reply to Re: Now think this out because it's not so bad » UGottaHaveHOPE, posted by tecknohed on November 25, 2007, at 17:35:42
> > No, the "bad smell" of Nardil will not go away, but again that is good news because it means the Nardil is flowing through your body, which has to happen for it to work.
>
> I found the smell went eventually, & so did EVERY other side effect (lack of energy got worse but I put that down to lack of efficacy rather than a side effect - when Nardil first worked I had more energy than ever). Nardil's side effects just take a long time to fade. Even the anorgasmia goes eventually.Hey! Yes I just noticed that the smell is fading from me, not much smell from my skin anymore or my stool. I think YouGottaHaveHope is right that it may not completely go away especially in the urine which I still find to smell of nardil pretty bad. I think the reason I had the smell so bad was because I started at 75mg right away and my body was completely not used to metabolizing it. People who titrate up wont notice it as bad as I did.. thats the whole poing of titrating.. lucky I didnt have to many bad other side effects even tho I started so high. Im pretty well Adapted to it now but I feel It could be better. I may go up to 90mgs but I fear If I do that now it will not kick in in time for the presentations I have to do at school in one week, I might just get more side efectd right away which will make me worse for presentating.. So I guesse ill stay at 75mg for now untill this semester is done then maybe try 90 if the 75 doesn't kick in better. Does anyone think that even tho it kicked in at 4 weeks and now I'm at 6.5 weeks that I will still get more benefits just staying at 75mgs? I dont want to go higher really, but if this is all 75 mgs will do I might have to. any input would be greatly appreaciated to know if my current dose will kick in even more.
Thanks
NardilStarted
Posted by tecknohed on November 26, 2007, at 4:51:47
In reply to Re: Now think this out because it's not so bad » tecknohed, posted by Nardilstarted2007 on November 25, 2007, at 19:44:26
>Im pretty well Adapted to it now but I feel It could be better. I may go up to 90mgs but I fear If I do that now it will not kick in in time for the presentations I have to do at school in one week, I might just get more side efectd right away which will make me worse for presentating.. So I guesse ill stay at 75mg for now untill this semester is done then maybe try 90 if the 75 doesn't kick in better. Does anyone think that even tho it kicked in at 4 weeks and now I'm at 6.5 weeks that I will still get more benefits just staying at 75mgs? I dont want to go higher really, but if this is all 75 mgs will do I might have to. any input would be greatly appreaciated to know if my current dose will kick in even more.
> Thanks
> NardilStarted
>I thought you said above "it sure has curbed my social phobia". Isn't this good enough? What else are you hoping for it to do?
Anyhow, you may indeed find more relief from 90mg, but that doesn't really leave you any room should you need to increase the dose in the future, unless your pdoc is VERY familiar with MAOIs & allows you to go higher.
OR, have you considered adding clonazepam to help the SP out a little more? You may only need 1-1.5mg/day. Dont know if you've ever tried it but I've found clonazepam the best benzo for SP for me, but I need 3mg/day of it though at this dose I seem to have stabilized & never find it more-ish. And as Nardil already raises GABA you shouldn't need a very high dose.
teck
Posted by Nardilstarted2007 on November 26, 2007, at 13:22:35
In reply to Re: Now think this out because it's not so bad » Nardilstarted2007, posted by tecknohed on November 26, 2007, at 4:51:47
> >Im pretty well Adapted to it now but I feel It could be better. I may go up to 90mgs but I fear If I do that now it will not kick in in time for the presentations I have to do at school in one week, I might just get more side efectd right away which will make me worse for presentating.. So I guesse ill stay at 75mg for now untill this semester is done then maybe try 90 if the 75 doesn't kick in better. Does anyone think that even tho it kicked in at 4 weeks and now I'm at 6.5 weeks that I will still get more benefits just staying at 75mgs? I dont want to go higher really, but if this is all 75 mgs will do I might have to. any input would be greatly appreaciated to know if my current dose will kick in even more.
> > Thanks
> > NardilStarted
> >
>
> I thought you said above "it sure has curbed my social phobia". Isn't this good enough? What else are you hoping for it to do?
>
> Anyhow, you may indeed find more relief from 90mg, but that doesn't really leave you any room should you need to increase the dose in the future, unless your pdoc is VERY familiar with MAOIs & allows you to go higher.
>
> OR, have you considered adding clonazepam to help the SP out a little more? You may only need 1-1.5mg/day. Dont know if you've ever tried it but I've found clonazepam the best benzo for SP for me, but I need 3mg/day of it though at this dose I seem to have stabilized & never find it more-ish. And as Nardil already raises GABA you shouldn't need a very high dose.
>
> teckHi Teck, Yes it has really curbed my SP, I can go anywhere and talk to anyone, so its working very well for that. I'ts quite a dramatic improvement and nardil keeps me mellow and more like myself unlike ssri's that would make me very depersonalized and give me hypomania for a few days then nothing then hypomania then nothing, so they made me bipolar you could say.
The nardil is wonderful except that I dont think it will curb a panic attack next week when I do some presentations at school, I just started toastmasters.. I am very comfortable around people but I'll still start to panic if I have to give a small speach. I know Nardil wont fix everything and I need exposure therapy as well. I am taking .5mg zanax 4x/day = 2mg's/day. Its just these damn speaches I dont know if I can do it, thats why I was wondering if nardil could be better. I'll give some thought to clonazepam but I dont want to change my current drug regime because I only have a week before presentations so I shouldn't be doing any trial's right now. I have a betta blocker aswell so hopefully that will get me through my presentations. Other then that ya Nardil is doing wonderful for SP and it almost feels like a mood stabilizer even though I've never been on one. So ya its gread but im still deathly scared to present.. oh well, we'll see what we can do in the future. I must say I'm glad not to be agoraphobic anymore and paranoid.
Your bud, NardilStarted
Posted by tecknohed on November 26, 2007, at 14:14:08
In reply to Re: Now think this out because it's not so bad » tecknohed, posted by Nardilstarted2007 on November 26, 2007, at 13:22:35
Yeah, the Xanax sounds like a good idea to keep & as long as it wont sedate you too much then you could add an extra dose before your presentations at school. My own pdoc wants me to stay on 3mg of clonazepam but did say I can take an extra dose in demanding situations.
If you do raise the xanax for these occasions it might be worth trying this out BEFORE the event happens, just to be sure you wont be too sedated. You could try an extra dose tommorow & see what happens.
Beta blocker sounds like a good plan but beware that they can still fog up your mind. Maybe try one a day or so BEFORE your presentations, again just to see how you'll react.
And you may well find Nardil cushions your panic more than you'd expect it to.
Good luck!
teck
Posted by Nardilstarted2007 on November 26, 2007, at 14:31:07
In reply to Re: Now think this out because it's not so bad » Nardilstarted2007, posted by tecknohed on November 26, 2007, at 14:14:08
> Yeah, the Xanax sounds like a good idea to keep & as long as it wont sedate you too much then you could add an extra dose before your presentations at school. My own pdoc wants me to stay on 3mg of clonazepam but did say I can take an extra dose in demanding situations.
>
> If you do raise the xanax for these occasions it might be worth trying this out BEFORE the event happens, just to be sure you wont be too sedated. You could try an extra dose tommorow & see what happens.
>
> Beta blocker sounds like a good plan but beware that they can still fog up your mind. Maybe try one a day or so BEFORE your presentations, again just to see how you'll react.
>
> And you may well find Nardil cushions your panic more than you'd expect it to.
>
> Good luck!
>
> teckHey, that sounds like a good idea. I have definately read that people are using clonazepam alot more then zanax for SP.. why I dont know, maybe just because its easier to get off of. I also read it seems to be more sedating then zanax so people use it as a sleep aid alot more than zanax but maybe thats just because of the longer half life. zanax is stated to be more anxiolitic and possible better for panic, but its probably individual based and the more u use them the less they will sedate you during the day. zanax you just have to take more doses during the day to keep it up in your blood stream as it wears off faster so i take it 4x aday. whats your dosing regime for clonazepam? Ya I'll do a couple trials with the betablocker and a bit more zanax to see if I'm still alert enough to do a presentation.
Thanks, talk to ya soon
Posted by tecknohed on November 26, 2007, at 16:18:36
In reply to Re: Now think this out because it's not so bad, posted by Nardilstarted2007 on November 26, 2007, at 14:31:07
Hers my whole dosing regime:
Breakfast (8am)
clonazepam 1mg
Marplan 20mg
Idebenone 100mg
Vinpocetine 5mgLunch (1pm)
clonazepam 1mg
Marplan 10mg
Idebenone 100mgDinner (6pm)
clonazepam 1mg
Marplan 10mg
Idebenone 100mgAs you can see I like to spread my doses out, even with clonazepam. Despite it's long half life I find clonazepam wears off after around 6 hours. Thats not to say anxiety will start after 6 hrs, just that thats how long its peak effect lasts for.
Posted by brooke484 on November 27, 2007, at 12:50:51
In reply to Deplin/Brooke, posted by stargazer2 on November 20, 2007, at 22:27:40
Did you take any information with you to the doctor? I would feel better if I had something to give mine instead of trying to explain why he should let me try some drug that he's never heard of before.
Thanks.
brooke
Posted by stargazer2 on November 29, 2007, at 22:35:25
In reply to Re: Deplin/Stargazer, posted by brooke484 on November 27, 2007, at 12:50:51
I don't think I took anything to show him I just told him what Deplin is, L-methylfolate. Told him Folic acid deficiency has been implicated in depression and deplin is a compound that can be directly used by the brain since it has been broken down to it's most basic components.
The only information I found on Deplin was from the manufacturer and I would never consider that unbiased so it is not something I would use as justification for a treatment. It did help me understand the process though. I also printed out articles on folic acid deficiency for my own use.
My pdoc just said "Do you want to try it?" and of course i said yes and he wrote a script. He knows me well enough to only present him with reliable information. If it was a medication and not a vitamin, he would have needed to review the information himself. That is what he has done with MAO add-ons, until I had a hypertensive reaction, and now he is more cautious about adding something to Nardil. But my reaction occurred with a higher dose than was recommended in the article so we didn't follow the advice accurately enough so it was our own fault. I was fine at the recommended dose of amphetamine.
Stargazer
Posted by brooke484 on November 30, 2007, at 11:10:20
In reply to Re: Deplin/Brooke, posted by stargazer2 on November 29, 2007, at 22:35:25
I did end up finding some good info that I just mailed him. I was kind of surprised that he's never heard of it. Aren't doctors supposed to be on top of these things?
brooke
Posted by stargazer2 on November 30, 2007, at 13:41:04
In reply to Re: Deplin/stargazer2, posted by brooke484 on November 30, 2007, at 11:10:20
I'm not surprised about not knowing anything about Deplin. It is not a psychotropic medication but a vitamin, so they wouldn't hear anything about this from their pharma reps their main source for new med information.
So unless we tell them about it from hearing about it on PB, we wouldn't even know, but PB is on the leading edge of things since there are so many of us hunting for new insight and things to try next.
It doesn't mean your doc is clueless, just less informed than many of us on PB.
Stargazer
Posted by Phillipa on November 30, 2007, at 21:19:39
In reply to Re: Deplin/brooke, posted by stargazer2 on November 30, 2007, at 13:41:04
Here's the but word. If something is a medicine how can it be a vitamin. Understandable why Dr. Bob switched to alernative. How can it be both as a prescription for a med but not a vitamin????Phllipa
Posted by stargazer2 on December 1, 2007, at 13:15:34
In reply to Re: Deplin/brooke » stargazer2, posted by Phillipa on November 30, 2007, at 21:19:39
Semantics more than anything...Many vitamins require a prescription, like B-12 or any vitamin whose dosage is higher than is normal.
For right now you need a prescription but I would still classify it as a vitamin but really not an alternative treatment. At least I don't think so.
Could go either way on meds or alternative board, but with a prescription it makes more sense to be here than on altrnatives.
Stargazer
Posted by Marty on December 2, 2007, at 1:05:39
In reply to Re: The 'Nardil Smell' do you have it?/Phillip, posted by stargazer2 on November 20, 2007, at 9:54:26
YES. The time I've been on Nardil:
- The pill was smelling quite bad.
- When I'd take a s__t it was smelling VERY bad.If I was you I would do what I didn't: call Pfizer and ask them if it's normal. At least ask them if the pill should small THAT bad.
Posted by stargazer2 on December 2, 2007, at 17:57:20
In reply to Re: The 'Nardil Smell' do you have it?/Phillip, posted by Marty on December 2, 2007, at 1:05:39
My new nardil pills have no smell at all and came in the original white Pfizer bottle, which contain 30 pills. Previous pills had the nasty smell and came in the typical amber bottle pharmacies use to put pills in. I wonder if that is the difference. The Pfizer bottle also has a huge canister for moisture absorbtion. IN my previous post I said that might make a difference. It's the only thing that I see of significance between the bottle from the pharmacy and the bottle from the manufacturer.
You have to make sure if it is the pharmacy bottle that there is a moisture absorbant canister in it. The pills may have the smell if they get moist.
Stargazer
Posted by Nardilstarted2007 on December 5, 2007, at 17:27:57
In reply to Re: The 'Nardil Smell' do you have it?/Phillip, posted by Marty on December 2, 2007, at 1:05:39
> YES. The time I've been on Nardil:
>
> - The pill was smelling quite bad.
> - When I'd take a s__t it was smelling VERY bad.
>
> If I was you I would do what I didn't: call Pfizer and ask them if it's normal. At least ask them if the pill should small THAT bad.
>Ya its pretty nasty, The smell started to go away after 7 weeks on 75mg/day but I just upped my dose to 90 and the smell is coming back again from my skin, showers take it away ofcourse. I guess I just need to adapt to 90 mgs and the smell will get less again.. urine and stool seems to take longer to go away and never will all the way I think.. Yes I should call them. My bottle says Erfa, so ill call them, but they probably get it from phizer, im in canada.
This is the end of the thread.
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