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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by pedr on September 8, 2009, at 14:43:46
Hi all,
I was actually feeling ok on 60mg Nardil, even occasionally 'good' for the first time in 13 years. I was cautiously hoping that I'd found my drug. Life had moved from pain, suffocating obsessions, suffering, suicidal ideation, overwhelming anxiety, dread of the future and feeling inhuman to something to make the most of, to be lived and explored. Sorry for the melodrama but it really was like night and day.Last Weds I started feeling flat and a bit down. This progressed into feeling very depressed on Sat & Sun. I felt like my dream was coming crashing down. I would give my life savings and everything I own for Nardil to keep working and not have to face the horrors of depression again. I was terrified and distraught. I have been praying on my knees that the Nardil kick in again.
Has anyone else experienced this sudden crash in mood @ 60mg? Why would this happen when things were going so well? The depression is far worse in the morning and earlier last week I switched from 30mg in the a.m. and 30mg in the p.m. to 60mg in the a.m. Could this be having some effect? I switched because I was having trouble sleeping but I will switch back just in case. Also, I had a single bottle of beer on Fri night and Sat night. Surely that small amount of alcohol could not cause such a dramatic regression?
I called my pdoc on Sunday and he agreed to raise the dose to 75mg. I'm 75kg which I've read makes this a suitable dose at 1kg=1mg. Something I've been meaning to ask for a while is how long a dosage adjustment like this will take to kick in? Surely it's not the 4-8 weeks that starting Nardil takes? Also Scott wrote something about increasing from 60mg to 75mg being a way bigger jump in various metrics and effects than say 15mg to 30mg but I cannot find that post.
My pdoc has intimated that he can no longer help me if Nardil doesn't work. Can anyone recommend a progressive pdoc in NYC who would be willing to augment Nardil e.g. nortrip or provigil?
Sorry about the length of this post and the number of questions, I am terrified of going back to unbearable depression.
Thanks for reading,
Petep.s. Thankfully today I'm feeling more stable again but this brief crash has left me feeling very vulnerable.
Posted by Phillipa on September 8, 2009, at 17:37:58
In reply to Nardil crash @ 60mg, posted by pedr on September 8, 2009, at 14:43:46
Having no experience with being on an Maoi hoping someone on nardil joins. I know Ace has been here frequently later. Maybe you feel better today. And it will last? Love Phillipa
Posted by ColoradoSnowflake on September 9, 2009, at 1:37:56
In reply to Nardil crash @ 60mg, posted by pedr on September 8, 2009, at 14:43:46
Hi Pedr:
I had the same thing happen. I have been doing really well on Parnate. Then this last weekend I fell head first into the slimy black hole: depressed,worthless, hopeless, thinking of suicide (which the Parnate had pretty much wiped out), angry about the whole thing and utterly overwhelmed and miserable.
I decided to increase my Parnate to 70mg. and to always take the whole dose of Provigil, which I had been shorting trying to make it last longer ($$), and if my sleep is affected I'll add more Nortript. too.
Today I got up feeling exhausted, went to my exercise class, and started feeling better. Gradually as this day has passed I'm back to feeling really good again.
It was pretty scary, and of course I thought it was forever.
Maybe that just happens sometimes, especially when one's body is getting used to new drugs.
I'm going to try to remember not to freak out if this happens to me again.
I hope you are totally OK now!
Best,
Gayle
Posted by ColoradoSnowflake on September 9, 2009, at 1:41:10
In reply to Re: Nardil crash @ 60mg Pedr, posted by ColoradoSnowflake on September 9, 2009, at 1:37:56
I forgot to say mine lasted Sat, Sun, Mon.
Maybe it was the "holiday" weekend.
Gayle
Posted by pedr on September 9, 2009, at 10:11:34
In reply to Re: Nardil crash @ 60mg Pedr, posted by ColoradoSnowflake on September 9, 2009, at 1:37:56
> Hi Pedr:
>
> I had the same thing happen. I have been doing really well on Parnate. Then this last weekend I fell head first into the slimy black hole: depressed,worthless, hopeless, thinking of suicide (which the Parnate had pretty much wiped out), angry about the whole thing and utterly overwhelmed and miserable.no way. That's exactly how I felt. One day I was relatively happy, then next I was contemplating suicide and convinced that my good luck was over and I was going back to intense suffering.
>
> I decided to increase my Parnate to 70mg. and to always take the whole dose of Provigil, which I had been shorting trying to make it last longer ($$), and if my sleep is affected I'll add more Nortript. too.that could explain it then, if you'd been shorting the dose. At least you can perhaps rationalize what happened - have a reason for it. That always helps!
>
> Today I got up feeling exhausted, went to my exercise class, and started feeling better. Gradually as this day has passed I'm back to feeling really good again.Phew. Thank God for that.
>
> It was pretty scary, and of course I thought it was forever.Crazy isn't it. I was telling my wife that everything was over, that I was doomed, that Nardil had failed, that I was going right back down. Two days later and (touch wood) I am 'OK' again.
>
> Maybe that just happens sometimes, especially when one's body is getting used to new drugs.I hope not :( I hope it was due to the beer I had or moving from 2+2 to all 4 pills in the a.m. I doubt it's either of those reasons though, really :/ I really don't like uncertainty.
>
> I'm going to try to remember not to freak out if this happens to me again.
>
> I hope you are totally OK now!Thanks. Doing OK since. Hope you carry on OK too.
Pete>
> Best,
> Gayle
Posted by bleauberry on September 9, 2009, at 10:28:12
In reply to Nardil crash @ 60mg, posted by pedr on September 8, 2009, at 14:43:46
It was around a full moon. I know it sounds ridiculous on the surface, but from now on keep a diary of what happens in the days leading up and after a full moon. Maybe a connection maybe not. But when you are feeling vulnerable and looking for an answer, everything should be suspect. Nothing can be ruled out until it is definitively proven to be ruled out. Ask any emergency room nurse or physician if they see increased mental illness traffic around a full moon and they will yes, "Big time, and we schedule extra staff during the full moon to handle it."
As you are probably aware, there has been enough anecdotal evidence on Nardil's new formula to be suspect of one batch verses another, or even suspect quality within the same batch. This probably does not apply, but I was just wondering if maybe you had just started a new bottle of Nardil, or it had been exposed to unusual heat or moisture or something?
From what I gather at forums that talk about Nardil, one of the primary suspect things that changed with the new formulation are the ingredients that were related to absorption...speed, availability, etc. I wonder if maybe there aren't certain foods that might interfere? Just an idea. Probably a wild guess, but hey, easy enough to diary and see.
Other than those things, depression is an ongoing non-static syndrome. It is in motion. Doesn't stand still. Fluctuations. It is my feeling that most depressions have an underlying physical cause. The right meds are able to make bridges over roadblocks, or new paths around a dam, etc. But maybe if the underlying problem is still undetected and still advancing, at some point the med becomes vulnerable of not doing enough to overcome that roadblock? And during a time when the underlying problem happens to be on a temporary upswing in power, the med just falls short. It works good enough again when things calm down. The hard part is finding out what is it under the surface in the body that is doing it.
Posted by pedr on September 9, 2009, at 10:31:35
In reply to Re: Nardil crash @ 60mg Pedr, posted by ColoradoSnowflake on September 9, 2009, at 1:41:10
> I forgot to say mine lasted Sat, Sun, Mon.
> Maybe it was the "holiday" weekend.
> Gayleheh heh. Not much of a holiday, was it...
Posted by bleauberry on September 9, 2009, at 10:34:41
In reply to Re: Nardil crash @ 60mg Pedr, posted by ColoradoSnowflake on September 9, 2009, at 1:41:10
> I forgot to say mine lasted Sat, Sun, Mon.
> Maybe it was the "holiday" weekend.
> GayleIt was also a full moon.
The moon is powerful enough to move entire oceans. Just imagine what it can do in the human body.
Lyme patients have discovered their symptoms flare up on a monthly basis, right around the full moon. Some even up their antibiotic doses at those times to kill more of the bugs coming out to play at the full moon. Any trauma room nurse, MD, or receptionist will attest to the remarkable increase of patient traffic on a full moon. Kind of makes you wonder.
I'm not on meds right now, but I too had a rather heavy downswing this past weekend. It was a rather ordinary weekend just like any other, so I don't know what made such a difference, other than what I mentioned above.
Posted by pedr on September 9, 2009, at 14:52:34
In reply to Re: Nardil crash @ 60mg, posted by bleauberry on September 9, 2009, at 10:28:12
> It was around a full moon. I know it sounds ridiculous on the surface, but from now on keep a diary of what happens in the days leading up and after a full moon. Maybe a connection maybe not. But when you are feeling vulnerable and looking for an answer, everything should be suspect. Nothing can be ruled out until it is definitively proven to be ruled out. Ask any emergency room nurse or physician if they see increased mental illness traffic around a full moon and they will yes, "Big time, and we schedule extra staff during the full moon to handle it."
does sound ridiculous ostensibly but you're right, never rule anything out until you've tested it. I already keep a detailed log of my depression and IBS-C and so this should be easy to retroactively process.
>
> As you are probably aware, there has been enough anecdotal evidence on Nardil's new formula to be suspect of one batch verses another, or even suspect quality within the same batch. This probably does not apply, but I was just wondering if maybe you had just started a new bottle of Nardil, or it had been exposed to unusual heat or moisture or something?Good suggestion but no, I hadn't started a new supply and it's sitting in the bathroom as usual. I should probably move it out if heat&moisture can be a problem?
> From what I gather at forums that talk about Nardil, one of the primary suspect things that changed with the new formulation are the ingredients that were related to absorption...speed, availability, etc. I wonder if maybe there aren't certain foods that might interfere? Just an idea. Probably a wild guess, but hey, easy enough to diary and see.
Interesting. I used to keep a food log when my IBS-C was much worse but I no longer do. Perhaps I can start that off again. I also take 300mg Zantac. Sometimes with the Nardil and sometimes hours beforehand. I should probably not take it at the same time as the pH will be different depending on when I took the Zantac.
> Other than those things, depression is an ongoing non-static syndrome. It is in motion. Doesn't stand still. Fluctuations. It is my feeling that most depressions have an underlying physical cause. The right meds are able to make bridges over roadblocks, or new paths around a dam, etc. But maybe if the underlying problem is still undetected and still advancing, at some point the med becomes vulnerable of not doing enough to overcome that roadblock? And during a time when the underlying problem happens to be on a temporary upswing in power, the med just falls short. It works good enough again when things calm down. The hard part is finding out what is it under the surface in the body that is doing it.Agreed. However I'm pretty good at detecting what beliefs are getting me down (and I have plenty). Also, when I feel a very bad person from beliefs I hold, that feels completely different to the sort of "chemical" (I hate using that word but can't think of any better) or biological depression I felt at the weekend. The kind of incredibly powerful depression you feel in your gut and heart, that makes you want to curl up and disappear.
Thanks for the interesting suggestions.
Pete
Posted by atypical on September 9, 2009, at 17:07:04
In reply to Nardil crash @ 60mg, posted by pedr on September 8, 2009, at 14:43:46
Hey Pete, I'm in sort of a similar situation as you. I started taking Nardil like two months ago for atypical depression/dysthymia. While I was on 45mg I had a few days of horrid suicidal thoughts which I never had before. Pure horror. But they did pass. I like how someone mentioned in reply to your post that depression is indeed fluid. Moods change. Two bad days feels like they will last forever, but moods ebb and flow and the pressure let's go a little bit over time.
Well, now I've moved up to 60mg and I still feel the mild depression/low-grade constant sadness, no pleasure or joy that has ruled most of my last 12 years. It's not horrible or disabling, but it is suffering nonetheless. I truly hoped Nardil would finally conquer it. My doctor may raise the dose to 75mg as I am about 155-160 lbs. And I pray that will happen. I have so much life to live and enjoy. I just want to be able to live fully and be able to enjoy it. The last week I have been feeling a lot lower because a woman I started dating is not responding back to me.
Try finding a university-affiliated psychiatrist. Or a psychopharmacologist -- no therapy doc. You should have no problem being in NYC.
I wish you the best!
Atypical
Posted by pedr on September 15, 2009, at 12:41:08
In reply to Re: Nardil crash @ 60mg, posted by atypical on September 9, 2009, at 17:07:04
> Hey Pete, I'm in sort of a similar situation as you. I started taking Nardil like two months ago for atypical depression/dysthymia. While I was on 45mg I had a few days of horrid suicidal thoughts which I never had before. Pure horror. But they did pass. I like how someone mentioned in reply to your post that depression is indeed fluid.
Moods change. Two bad days feels like they will last forever, but moods ebb and flow and the pressure let's go a little bit over time.Hi mate, I agree that depression ebbs and flows but this was black and white. Bang - horrifying fear, bang - gone. Not the usual ups and downs of life with depression for me.
>
> Well, now I've moved up to 60mg and I still feel the mild depression/low-grade constant sadness, no pleasure or joy that has ruled most of my last 12 years. It's not horrible or disabling, but it is suffering nonetheless.for sure. No-one should have to experience that, it needs sorting out if possible. You shouldn't have to live with it.
> I truly hoped Nardil would finally conquer it. My doctor may raise the dose to 75mg as I am about 155-160 lbs. And I pray that will happen.
How long have you been on Nardil? I'm sure you're aware of how long it can take to kick in. How long have you been on 60mg (the dose I assume you are on) ?
> I have so much life to live and enjoy. I just want to be able to live fully and be able to enjoy it.
And you should be able to achieve that (easy for me to say now I don't feel desperately low at the moment). I don't know your background but I'm sure there must be some routes you have yet to try?
> The last week I have been feeling a lot lower because a woman I started dating is not responding back to me.
That's all you need, women trouble... You'll not be receiving any good advice from me, trust me!
>
> Try finding a university-affiliated psychiatrist. Or a psychopharmacologist -- no therapy doc. You should have no problem being in NYC.Yep, that's the plan. Just not sure how to go about it or what insurance they take. I guess I'll have to find out should my pdoc stick to his guns.
>
> I wish you the best!
>
> AtypicalDitto. Good luck with the new dose.
Petep.s. sorry for late reply, am on vacation and had forgotten my password
This is the end of the thread.
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