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Dr. Bob is Robert Hsiung, MD,
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Posted by PilledOut on July 8, 2016, at 14:18:09
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by rose45 on July 8, 2016, at 13:39:20
That's good to know, rose45.
I took a break from Nardil the past 3 days. Today I started on it again, but I took 30mg instead of 45. Again, I'm getting the following symptoms: dilated eyes, eyes can't open completely, feeling hazy, sick feeling, some shaking, bit of headache here and there, cold hands, sickly feeling in face, face drained of color, and ringing in ears at one point. And now, typing feels weird as well. The side effects are relatively mild compared to what happened on Monday, though.
When I was initially on 30mg, I hadn't felt these symptoms because I had been taking it everyday, but today I'm feeling them, probably because I skipped 3 days.
I'm not working or in school right now, so I can wait out the horrible side effects. I'd definitely need to take some days off if I were working or in school!
If I had Monday's severe symptoms on any other med, I would've stopped it immediately. But Nardil is known to be such an amazing med that I'm giving it another chance. I'm kind of scared to go through all these side effects, but I hope they'll go away soon.
To avoid Monday's extreme side effects, I'm going to try taking Nardil in divided doses, spaced throughout the day. Also, if I feel that I have too much Nardil in my system, I'm going to skip or lower the dose for a day or two, and then go up to the regular dose again. I talked to my doctor, and she advised that.
Posted by rose45 on July 8, 2016, at 17:02:19
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by PilledOut on July 8, 2016, at 14:18:09
I wish I could say something to help. And I wish your doctor was more of an expert in MAOIs. In my case, I was in hospital and the doctors were not that interested in my symptoms. They were focused on making me stay on the medication and to keep increasing the dose up to 60 mg. I was on that dose for 4 weeks before I felt better. I had insomnia, constipation and felt totally suicidal. But I was not on any other medications - so I dont know whether that is an issue, in your case. I could barely function, but I was in hospital, so meals were prepared for me etc but it was really grim in that hospital. I went through this process on 3 several occasions, because every time I decreased the medication too much, on future occasions, I became ill like that again, and again had to go through the entire 8 weeks of misery, titrating it up again. But I honestly have not read of anyone having as hard a time as I did with that medication. However, once it worked, it did really work.
Posted by SLS on July 8, 2016, at 17:37:25
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by PilledOut on July 8, 2016, at 14:18:09
I don't think you are going to avoid experiencing these startup cognitive side effects and secure an antidepressant response by jumping up and down in dosage or skipping days. You can only make things worse. Now, you say that you are experiencing problems at 30 mg/day? How do you interpret this? I would recommend against "pulsing" Nardil on and off. You are probably sensitizing the brain and autonomic nervous system to some of the pharmacological effects of Nardil.
I understand that you can't afford to experience cognitive impairments right now. You can either stop Nardil now and wait for a better time to give it a full trial or go up in dosage very slowly. Cut the pills in half. Try to keep your dosages steady. Perhaps you can restart Nardil at 15 mg/day and increase the dosage by 7.5 mg every week or two.
Please continue to post as you progress through your Nardil trial. I hope people here can help you through it or give you sufficient reason to end it. My period of cognitive impairment weirdness lasted for roughly 3 days once I reached 60 mg/day. I believe it was a sign that Nardil was doing to the brain what it was supposed to. For the most part, the drugs that worked for me gave me some sort of changes in cognition or perception temporarily.
I'm not in your head, so I really don't know what you are experiencing. I may be wrong in my interpretation of your words. Perhaps my suggestions are not appropriate for you. All I can say is that the cognitive side effects that occur briefly at the beginning of treatment is not uncommon.
- Scott
Posted by PilledOut on July 8, 2016, at 21:41:14
In reply to Re: Strange side effects from Nardil, eg loud sounds » PilledOut, posted by SLS on July 8, 2016, at 17:37:25
Hi Scott, sorry, this might be difficult to follow because I've been writing about my experiences over several days. If you like, you can re-read all my posts in this thread to get a better understanding of what's been happening.
Actually, I wrote that I was not working or in school right now, so I can afford to go through bad side effects, like rose45 did in the hospital.
I was not purposely starting Nardil on and off. On Monday, I had the extreme side effects that I wrote about in the first post. That's why I stopped it for 3 days. I was actually going to stop Nardil until my next dr's visit next week, but I decided to start it up again today.
Yes, I had side effects at 30mg, but they were much milder than the extreme effects I got on Monday when I was on 45mg.
---------------------
I actually got an EXTREME, TERRIFYING experience this afternoon. All of a sudden, I could barely breathe, I was going to faint, my heart was beating super fast, my face was sickly, and my hands were cold and clammy. I thought I needed to be rushed to the ER asap. But I sat down and got better. It was over in less than 10 minutes. But it was horrific, and I really thought I was dying. I had a similar experience when I was on clomipramine a few months ago.Was that a hypertensive crisis? Didn't sound like it. It does fit into the description of panic attack. Nothing seemed to lead it on; I was just calmly reading when it suddenly happened. I had taken the 30mg Nardil in the morning. For lunch, I had a pizza slice and a Drumstick ice cream cone. (I had pizza quite a few times on Nardil with no effects.) Then I got a headache right afterwards. Then a couple of hours later, the "attack" came on.
Did it have anything to do with Nardil? It was absolutely terrifying, and I wouldn't want it to happen again. Anyway, I'm stopping Nardil until my dr's appt next week.
Posted by jonhed on July 9, 2016, at 2:25:05
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by PilledOut on July 8, 2016, at 21:41:14
I'm sorry to say this and i hope you can do something about it, maybe add an benzo or something.
But i think you are experiencing full blown panic attacks with dissociative elements (it's usual..).I think they will go away, but you need an add on until the nardil start to work.
I have had this feeling many times to and it is panic attacks, extreme ones.
I really feel with you cause it's the worst thing you could go through, but it gets better, and please, tell your doctor and make him/her put you on a strong benzo for some weeks..
(just my opinion)
It makes me sad to read that..
Posted by SLS on July 9, 2016, at 7:04:49
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by PilledOut on July 8, 2016, at 21:41:14
> I actually got an EXTREME, TERRIFYING experience this afternoon. All of a sudden, I could barely breathe, I was going to faint, my heart was beating super fast, my face was sickly, and my hands were cold and clammy. I thought I needed to be rushed to the ER asap. But I sat down and got better. It was over in less than 10 minutes. But it was horrific, and I really thought I was dying. I had a similar experience when I was on clomipramine a few months ago.
Do you think it was an attack of low blood pressure? This is not uncommon with Nardil when getting up from a seated position (orthostatic hypotension). This was a big problem for me when I take Nardil, but it got about 50% better over time. When the blood pressure drops, the heart must beat faster and more forcibly to compensate for this. This can result in rapid heartbeat and palpitations. Tricyclics can do this too, but not as bad.
Anyway, I think you are doing the right thing by stopping Nardil and talking to your doctor. Despite your very detailed descriptions, I don't think anyone here can guarantee that you can safely take this drug. If your doctor is unfamiliar with MAOIs, he will probably want you to stop taking it indefinitely.
> Was that a hypertensive crisis?If it were a common headache, I doubt it. However, if your headache presented as a rhythmic and painful pounding in the back of your head, then a hypertensive reaction is the likely explanation for your reaction.
It is important to recognize that the effect on total MAO inhibition produced by Nardil is latent and involves a lag time. This happens both on the way up and on the way down in dosage. That said, I am all but sure that Nardil has properties other than MAO inhibition. It seems to be an acute stimulating effect that is different from Parnate. I experienced this 0.5 to 1.5 hours after dosing. I really screwed around with Nardil more than I should have because I was misinterpreting this effect. Because of this, I may have more experience with the personality of this drug than most other people. When I was going up and down in dosage, I experienced changes in the size of my pupils (I think they became bigger), sweating without feeling hot, tachycardia and palpitations. In other words, I experienced a kind of transient dysautonomia when I raised the dosage after having reduced it.
A few ideas:
1. Restart Nardil at 15 and increase the dosage by 7.5 mg every 2 weeks. Some people do respond to 30-45 mg/day, but not many. I would say that 45 mg/day might be a good dosage to target first. You could maybe give it 3 or 4 weeks to work. From there, you could then try to move up to 60 mg/day; increasing the dosage by 7.5 mg at a time.
2. Try taking Marplan (isocarboxazid). It is similar to Nardil, but much more tolerable.
3. While taking Nardil, take a beta-blocker to prevent or lessen the intensity of sympathetic nervous system stimulation. You can take propranolol, atenolol or pindolol. Atenolol might be best, as it does not cross the blood brain barrier and has fewer side effects. You could then discontinue it gradually once you are able to establish a therapeutic dosage of Nardil.
I guess you need to weigh cost versus potential benefit of taking Nardil - or any other drug.
Other than clomipramine, what other tricyclics have you tried, and what were the results?
Do you think you need to take a break from trying medication at this point?
Is perfectionism or obsessiveness a problem?
- Scott
Posted by jonhed on July 9, 2016, at 8:39:04
In reply to Re: Strange side effects from Nardil, eg loud sounds » PilledOut, posted by SLS on July 9, 2016, at 7:04:49
So just to be clear, it is totally ruled out that it was a panic attack?
The symptoms he describes is the symptoms of, at least mine, panic attacks.I know that it could be other things to, but i hope that we don't rule out the possibility that it was a panic attack.
Then, atenolol could make the anxiety worse.
I'm NOT saying your wrong, the things you purpose sounds that it could be right to, but have in mind that i could be other things to.
As i have said, it is good that it is discussions about things. That is how we can help each other :-)
Kind regards. J
Posted by SLS on July 9, 2016, at 10:17:01
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by jonhed on July 9, 2016, at 8:39:04
> I know that it could be other things to, but i hope that we don't rule out the possibility that it was a panic attack.
>
> Then, atenolol could make the anxiety worse.I didn't know that. Do you know why?
Oh, you don't want to take a beta-blocker if you have asthma.
I would say that a panic attack would include hyperventilation. I don't remember that happening with me. Interestingly, Nardil can effectively treat GAD and panic attacks. It may be that a panic attack emerged as the result of extreme worrying about the upsetting side effects produced by Nardil.
This is a bit of a conundrum. If I had not known about startup side effects, I doubt that I would have continued taking Nardil, even though it would have ultimately improve my condition.
I think the severity of the side effects should be taken into consideration. If the side effects were intense, I don't think it makes sense to continue with Nardil.
- Scott
Posted by jonhed on July 9, 2016, at 10:26:29
In reply to Re: Strange side effects from Nardil, eg loud sounds » jonhed, posted by SLS on July 9, 2016, at 10:17:01
It's something with it, even if it's to a little extent, reduces noradrenaline, and that can, in some individs, trigger depressive symptoms. Maybe not anxiety, but depression i know.
I know i got depressive on atenolol, metoprolol and def on clonodine (i know, that is something else but anyway),
and my pdoc even told me that i could.But as for everything, some are very helped from beta-blockers, some are don't.
I was gonna write that, cause my most extreme panic attacks have occurred after excessive worrying about a medication that i take.
Even if it is an axiolytic, (read buspar).But i agree with you, the severity of the symptoms must be taken seriously.
Posted by jonhed on July 9, 2016, at 10:37:54
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by jonhed on July 9, 2016, at 10:26:29
I still have 99 of 100 pills of Parnate left just because of that worry.
2 weeks i was in panic. But i am very anxious in that way..
Posted by PilledOut on July 9, 2016, at 10:49:31
In reply to Re: Strange side effects from Nardil, eg loud sounds » PilledOut, posted by SLS on July 9, 2016, at 7:04:49
I've often felt that my various symptoms on Nardil and tricylics were at least partly from low blood pressure. However, I felt the attack coming on while seated.
I had a common headache with no throbbing or pulsing.
I tried imipramine not long before I tried clomipramine. Imipramine had similar effects to clomipramine and Nardil - dilated eyes, sick feeling, swaying/not standing still, face drained of color, hazy feeling, difficulty concentrating. These old school drugs seem kind of similar. One day I was walking while I was on imipramine and the effects were much worse, and it was hard to get home. I told my doctor about this, and she had me stop it.
She had me stop the clomipramine after I told her about the "attack." The clomipramine attack gave me blurred vision and a blacking out feeling, and I did not hyperventilate. However, the Nardil attack yesterday made me hyperventilate (it was terrifying), but I did not get blurred vision.
Yes, my side effects have been extreme, and I'm sure I need to stop Nardil. I haven't had any luck with meds over the years.
I do take Ativan and Xanax as needed, no more than 2-3 times a week. I would just stick with that for now. I'm sure I should stop Nardil. And I don't want to try any more meds for now.
Posted by SLS on July 9, 2016, at 10:58:44
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by jonhed on July 9, 2016, at 10:37:54
> I still have 99 of 100 pills of Parnate left just because of that worry.
>
> 2 weeks i was in panic. But i am very anxious in that way..Yes, I know.
:-(
- Scott
Posted by PilledOut on July 9, 2016, at 11:05:53
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by jonhed on July 9, 2016, at 8:39:04
I read about panic attacks, and it said it can strike anytime; you don't need to be feeling panicky or anxious before getting them.
I did get an attack when getting off an SSRI - probably Cymbalta or Celexa.
Then there was the attack while I was on clomipramine recently.
And there's the attack on Nardil, but this is the first time it's been accompanied by hyperventilation.
I think some meds give me the attack, while on them or getting off them. It's not necessarily a "panic attack," but the effects are very similar (maybe identical).
Posted by jonhed on July 9, 2016, at 11:19:22
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by PilledOut on July 9, 2016, at 11:05:53
In my experience they can build up over days, and things become more and more unreal and "panicky" over time.
If it is dissociative attacks, it don't have to involve hyperventilating and such things.I think that it sound like some sort of anxiety and the best is maybe for you to take a break for a while?
have you tried CBT?
I was able to medicate after 2 years of CBT, but it's still hard.
How are you right now, have you stopped nardil and do you think that the "positive" effects of your medications whey higher than the negative?
If not, i think that a break is the best.
For me it is like i need to "feel" that it is a "nice" medicine i take. Like the pill is a "warm" person with much empathy, or else it always poops out.
I think medications can be hard, soft, stingy, flat, colorful, colorless, round or spikey.
And if i don't like one of the things in the medicine, it won't work.Can you relate to that?
(I promise, i'm not psychotic and have never been)
Posted by PilledOut on July 9, 2016, at 11:37:42
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by jonhed on July 9, 2016, at 11:19:22
Yes, I have lots of anxiety, stress, and trauma, so things probably build up over time.
I think Nardil's extreme side effects are outweighing any benefits it might have in the future. I don't think I should risk continuing with it.
As for the way meds feel - I know that Xanax feels druggy, like you're drunk, but with a low, dark, "musty" feel. Ativan usually feels light and flowy.
I don't usually think of meds in terms of hard, soft, stingy, colorful, etc. But when i heard the loud noises louder on Nardil, I did feel the noises as metallic, tinny, and bright.
Posted by jonhed on July 9, 2016, at 11:52:25
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by PilledOut on July 9, 2016, at 11:37:42
Yeah, it's good to know because if you have some tendencies towards those kind of feelings, i think it's harder to succeed with a medication. Cause it has to feel completely "right".
Just my guess.I feel xanax as druggy to but metallic and very light.
Zopiclone is dark and metallic, etc etc.Diazepam is the "heaviest" benzo i know, and by that i mean in the feeling of it. It makes me depressed to take it, and clonazepam is very neutral and therefore easy to combine with other substances that are not narcotics.
This never become different over time, for me, all the above has been feeling the same since i was a teenager.
Parnate was like eating the devil for me, because of the interactions with tyramine.
But i think in my mind that nardil, even though i've never tried it, it feel much lighter than parnate.All my three medications i eat now are "happy" medicines, so it works now. But if i were about to but in one more, it could damage the whole happy feeling of it.
Yeah, it's complex with medicines.
Sometimes you need time off.Have you ever fully liked one of your medication?
If so, i say give that medication a try again, even if it where several years ago that you took it.
Things changes over time, and a medicine that didn't help you, but didn't cause panic, can help you today.
It's not impossible.(and now i'm not talking about benzos)
Posted by PilledOut on July 9, 2016, at 12:21:05
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by jonhed on July 9, 2016, at 11:52:25
Nardil, without the side effects, feels like Ativan - light and flowy, like there's wetness flowing through me. If I ever got over the side effects from Nardil, I think I'd be left with a pleasant, anxiety-free feel. But I'll need to get off Nardil for the time being.
I'm not sure if I ever liked any med 100%. I actually haven't really thought of the way meds feel, except for Xanax and Ativan.
After a break from trying new meds, I can talk with my doctor about revisiting meds I tried in the past. I have re-taken some meds over the years, but nothing has helped.
My doctor also talked about trying some meds in combination. I've done that in the past as well, but they didn't help.
Posted by jonhed on July 9, 2016, at 13:14:44
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by PilledOut on July 9, 2016, at 12:21:05
Oh, nardil sounds very nice then. That's what i have been thinking too, too bad that the side effects are there though..
If my medicine poops out now, i'm going to keep trying get my doctor to import tianeptine.
I very much think that it is the best anti-depressant ever (in theory).It should be like my combination but in one pill.
But i have no idea..
Posted by linkadge on July 9, 2016, at 13:42:12
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by SLS on July 6, 2016, at 16:36:23
Both the TCAs and MAOIs can result in big increases in norepinephrine.
This could, in theory, make sounds appear louder.
Over, time the adrenaline receptors will down regulate and this side effect should diminish.
I would simply start with lower doses, and increase slower.
Linkadge
Posted by SLS on July 9, 2016, at 14:07:51
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by jonhed on July 9, 2016, at 11:19:22
> (I promise, i'm not psychotic and have never been)
Don't knock it until you try it.
:-)
- Scott
Posted by jonhed on July 10, 2016, at 4:51:28
In reply to Re: Strange side effects from Nardil, eg loud sounds » jonhed, posted by SLS on July 9, 2016, at 14:07:51
Try to be psychotic?
I don't know, i've been psychotic in the past when i was abusing drugs but never without drugs or certain medicines.
It is 2 years now that i have been away from psychosis, and the last time was on some rc-drug.. they are dangerous.
Posted by Lamdage22 on July 10, 2016, at 6:10:50
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by jonhed on July 10, 2016, at 4:51:28
> Try to be psychotic?
> I don't know, i've been psychotic in the past when i was abusing drugs but never without drugs or certain medicines.
> It is 2 years now that i have been away from psychosis, and the last time was on some rc-drug.. they are dangerous.
>
>Me too
Posted by jonhed on July 10, 2016, at 7:58:03
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by Lamdage22 on July 10, 2016, at 6:10:50
Glad to hear that you are psychosis-free lamdage22!
It's not fun and even though the psychosis sometimes just lasts for 1-2 weeks, i think the after effects can be much longer. For me sometimes 3-4 month of thinking disturbances.
How are you today lamdage22?
Very nice to hear from you, i've been thinking about you!
Posted by Lamdage22 on July 10, 2016, at 10:01:03
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by jonhed on July 10, 2016, at 7:58:03
> How are you today lamdage22?
>
> Very nice to hear from you, i've been thinking about you!I am fine, thanks. I took 0.5mg Lorazepam last night but other than that its fine. Also some distorted thinking. I hate when my mind goes on and on with thoughts and it doesnt want to stop.
Good to see that 0.5mg has an effect nowadays. I used to have tolerance to this drug.
Posted by jonhed on July 10, 2016, at 10:23:55
In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by Lamdage22 on July 10, 2016, at 10:01:03
Yeah, good to hear. 0.5mg isn't much so if that is working, it's really good i must say!
This is the end of the thread.
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