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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by ace on February 23, 2003, at 21:26:00
OK guys, It's me again. I'm starting to get a bit worried. As you know from my previous posts Nardil has had a tremendous impact on my SP, Phobic Anxiety, Derealization, and episodic depression. I LOVE IT.
But this is the prob -- 12 at 90mg, and OCD is not really being helped (only by 30% or so). I'm still getting OCD processes (ego-dystonic ideas, which say it's 'bad' forever if you do this or that, and it will be on your mind forever, then a idea pops up to say 'yes' to the 'bad' thought. I try to say 'no' to 'cover myself'), and ruminations.
I have three options. I can't bear the thought of stopping Nardil I love it so much.
Please, ANY comments or alternatives PLEASE SUGGEST!!!!
1. Nardil + Zyprexa (for OCD)2. Nardil + Risperidone (for OCD)
3. Nardil + Tramadol (for OCD) #carefully
4. Cease Nardil, institute low dose TCA (Anafrnail?), restart Nardil
5. Klonopin, Anafranil (for OCD) - THIS is last line -- I almost cry when considering ceasing Nardil.
Posted by JohnV on February 23, 2003, at 22:11:10
In reply to Nardil + anti-OCD - PLEASE, PLEASE HELP!!!!!, posted by ace on February 23, 2003, at 21:26:00
Hi:
If weight gain isn't a real issue, the Nardil + Zyprexa, AND Klonopin is highly advised. (Although I don't have much experience with Nardil...so you must really consult doc about this.) Zyprexa does have the ability (sometimes) to cause some anxiety, and the klonipin just moves in and ends that quickly.
Oh, and don't worry about diagnosis (OCD, etc.) It is conquering symtoms that help, and diagnosis only plays a part on the bigger picture. Look at each symtom individually, take care of them, and you should end up feeling great. Higher dose Zyprexa and a benzo like Klonipin worked wonders with my Effexor. The Effexor looked after depression/energy, and the Zyprexa/klonipin really kept me in a nice calm mood.
Good luck,
John (V)
Posted by exbenzouser on February 23, 2003, at 22:11:46
In reply to Nardil + anti-OCD - PLEASE, PLEASE HELP!!!!!, posted by ace on February 23, 2003, at 21:26:00
I can't respond to all of your questions but I do have a couple of comments. First of all I don't tolerate medications very well but Nardil is one medication that I did well on for a while until my blood pressure bottomed out and I went off of it. I wanted to go back on it at lower dose but it hasn't been available here lately. It seems to be working well for you. If it works I wouldn't give it up. Secondly, I am now against the long term use of benzaodiazepines as I am currently going through klonopin withdrawal myself. It works great in the short term (two weeks max) but long term it becomes a trap as your body develops tolerance to it. That has been my experience FWIW.
Larry
Posted by Ritch on February 24, 2003, at 9:20:48
In reply to Nardil + anti-OCD - PLEASE, PLEASE HELP!!!!!, posted by ace on February 23, 2003, at 21:26:00
> OK guys, It's me again. I'm starting to get a bit worried. As you know from my previous posts Nardil has had a tremendous impact on my SP, Phobic Anxiety, Derealization, and episodic depression. I LOVE IT.
>
> But this is the prob -- 12 at 90mg, and OCD is not really being helped (only by 30% or so). I'm still getting OCD processes (ego-dystonic ideas, which say it's 'bad' forever if you do this or that, and it will be on your mind forever, then a idea pops up to say 'yes' to the 'bad' thought. I try to say 'no' to 'cover myself'), and ruminations.
>
> I have three options. I can't bear the thought of stopping Nardil I love it so much.
>
> Please, ANY comments or alternatives PLEASE SUGGEST!!!!
>
>
> 1. Nardil + Zyprexa (for OCD)
>
> 2. Nardil + Risperidone (for OCD)
>
> 3. Nardil + Tramadol (for OCD) #carefully
>
> 4. Cease Nardil, institute low dose TCA (Anafrnail?), restart Nardil
>
> 5. Klonopin, Anafranil (for OCD) - THIS is last line -- I almost cry when considering ceasing Nardil.
>
>
What about Nardil+Neurontin? Wouldn't have any drug interaction there.
Posted by Thomas123 on February 24, 2003, at 11:08:04
In reply to Nardil + anti-OCD - PLEASE, PLEASE HELP!!!!!, posted by ace on February 23, 2003, at 21:26:00
I think option two is the best. Nardil is working. Stick with Nardil. Risperdal causes less weight gain than Zyprexa and isn't associated with diabetes. Risperdal can be taken once at night. At low dosages there is no daytime sleepiness if taken at night.
Seroquel might be considered. Seroquel I think would interfer less with the dopaminergic action of Nardil than either Zyprexa or Risperdal. Regardless of what AP you take start at low dosages.Good luck.
Posted by ace on February 24, 2003, at 18:51:23
In reply to Re: Nardil + anti-OCD - PLEASE, PLEASE HELP!!!!! ?ace, posted by Ritch on February 24, 2003, at 9:20:48
> > OK guys, It's me again. I'm starting to get a bit worried. As you know from my previous posts Nardil has had a tremendous impact on my SP, Phobic Anxiety, Derealization, and episodic depression. I LOVE IT.
> >
> > But this is the prob -- 12 at 90mg, and OCD is not really being helped (only by 30% or so). I'm still getting OCD processes (ego-dystonic ideas, which say it's 'bad' forever if you do this or that, and it will be on your mind forever, then a idea pops up to say 'yes' to the 'bad' thought. I try to say 'no' to 'cover myself'), and ruminations.
> >
> > I have three options. I can't bear the thought of stopping Nardil I love it so much.
> >
> > Please, ANY comments or alternatives PLEASE SUGGEST!!!!
> >
> >
> > 1. Nardil + Zyprexa (for OCD)
> >
> > 2. Nardil + Risperidone (for OCD)
> >
> > 3. Nardil + Tramadol (for OCD) #carefully
> >
> > 4. Cease Nardil, institute low dose TCA (Anafrnail?), restart Nardil
> >
> > 5. Klonopin, Anafranil (for OCD) - THIS is last line -- I almost cry when considering ceasing Nardil.
> >
> >
>
>
> What about Nardil+Neurontin? Wouldn't have any drug interaction there.
>Hey Ritch!,
Thanks for the input. But as a mood stabilizer...do you think it would work?
I'll put a search on here. Thanks again.ACE,
NARDIL, 90mg.
Posted by Ritch on February 24, 2003, at 22:08:39
In reply to Re: Nardil + anti-OCD - PLEASE, PLEASE HELP!!!!! » Ritch, posted by ace on February 24, 2003, at 18:51:23
> > > OK guys, It's me again. I'm starting to get a bit worried. As you know from my previous posts Nardil has had a tremendous impact on my SP, Phobic Anxiety, Derealization, and episodic depression. I LOVE IT.
> > >
> > > But this is the prob -- 12 at 90mg, and OCD is not really being helped (only by 30% or so). I'm still getting OCD processes (ego-dystonic ideas, which say it's 'bad' forever if you do this or that, and it will be on your mind forever, then a idea pops up to say 'yes' to the 'bad' thought. I try to say 'no' to 'cover myself'), and ruminations.
> > >
> > > I have three options. I can't bear the thought of stopping Nardil I love it so much.
> > >
> > > Please, ANY comments or alternatives PLEASE SUGGEST!!!!
> > >
> > >
> > > 1. Nardil + Zyprexa (for OCD)
> > >
> > > 2. Nardil + Risperidone (for OCD)
> > >
> > > 3. Nardil + Tramadol (for OCD) #carefully
> > >
> > > 4. Cease Nardil, institute low dose TCA (Anafrnail?), restart Nardil
> > >
> > > 5. Klonopin, Anafranil (for OCD) - THIS is last line -- I almost cry when considering ceasing Nardil.
> > >
> > >
> >
> >
> > What about Nardil+Neurontin? Wouldn't have any drug interaction there.
> >
>
> Hey Ritch!,
> Thanks for the input. But as a mood stabilizer...do you think it would work?
> I'll put a search on here. Thanks again.
>
> ACE,
> NARDIL, 90mg.It is only a very mild antimanic. I have found very good anti-anxiety/anti-agitation qualities with it (without worsening depression as benzos and Depakote can do and without aggravating hypomania like AD's). I get some weird chest muscle and inner ear spasms from it which keeps me from taking it, otherwise I could get by on just that and a little Effexor most of the time (with a little Depakote thrown in to keep me off Pluto). The main reason I mentioned it was hearing a warning about sudden discontinuation of it in epilepsy patients that had co-morbid OCD, and that their OCD was greatly aggravated when they stopped it. Which makes me wonder if it could be helpful if you can't take (or don't want to attempt) an SSRI or Anafranil (highly serotonergic) trial while on an MAOI that is very beneficial.
Posted by bobbiedobbs on August 3, 2003, at 1:04:40
In reply to Re: Nardil + anti-OCD - PLEASE, PLEASE HELP!!!!! » Ritch » ace, posted by Ritch on February 24, 2003, at 22:08:39
Ace, what course of action did you wind up taking? I have the same problem - need to give up MAOI - optionis are Lexapro and Luvox but I'm afraid of loss of MAOI benefit. While on MAOIs, the advice I got from doctors for OCD was 1) Nardil and Risperdahl (total disaster) b) Nrdio and Neuronton (didn't try) c) Nardil and Klonopin (eh, plus put me to sleep)
Posted by ace on October 8, 2003, at 4:20:35
In reply to Re: Nardil + anti-OCD - PLEASE, PLEASE HELP!!!!!, posted by bobbiedobbs on August 3, 2003, at 1:04:40
> Ace, what course of action did you wind up taking? I have the same problem - need to give up MAOI - optionis are Lexapro and Luvox but I'm afraid of loss of MAOI benefit. While on MAOIs, the advice I got from doctors for OCD was 1) Nardil and Risperdahl (total disaster) b) Nrdio and Neuronton (didn't try) c) Nardil and Klonopin (eh, plus put me to sleep)
Hey Bro!,
I will still have to augment for the OCD- I'll probably try Amisulpride.
But I'm not letting Nardil go- it helps SOOoooooo much!!!!
How have you been!?
Ace.
Posted by temoigneur on December 4, 2003, at 20:37:36
In reply to Re: Nardil + anti-OCD - PLEASE, PLEASE HELP!!!!! » Ritch » ace, posted by Ritch on February 24, 2003, at 22:08:39
> > > > OK guys, It's me again. I'm starting to get a bit worried. As you know from my previous posts Nardil has had a tremendous impact on my SP, Phobic Anxiety, Derealization, and episodic depression. I LOVE IT.
> > > >
> > > > But this is the prob -- 12 at 90mg, and OCD is not really being helped (only by 30% or so). I'm still getting OCD processes (ego-dystonic ideas, which say it's 'bad' forever if you do this or that, and it will be on your mind forever, then a idea pops up to say 'yes' to the 'bad' thought. I try to say 'no' to 'cover myself'), and ruminations.
> > > >
> > > > I have three options. I can't bear the thought of stopping Nardil I love it so much.
> > > >
> > > > Please, ANY comments or alternatives PLEASE SUGGEST!!!!
> > > >
> > > >
> > > > 1. Nardil + Zyprexa (for OCD)
> > > >
> > > > 2. Nardil + Risperidone (for OCD)
> > > >
> > > > 3. Nardil + Tramadol (for OCD) #carefully
> > > >
> > > > 4. Cease Nardil, institute low dose TCA (Anafrnail?), restart Nardil
> > > >
> > > > 5. Klonopin, Anafranil (for OCD) - THIS is last line -- I almost cry when considering ceasing Nardil.
> > > >
> > > >
> > >
> > >
> > > What about Nardil+Neurontin? Wouldn't have any drug interaction there.
> > >
> >
> > Hey Ritch!,
> > Thanks for the input. But as a mood stabilizer...do you think it would work?
> > I'll put a search on here. Thanks again.
> >
> > ACE,
> > NARDIL, 90mg.
>
> It is only a very mild antimanic. I have found very good anti-anxiety/anti-agitation qualities with it (without worsening depression as benzos and Depakote can do and without aggravating hypomania like AD's). I get some weird chest muscle and inner ear spasms from it which keeps me from taking it, otherwise I could get by on just that and a little Effexor most of the time (with a little Depakote thrown in to keep me off Pluto). The main reason I mentioned it was hearing a warning about sudden discontinuation of it in epilepsy patients that had co-morbid OCD, and that their OCD was greatly aggravated when they stopped it. Which makes me wonder if it could be helpful if you can't take (or don't want to attempt) an SSRI or Anafranil (highly serotonergic) trial while on an MAOI that is very beneficial.
>
>Hi Ace how's it going, temo, (Ben) here - haha here's the situation, I tried Nardil and Lithium and it seemed to help, but as always when the agent is working, I couldn't sleep. I've heard that Anafranil is sedating, but thought it could never under any circumstances be combined with Nardil, if you have any information indicating otherwise I would be extremely grateful if I could get a hold of it. Also didn't know that Tramadol could be taken with nardil. My options are VERY limited, I could go through the list, but let's just say I think I'm going to need an unusual combination I go see an anxiety specialist next Thursday for the first time, if you had information on nardil + Anafranil, I would be eternally gratefull
Ben
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Dr. Bob is Robert Hsiung, MD,
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