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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Neurogen on February 7, 2009, at 8:59:04
Hello,
I orginally got on Nardil for SP and dysthymia/depression a year ago. I quickly titrated up to 75mg/day over a span of 4days or so. It was my 1mg/kg target. Sideeffects were minimal. By the end of the first week, I was feeling the drug good. Everytime I took a pill, within minutes I would get this soothing GABA buzz in my brain. My SA was completely wiped out. Depression was history. I felt free for the first time in my life. I stayed on the Nardil for approx. 1.5mo, about have that time taking 60mg or less.
I felt my brain was fixed, didnt want to pay expensive psych for more.I begin smoking pot again, excessively. I then experienced a major financial loss, which led to my cessation of the pot, and major lifestyle changes. My stress level slowly rose up, and I could literally feel my frontal lobe shutting down, becoming cloudy and atrophied.. Depression taking over. My SA came back strong and it brought some lovely Obsessional OCD with it.
I went into a severe melancholic depression. Worst episode I'd ever had. I had been on Nardil 60mg for 2weeks as I spiraled deeper. It was doing nothing at all, which had me confused and more depressed. I checked into the hospital, desperate, and having suicidal thoughts. I got them to increase dose to 75mg. Discharged after a week. Suicidal thoughts were leaving, but I was still very messed up. It's been a slow climb to remission.
Was at 60mg 2weeks, nothing.
Was at 75mg for about 10 weeks. Big improvement from beginning, but still depressed/anxiety problems .
Raise to 90mg for 6weeks, more improvement, depression nearly gone, anxiety lingers.
Raise to 105mg.
2.5 weeks in, slight improvement on anxiety.I don't like being on such a high dose. Sex is messed up, constipation annoying. They'll subside in time, but im tired of it.
I've now gained 20pounds over my initial weight.
I'm about 86kg and its coming down through exercise/diet.I augment with Klonopin .5/1mg sometimes when I want to zap the SA away.
So I wonder.. My mental conditions were very different both times on the drug. But I've been on Nardil now for about 4months at high dosages and it's acting like it's half-cocked.
It was like my first trial was with this different magical drug.Now what?..how to recapture full Nardil. Monotherapy prefferred.
Is there a therapeutic window I missed? Too much MAO inhibition? Lower dosage?
Drug holiday? Restart in a month.
Go Parnate?
Posted by Phillipa on February 7, 2009, at 10:57:35
In reply to Nardil, what now.., posted by Neurogen on February 7, 2009, at 8:59:04
I see you're new to babble. Welcome I'm sure someone with nardil experience will help to answer your questions. I personally have not been on the med. Welcome again. Phillipa
Posted by egg on February 7, 2009, at 18:25:07
In reply to Nardil, what now.., posted by Neurogen on February 7, 2009, at 8:59:04
Hi, Neurogen. Am relatively new to this board, too, although very familiar with Nardil.
When I first took Nardil my doc put me up to 105mg. This was back in the early 80s, but within a few months I stabilized enough to completely withdraw from Xanax. I hated Nardil's side effects but preferred them to the alternative. (Thanks for reminding me of that GABA buzz, which is something I hadn't thought of in decades ...)
I don't know why your second trip with Nardil isn't going as well as the first, and so I'm just going to throw out an idea: perhaps you have a bad batch? Batches?
If you've done any research on this and other boards, you're probably aware of the "old vs. new" Nardil formula. The composition of Nardil was altered in the early 00s. Since then, I and others have noticed the quality of the drug varies according to batch.
Characteristics of a "bad" batch include a terrible odor and taste. Even the "good" batches have a rotten odor and taste, since the pill's original coating was removed in the redo -- but the smell of a "bad" batch made me puke.
What helped me deal with this variation was finding a pharmacist I trusted and who was willing to return bad batches to the manufacturer.
Btw -- I eventually went down on my original dose and mainly hung out at 30-45mg for over 20 years. After the formulaic change, I supplemented with .5-1.5mg of Klonopin (taken only at night).
Hang in there. :)
Posted by Neurogen on February 10, 2009, at 10:38:32
In reply to Re: Nardil, what now.., posted by egg on February 7, 2009, at 18:25:07
I doubt my problem is with a bad batch.
Anyone with experience stopping and restarting Nardil?
Posted by SLS on February 10, 2009, at 11:08:08
In reply to Re: Nardil---Therapeutic window? Drug holiday?, posted by Neurogen on February 10, 2009, at 10:38:32
Hi.
To the best of my knowledge, Nardil does not have a window of efficacy in the same way as does nortriptyline. If Nardil works at 60mg, it will still work at 90mg. The difference lies in the occurrence of side effects.
I don't know if that's the answer to the question you were asking.
With Nardil, a drug holiday of 3 months often allows for it regain its effectiveness. I would probably move on to Parnate if you have never tried it before. Should it not work, by the time you get done with it, it will be time for you to go back to Nardil again. One of my doctors had a patient whom he cycled between the two drugs.
- Scott
Posted by egg on February 12, 2009, at 21:37:55
In reply to Re: Nardil---Therapeutic window? Drug holiday?, posted by SLS on February 10, 2009, at 11:08:08
> With Nardil, a drug holiday of 3 months often allows for it regain its effectiveness.2-3 months was it for me in the past, and going back on had a close to immediate effect. (Immediate = within a few days my set of PA symptoms started to subside.)
This is the end of the thread.
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