![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 37. Go back in thread:
Posted by Lamdage22 on January 17, 2020, at 20:27:40
In reply to Re: Nardil success/restart, posted by greg rizzo on January 17, 2020, at 15:38:06
Yes, but why the antacid? For enteric-coated capsules, stomach acid is a good thing because if it wasn't acidic, the capsule would dissolve.
> Correct, and the stomach by nature is very acidic by contrast
Posted by greg rizzo on January 18, 2020, at 5:13:07
In reply to Re: Nardil success/restart, posted by Lamdage22 on January 17, 2020, at 20:27:40
I don't want the capsule to be brken down and excreted by the liver. Maximun absortion takes place in the intestine according to Dr. Bod (admin. of this site, and others). Definitely some absorbtion takles place in the the stomach, but I want to get maximum absorbtion by the intestines.
You're right--it may be overkill to use both an antacid and enteric capsules. But I don't claim to be an expert so there's definitely some tweaking that mat be necessary.
Since the old nardil used carnuba wax as an outer coating on nardil to increase absorbtion of nardil, that may be worth rxploring also.
Don't have all the answers yet but "giving up" is not in my vocabulary.
It's only been 2 weeks roughly and I am more ready to get out of bed in the am, have more energy & better mood, no depressive, dark moods and thoughts of suicide like I did before.
So we'll see............
Posted by Lamdage22 on January 18, 2020, at 5:49:40
In reply to Re: Nardil success/restart, posted by greg rizzo on January 18, 2020, at 5:13:07
I'm not suggesting you should give up. No one should. I think it is not an overkill, but it could totally cancel each other out:
Enteric-coated capsules are designed to withstand the acid in the stomach. The intestine is a more alkaline environment and thats why the capsule will dissolve in your intestine and NOT in your stomach. The more acid in your stomach, the less likely the capsule is goint to dissolve in it. The more alkaline, the more likely it is to dissolve.
Thats how enteric coated capsules manage to not dissolve in your stomach, but in your intestine. By being resistant to acid and dissolvable in alkaline environments like your intestine. The antacid might make it dissolve in your stomach.
I guess it depends on what kind of capsules you have. Some have more of a "time-release" mechanism, but many behave as i described.
I think that capsules can't have the time-release mechanism because they are empty.If your capsules are legitimate it might work better without the antacid.
Maybe someone else can confirm, but I am almost certain.
> I don't want the capsule to be brken down and excreted by the liver. Maximun absortion takes place in the intestine according to Dr. Bod (admin. of this site, and others). Definitely some absorbtion takles place in the the stomach, but I want to get maximum absorbtion by the intestines.
> You're right--it may be overkill to use both an antacid and enteric capsules. But I don't claim to be an expert so there's definitely some tweaking that mat be necessary.
> Since the old nardil used carnuba wax as an outer coating on nardil to increase absorbtion of nardil, that may be worth rxploring also.
> Don't have all the answers yet but "giving up" is not in my vocabulary.
> It's only been 2 weeks roughly and I am more ready to get out of bed in the am, have more energy & better mood, no depressive, dark moods and thoughts of suicide like I did before.
> So we'll see............
Posted by undopaminergic on January 18, 2020, at 6:47:52
In reply to Re: Nardil success/restart, posted by Lamdage22 on January 18, 2020, at 5:49:40
>
> Maybe someone else can confirm, but I am almost certain.I'm no expert, but you are clearly right that enteric-coated capsules are designed to be resistant to stomach acid. And they are of course designed to dissolve before they get excreted in the faeces.
However, antacids, unless overdosed, do not neutralise (or alkalise) all of the stomach acid. On the other hand, it is pointless to take antacids if you are using enteric-coated capsules.
-undopaminergic
Posted by greg rizzo on January 18, 2020, at 9:54:11
In reply to Re: Nardil success/restart, posted by undopaminergic on January 18, 2020, at 6:47:52
We'll see won't we? Proof is in the pudding.
So far the puddin' ain't tastin' too bad.What are you doing/working on to make your antidepressant more effective?
Posted by undopaminergic on January 18, 2020, at 9:57:46
In reply to Re: Nardil success/restart, posted by greg rizzo on January 18, 2020, at 9:54:11
> We'll see won't we? Proof is in the pudding.
> So far the puddin' ain't tastin' too bad.Good luck.
> What are you doing/working on to make your antidepressant more effective?
I'm researching low dose lithium. Another step is to try a higher dose of the antidepressant (trimipramine; Surmontil) that I'm already taking.
-undopaminergic
Posted by greg rizzo on January 18, 2020, at 10:04:59
In reply to Re: Nardil success/restart » greg rizzo, posted by undopaminergic on January 18, 2020, at 9:57:46
Good idea. Just had a meeting with my Psych Doc and he'S a strong advocate of augmenting an antidepressant with lithium in certain cases if other methods of augmentation prove unsuccessful for TRD.
Posted by Lamdage22 on January 18, 2020, at 10:27:47
In reply to Re: Nardil success/restart » rjlockhart37, posted by Jadde on January 17, 2020, at 8:59:18
I feel bad about Jadde, we hijacked her thread. I have been taking 225 Lithium for years. I feel it has curbed 70% of suicidal thoughts. @greg: You cant be stopped. But dont spend years, there are many other options!
Posted by Lamdage22 on January 18, 2020, at 10:28:51
In reply to Re: Nardil success/restart, posted by Lamdage22 on January 18, 2020, at 10:27:47
I was only trying to stop the antacid, because it doesnt make sense. But i cant:)
Posted by Jadde on January 18, 2020, at 11:12:17
In reply to Re: Nardil success/restart, posted by Lamdage22 on January 18, 2020, at 10:27:47
> I feel bad about Jadde, we hijacked her thread. I have been taking 225 Lithium for years. I feel it has curbed 70% of suicidal thoughts. @greg: You cant be stopped. But dont spend years, there are many other options!
You did, but thats okay. Sounds like you two have unfinished business. Im sure I hijacked a thread or two back in the day :)
Jade
Posted by Lamdage22 on January 18, 2020, at 11:14:01
In reply to Nardil success/restart, posted by Jadde on January 16, 2020, at 9:43:41
So how are things?
Posted by Jadde on January 18, 2020, at 11:17:22
In reply to Re: Nardil success/restart, posted by Lamdage22 on January 18, 2020, at 11:14:01
> So how are things?
Things were great until I stopped Nardil. Doing the waiting game, hoping it will do its magic once more.
Jade
Posted by Lamdage22 on January 18, 2020, at 11:21:44
In reply to Re: Nardil success/restart, posted by Jadde on January 18, 2020, at 11:17:22
How long were you in remission? Nardil was a very defining experience for me. In a good and in a bad way. I became really angry about stuff.
Posted by greg rizzo on January 18, 2020, at 11:30:21
In reply to Re: Nardil success/restart, posted by Lamdage22 on January 18, 2020, at 11:14:01
~Looking good so far like to be sure of my results so I'll wait a couple more weeks to bre sure.
Sorry to hijack someone's else thread. I didn't know that.
Posted by greg rizzo on January 18, 2020, at 11:35:26
In reply to Re: Nardil success/restart, posted by Jadde on January 18, 2020, at 11:17:22
We'll see. Proof is in the pudding.
So far the puddin' ain't tastin' too bad.Im optomistic but I think 2 more weeks will tell the final tale
Posted by Jadde on January 18, 2020, at 11:36:43
In reply to Re: Nardil success/restart, posted by Lamdage22 on January 18, 2020, at 11:21:44
> How long were you in remission? Nardil was a very defining experience for me. In a good and in a bad way. I became really angry about stuff.
>
>3 years. I remember things didnt end well for you on Nardil. Im sorry. I had the same experience on Parnate. Interestingly, I too had a period of being angry on Nardil (I think I was hypomanic at the time).
Jade
Posted by greg rizzo on January 18, 2020, at 11:53:23
In reply to Re: Nardil success/restart, posted by Lamdage22 on January 18, 2020, at 11:21:44
I felt absolutely fantastic on Nardil made by Parke Davis after trying about 8 SSRI's & SSNI's that had no effect.
That was 1988. Like I said--felt gret until I got my first dose from Pfizer. I sat of my bed and unexplicably started crying like a baby due to depression. At that time I was unaware Pfizer bought the rights to manufacure. Since that time I have suffered greatly and augmented with Povigil just to bsurive. (suicidal thohgts predominated my thought processes)
Trying this new formula has not resulted in a down day and I am off the Provigil.
BUT oft times there is a "placebo effect" which makes you feel better just because you have renewed hope with something new you are trying you hope so much is 'the cure.'
SOOOO--I believe it will take at least 2 more weeks of feeling good before I am convinced the trial may be working. So don't be overly optomist yet. The test is far from over.
Posted by Lamdage22 on January 18, 2020, at 12:31:10
In reply to Re: Nardil success/restart » Lamdage22, posted by Jadde on January 18, 2020, at 11:36:43
I would try like 6-8 weeks at full dosage before giving up. You didn't have a small effect, you were in remission! So the chance of getting that back is worth it id say.
@greg: Understandable that you wanna try to make it work again. I was sky high on Nardil. I imagine that not everybody has this Old/New Nardil problem.
Posted by greg rizzo on January 18, 2020, at 13:56:54
In reply to Re: Nardil success/restart, posted by Lamdage22 on January 18, 2020, at 12:31:10
I've been on 75 for most of my years on Nardil. Tried 90 mg but didn't help. Suggested to 2 different psych docs that we step up to 105 mg as a trial. Both said it wouln't help. I don't remember their rational for saying it wouldn't help but neither would even consider it.
Again don't know their reasons for not allowing me to try it. Felt it wouldn' help? Feared a hypertensive crisis would result? Made no mention of a hypertensive crisis, just said it wouldn't help. Beats me why not give it a try. I believe 105 mg is at the upper level of recommended dose. Not positive-haven't looked it up.
Posted by Jadde on January 18, 2020, at 16:18:35
In reply to Re: Nardil success/restart, posted by greg rizzo on January 18, 2020, at 13:56:54
> I've been on 75 for most of my years on Nardil. Tried 90 mg but didn't help. Suggested to 2 different psych docs that we step up to 105 mg as a trial. Both said it wouln't help. I don't remember their rational for saying it wouldn't help but neither would even consider it.
> Again don't know their reasons for not allowing me to try it. Felt it wouldn' help? Feared a hypertensive crisis would result? Made no mention of a hypertensive crisis, just said it wouldn't help. Beats me why not give it a try. I believe 105 mg is at the upper level of recommended dose. Not positive-haven't looked it up.
>
>Hi. I went up to 90mg and had a weird episode. I couldnt talk, and was very confused. Ended up in the ER. So 75mg is max for me. Maybe your docs had concerns in this regard. Anyway, question, you must have gone off Nardil during all that time. How long before you felt Nardil response after discontinuing?
Posted by Lamdage22 on January 19, 2020, at 4:05:18
In reply to Re: Nardil success/restart, posted by greg rizzo on January 18, 2020, at 13:56:54
I went hypertensive on much more than 105. But I heard that higher dosages are more GABAergic, but no more MAOI inhibition. I don't know. It puzzles me how the same drug won't work after taking a break. It also puzzles me that some people have no problems with the new Nardil and others do.
Posted by undopaminergic on January 19, 2020, at 8:06:54
In reply to Re: Nardil success/restart, posted by Lamdage22 on January 19, 2020, at 4:05:18
> I went hypertensive on much more than 105. But I heard that higher dosages are more GABAergic, but no more MAOI inhibition.
>Right. You cannot inhibit more than 100% of MAO. Or alternatively, maybe the dose-response curve for MAO-inhibition flattens before reaching 100%, but either way, there is a ceiling.
> I don't know. It puzzles me how the same drug won't work after taking a break.
>It is because the brain has changed. Some receptors downregulated, some upregulated, and maybe something else too, such as a bit of apoptosis, or the opposite, such as nerve growth.
-undopaminergic
Posted by Jadde on January 19, 2020, at 9:54:06
In reply to Re: Nardil success/restart » Lamdage22, posted by undopaminergic on January 19, 2020, at 8:06:54
> > I don't know. It puzzles me how the same drug won't work after taking a break.
> >
>
> It is because the brain has changed. Some receptors downregulated, some upregulated, and maybe something else too, such as a bit of apoptosis, or the opposite, such as nerve growth.
>:( I wonder how many of us are facing this possibility
Posted by SLS on January 22, 2020, at 19:50:40
In reply to Nardil success/restart, posted by Jadde on January 16, 2020, at 9:43:41
> Hello,
> About 3 years ago I started on Nardil out of desperation. For those three years I have been depression free. It was a miracle, I had my life back (dose was 60mg).
>
> My current situation is as follows: surgery in November, stop and restart Nardil (after about 4 weeks). I started with 45mg, quickly increased to 60mg with no improvement in (returned) depression. I went up to 75mg where I have been for 2 weeks. Experiencing ALL the side effects but no benefit. Total time on Nardil, 9 weeks.
>
> Im feeling very defeated. Finding it hard to be a patient patient.
>
> My question, what are the chances that Nardil will start working after 9 weeks (most of that time on my old dose of 60mg) ? How long after upping to 75mg should I wait?It is excruciatingly hard to be patient when being awake is intolerable.
I would not come to any conclusions regarding 75 mg/day for at least 3 weeks. I have seen some people wait 3 months (12 weeks) before Nardil kicked-in. I would mention that anorgasmia often subsides after 3 months.
I hope you are pleasantly surprised.
- Scott
Posted by Jadde on January 24, 2020, at 9:53:30
In reply to Re: Nardil success/restart » Jadde, posted by SLS on January 22, 2020, at 19:50:40
> > Hello,
> > About 3 years ago I started on Nardil out of desperation. For those three years I have been depression free. It was a miracle, I had my life back (dose was 60mg).
> >
> > My current situation is as follows: surgery in November, stop and restart Nardil (after about 4 weeks). I started with 45mg, quickly increased to 60mg with no improvement in (returned) depression. I went up to 75mg where I have been for 2 weeks. Experiencing ALL the side effects but no benefit. Total time on Nardil, 9 weeks.
> >
> > Im feeling very defeated. Finding it hard to be a patient patient.
> >
> > My question, what are the chances that Nardil will start working after 9 weeks (most of that time on my old dose of 60mg) ? How long after upping to 75mg should I wait?
>
> It is excruciatingly hard to be patient when being awake is intolerable.
>
> I would not come to any conclusions regarding 75 mg/day for at least 3 weeks. I have seen some people wait 3 months (12 weeks) before Nardil kicked-in. I would mention that anorgasmia often subsides after 3 months.
>
> I hope you are pleasantly surprised.
>
>
> - Scott
>
>Thanks Scott. 3 1/2 weeks on 75mg. Im going to keep going. Ugh
Jade
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.