![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6 to 30 of 44. Go back in thread:
Posted by Phillipa on November 25, 2007, at 18:33:51
In reply to Re: What else with Nardil ? Sugesstions » Phillipa, posted by FredPotter on November 25, 2007, at 18:02:32
Fred because I'm not a med expert and unless I am confident something is safe will not suggest it . Phillipa ps what's going on with you????
Posted by stargazer2 on November 25, 2007, at 19:16:02
In reply to What else with Nardil ? Sugesstions, posted by tepi on November 25, 2007, at 14:06:03
This article (Current Psychiatry, June 2002, MAO inhibitors: An option worth trying in TR cases)Link at bottom of email... explains what can be given with MAO's, specifically TCA's except anafranil, or any that involve serotonin reuptake inhibition. Wellbutrin and trazadone can be safely givenwith Nardil.Other meds include some for hypotension and lethargy, such as pemoline, d-amphetamine, methylphenidate or modafinil (read article for safe doses)
I tried Amphetamine but blindly went above the stated limit of 5 mg which was a serious error in judgement, hence the hypertensive reaction I had.
I consider this article very important as I gave a copy to my pdoc for his review and that is what gave him the confidence to add nortriptylline to the Nardil. Unfortunately the effects were insignificant for me but many TCA's are helpful when taken at bedtime for insomnia.
http://www.dr-bob.org/babble/20061110/msgs/703504.html
Good reading on Nardil specifics...bookmark this one.
Stargazer
Posted by tepi on November 25, 2007, at 19:59:57
In reply to Re: What else with Nardil ? Sugesstions, posted by Racer on November 25, 2007, at 14:25:13
> It would help a lot to know what symptoms you're still having trouble with, because otherwise there's no way to know what might help...
>
> Good luck, and it's good to see you here.Hi racer
well for example , I went to a nephew party 2 hrs ago . I tought there was gonna be just some people , member of my family likrely. But When I reach the house I saw a lot of cars and that made me fell umconfortable ( I would have no enter there if were not for xanax and nardil )
Anyway I enter , and said good nigth , but nobody answered my greeting ( this kinds of things always made me going down , maybe they did not listen to me , anyway my mind did not thougth that, I ad toughts like , well nobody care Im here and more)
Then I just sit alone and started to hear what other people talk, I never talk , maybe I could answer question with 2 or 3 words but that is all. So all the time Im judginf how fool I am , wishing I could enter someplace and everboyd say hello , and when I talk everybody listen,
In this moment the little words I say are not taken in count. I am sure that they can feel how insecure I am.
Same happen on my job when I suggest something
I am still there because they see I can do it and wellIt is kind of paranoic thougths , insecurity about myself , always worried about what other people think of me.
Damn I feel better when I drink , why there is no med that could act like alcohol??This may sounds so stupid and you may think , "thats all ? , I thougth you had worst things" , but belive me , and I swear on my mother and father lives that this is the worst thing one`s can suffer (among others). It could be the perfect punish for a serial killer
I am back at house now , no one with to talk to
just thinking I need to do something
Posted by tepi on November 25, 2007, at 20:07:30
In reply to Re: What else with Nardil ? Sugesstions, posted by Sigismund on November 25, 2007, at 18:09:43
Posted by tepi on November 25, 2007, at 20:14:50
In reply to Re: What else with Nardil ? Sugesstions » Phillipa, posted by FredPotter on November 25, 2007, at 18:02:32
> > Tepi I'm not an MAOI expert and can't safely give advise. Love Phillipa
>
> Why did you post that Phillipa?
> I have tried Nortriptyline. It's said to be safe, but check first. It's said to have far more effect on norepinephrine than serotonin - hence the name
dear phillipa always answer my posts ,so she was being honest and wanted to let me know that.about your opinion Is the tofranil the comercial name, because I tried in the past all Tcas I belive and none worked
thanks
tepi
Posted by tepi on November 25, 2007, at 20:35:35
In reply to Re: What else with Nardil ? Sugesstions, posted by Sigismund on November 25, 2007, at 18:09:43
> Hi Tep
>
> The easiest and safest thing is to supplement with fish oil. They say around 1g/d EPA.
>
> If it doesn't help your mood and fear it will at least be good for you.
Hi , Ive trid in the past but mademy anxiety worst ,. It is rare because I knwo how great fish oild can be . I took it when I was on Zoloft and did more than the med
Coudl it be the brand of the fish oild ?
I tried 1mg of EPA or DHA dont remember excatly
Bad memory because of the xanax
>
> I'm hopeless with combos. They hardly ever work for me, and combos with Nardil are dicey.
>
> Nonetheless I have heard of...
>
> Dexedrine (some use for fear?, but quite a worry with Nardil, and hard to get.)
>
> or nortriptyline (more for depression?)
>
> with Nardil.
>
> Then there's Provigil, and I've no idea if it is safe with Nardil.
thanks!! . is provigil a mild stimulant ? DOnt remember , maybe it could be safer tha dexedrine
not sure if both are stimulantsis it hard to left them ? I can become depedant right . ANyway Im taking xanax and I know the risk of dependant
thank you sig !
Posted by Racer on November 25, 2007, at 20:53:17
In reply to Re: What else with Nardil ? Sugesstions » Racer, posted by tepi on November 25, 2007, at 19:59:57
>
> This may sounds so stupid and you may think , "thats all ? , I thougth you had worst things" ,I would never say any such thing to you, Tepi. I know you're suffering -- I was just looking for what was going on, whether you were suffering with depressive symptoms, loss of pleasure, obsessive thoughts, etc. It sounds as though what you're suffering is the same social anxiety you're taking the Nardil for -- in other words, as though the Nardil isn't really working very effectively.
Let's see, my first thought is to suggest psychotherapy, because I really do think it would help a lot with this. Other than that, I would suggest asking your doctor about trying an anti-psychotic, and getting you off the Xanax. Seroquel can be very helpful, or maybe Abilify -- although Abilify can be agitating, which wouldn't be all that helpful for you. Both can help boost antidepressants, and Seroquel can help with sleep.
Honestly, I know your situation isn't good, in terms of doctors, so I know that you're going to have a hard time finding a good solution. I wish there was something that could fix that for you -- in fact, in my experience, finding a psychiatrist you can form a good alliance with makes a huge amount of difference in treatment outcome. If you trust your doctor, you'll have an easier time dealing with any problems that come up, and an easier time waiting out the start up period. I wish I could wave a wand and give you that.
In the meantime, I guess I'd have to say I'd recommend an anti-psychotic instead of Xanax, and maybe look at possibly swapping the Nardil for something a bit more effective.
Good luck.
Posted by tepi on November 25, 2007, at 20:56:38
In reply to Re: What else with Nardil ? Tepi, posted by stargazer2 on November 25, 2007, at 19:16:02
at bedtime for insomnia.
>
> http://www.dr-bob.org/babble/20061110/msgs/703504.html
>
> Good reading on Nardil specifics...bookmark this one.
>
> Stargazer
thanks !!! one question you mean all the poists rigth ? or there is a webpage about this?Tepi
Posted by tepi on November 25, 2007, at 22:24:49
In reply to Re: What else with Nardil ? Sugesstions » tepi, posted by Racer on November 25, 2007, at 20:53:17
> >
> > This may sounds so stupid and you may think , "thats all ? , I thougth you had worst things" ,
>
> I would never say any such thing to you, Tepi. I know you're suffering -- I was just looking for what was going on, whether you were suffering with depressive symptoms, loss of pleasure, obsessive thoughts, etc.thank razer , I wrote this not thinking properly in you . I just get desperated when I try to xplain a doctor or anyone and they just look at me waiting me to say something more terrible but I wish I could xplain this with the correct words. I got desperated when they tell me , and thats all ?
It sounds as though what you're suffering is the same social anxiety you're taking the Nardil for -- in other words, as though the Nardil isn't really working very effectively.
>I know you dont know me very well , but I wanna tell you I have tried almost evrything on the market and Nardil has been the best
> Let's see, my first thought is to suggest psychotherapy, because I really do think it would help a lot with this.
thanks , what kind of pshcioterapy?
Other than that, I would suggest asking your doctor about trying an anti-psychotic,>>>>> I have tried them all , zyrpexa , seroquel abilify , risperdal , solian , geodon . Also conventionalls like perpehazine , haldol ,fluanxol and
other more I dont rememberand getting you off the Xanax. Seroquel can be very helpful, or maybe Abilify -- although Abilify can be agitating, which wouldn't be all that helpful for you. Both can help boost antidepressants, and Seroquel can help with sleep.
>Yes seroquel was the best for me from all of them
but in terms of anxiety Xanax works better than seroquel for me.
Maybe I could both don you think? maybe just 25 mg of seroquel> Honestly, I know your situation isn't good, in terms of doctors, so I know that you're going to have a hard time finding a good solution. I wish there was something that could fix that for you -- in fact, in my experience, finding a psychiatrist you can form a good alliance with makes a huge amount of difference in treatment outcome. If you trust your doctor, you'll have an easier time dealing with any problems that come up, and an easier time waiting out the start up period. I wish I could wave a wand and give you that.
>
> In the meantime, I guess I'd have to say I'd recommend an anti-psychotic instead of Xanax, and maybe look at possibly swapping the Nardil for something a bit more effective.
>
> Good luck.Thanks for your suggestions , they all are well received . it is hard to suggest something not knowing a pacient history , I think that was has happened here
Lucky you already know a little bit more of me and more advices are hosnestly well received.
thanks!!
tepi
Posted by Phillipa on November 25, 2007, at 23:21:47
In reply to Re: What else with Nardil ? Sugesstions » Racer, posted by tepi on November 25, 2007, at 22:24:49
Tepi how I wish I could help you. Love Phillipa yes we go back a while don't we.
Posted by Sigismund on November 26, 2007, at 1:11:16
In reply to Re: What else with Nardil ? Sugesstions » Racer, posted by tepi on November 25, 2007, at 19:59:57
>When I reach the house I saw a lot of cars and that made me fell umconfortable
****Yes
>( I would have no enter there if were not for xanax and nardil)****I quite understand
>Anyway I enter , and said good nigth , but nobody answered my greeting****I once went to a bar to order a drink. The bartender did not hear my order. I was too frightened to say it again, too frightened to leave and too frightened to convincingly pretend that everything was OK. I sat there very still for 30 minutes before I could leave.
>(this kinds of things always made me going down , maybe they did not listen to me, anyway my mind did not thougth that, I ad toughts like , well nobody care Im here and more)****Maybe they felt uncomfortable and lacked the social skills to do anything about it?
>Then I just sit alone and started to hear what other people talk, I never talk , maybe I could answer question with 2 or 3 words but that is all. So all the time Im judginf how fool I am,****you are not a fool, clearly, but you felt that they were not talking to you because you were not worth talking to.
>wishing I could enter someplace and everboyd say hello , and when I talk everybody listen,****Yes
>In this moment the little words I say are not taken in count. I am sure that they can feel how insecure I am.****I firmly believe that they CAN see how you feel. After all I (believe I) know how they feel.
>Same happen on my job when I suggest something
I am still there because they see I can do it and well. It is kind of paranoic thougths , insecurity about myself , always worried about what other people think of me.
Damn I feel better when I drink, why there is no med that could act like alcohol??****Tep, I was thinking today...if you thought that things would never get any better, you might just kill yourself, but maybe you would think 'My God, I have done this, and not too many people could'?
I always have 2 oz of spirits (no more) in the evening and I drink it REALLY quickly.
Posted by stargazer2 on November 26, 2007, at 7:10:49
In reply to Re: What else with Nardil ? Tepi, posted by stargazer2 on November 25, 2007, at 19:16:02
http://www.dr-bob.org/babble/20061003/msgs/693453.html.
Hopefully this is the one...SG
Posted by FredPotter on November 26, 2007, at 13:42:22
In reply to Re: What else with Nardil ? Sugesstions » FredPotter, posted by tepi on November 25, 2007, at 20:14:50
I suppose I don't see the point of posting things which don't contain any information. I appreciate support, but I prefer being given information.
I think Tofranil is imipramine. It acts on serotonin as well, I think, so it would not be a good idea to combine it with Nardil as it might trigger central serotonin syndrome
Fred
Posted by tepi on November 26, 2007, at 22:29:24
In reply to Re: What else with Nardil ? Sugesstions » tepi, posted by Sigismund on November 26, 2007, at 1:11:16
Do you suffer the same symtopms? , that thin you said of the bar , I would have done the same I guess , Why we cant asked it again and louder !
With security an authority.
Women like men that are secure of themselves , good what to do then
> ****Tep, I was thinking today...if you thought that things would never get any better, you might just kill yourself, but maybe you would think 'My God, I have done this, and not too many people could'?But how stop thinking that ??!! it is my sick mind , it is something I have no control over it !
> I always have 2 oz of spirits (no more) in the evening and I drink it REALLY quickly.what are those ? alcohol?
do they work ? do you feel that each day you nedd a greater amount to have the same results?
You sound ver like me , what do you suffer from ?
Posted by tepi on November 26, 2007, at 22:54:22
In reply to Wrong link, let me try again to get it for you/Tep, posted by stargazer2 on November 26, 2007, at 7:10:49
Posted by tepi on November 26, 2007, at 22:58:13
In reply to Re: What else with Nardil ? Sugesstions » tepi, posted by FredPotter on November 26, 2007, at 13:42:22
> I suppose I don't see the point of posting things which don't contain any information. I appreciate support, but I prefer being given information.
>
> I think Tofranil is imipramine. It acts on serotonin as well, I think, so it would not be a good idea to combine it with Nardil as it might trigger central serotonin syndrome
> Fredthen must be anafranil , well yes I have taken both in the past and none worked .
No, I would not try them with Nardilthanks fred
Posted by tepi on November 26, 2007, at 23:02:34
In reply to Re: What else with Nardil ? Sugesstions » tepi, posted by FredPotter on November 26, 2007, at 13:42:22
Ey what do you think about stimulant
maybe a mild one.Those drugs are the only ones I have never
take in my life.IS there anyone acting like cofee?
do you need more anyday to achieve same results?
What if I take cofee daily , as an stimulantIt would be gret enjoy all the things I do and focus just in my life
Tepi
Posted by Sigismund on November 26, 2007, at 23:25:07
In reply to Re: What else with Nardil ? Sugesstions » Sigismund, posted by tepi on November 26, 2007, at 22:29:24
> Do you suffer the same symtopms? , that thin you said of the bar , I would have done the same I guess , Why we cant asked it again and louder!
It's not so bad now, Tep. That was a long time ago. I am so used to some fear that I would be a different person without it.
And I have come to like myself (a bit) just as I am.
> With security an authority.
> Women like men that are secure of themselves , good what to do thenThey do indeed
>
> > ****Tep, I was thinking today...if you thought that things would never get any better, you might just kill yourself, but maybe you would think 'My God, I have done this, and not too many people could'?
>
> But how stop thinking that ??!! it is my sick mind , it is something I have no control over it !A different way of saying the same thing is to say that you are strong, to be able to have survived as long as you have.
> > I always have 2 oz of spirits (no more) in the evening and I drink it REALLY quickly.
>
> what are those ? alcohol?Yes, like 2 beers.
> do they work ? do you feel that each day you nedd a greater amount to have the same results?The drink works a bit, but I don't expect too much.
> You sound ver like me , what do you suffer fromBack when I was 20 we didn't have a name for it. I went to a therapist which was good for me. I now take some tianeptine, a little Valium, and some supplements.
I think benzos actually increase fear.
I know they reduce fear.
How do they do both?
Posted by stargazer2 on November 27, 2007, at 7:49:36
In reply to Re: What else with Nardil ? Sugesstions » FredPotter, posted by tepi on November 26, 2007, at 22:58:13
Posted by shasling on November 27, 2007, at 14:21:34
In reply to What about stimulants ??? any comment, posted by tepi on November 26, 2007, at 23:02:34
>
> Ey what do you think about stimulant
> maybe a mild one.
>
> Those drugs are the only ones I have never
> take in my life.
>
> IS there anyone acting like cofee?
>
> do you need more anyday to achieve same results?
>
>
> What if I take cofee daily , as an stimulant
>
> It would be gret enjoy all the things I do and focus just in my life
>
> TepiHi Tepi, email me, maybe I can help you...
your friend Suzie
Posted by cumulative on November 27, 2007, at 16:51:16
In reply to What else with Nardil ? Sugesstions, posted by tepi on November 25, 2007, at 14:06:03
It didn't work for stargazer, it may work for you. Extreme caution is needed ... titrate upwards to a working dose slowly, and keep anti-hypertensive medication on hand. The combination can be truly excellent if it works.
http://www.dr-bob.org/tips/split/MAOIs-in-high-doses-and-wi.html
Posted by Phillipa on November 27, 2007, at 18:55:47
In reply to Re: What else with Nardil ? Sugesstions » tepi, posted by Sigismund on November 26, 2007, at 23:25:07
Sigi you sound like a Buddist. Isn't that their philosophy? May be wrong may be right. Phillipa
Posted by bleauberry on November 28, 2007, at 17:39:59
In reply to What else with Nardil ? Sugesstions, posted by tepi on November 25, 2007, at 14:06:03
I heard an alternative doc once say, "If you try 5htp up to 200mg a day, and then you add St Johns Wort to it, and you are still not getting better, believe me your depression is not due to a serotonin deficiency."
That kind of logic makes sense to me. I mean, I could debate the doses and question the risk of serotonin syndrome and stuff like that, but the overall logic of the statement makes sense. The same could be applied to Nardil. If you dramatically increase serotonin, norepinephrine, dopamine, gaba, and whatever else Nardil does, and you are not getting better, you can probably be fairly sure you do not have deficiencies of those things. Your problems are from something else.
For years and years I was, and in many ways still am, the typical babbler who is focused on hard science and brain chemistry, totally ignoring the alternative causes of mood disorders. Things like hypocortisol, candida overgrowth, food sensitivities, heavy metal burden, thyroid (even when lab tests "appear" normal). The brain is connected to the body and is dramatically impacted by what goes on in the body. I still focus on hard science, but have come to see how it is shamefully limited, and have thus taken in a great deal of knowledge of other things that powerfully impact brain function besides simple neurotransmitters.
If staying focused just on the brain, then maybe look at certain receptors that are out of whack and need either an agonist or an antagonist to balance them out. Things like remeron, zyprexa, pramipexole, modafinil,...anything that either blocks or helps receptors.
Might be time to open the doors to learning more about causes of mood problems other than neurotransmitter deficiencies.
Simple things you can do. See if you have silver fillings. See if you have a white coating on your tongue. Check your body temperature first thing in the morning, and 3 more times throughout the day, record them for a couple weeks, take a lab stool sample, take a food intolerance lab test, take a 24 hour cortisol test, try T3 or Armour Thyroid regardless of your lab results, etc.
Or try adding something to Nardil. Not sure what the point is there though. Neurotransmitter deficiency doesn't appear to be the culprit.
Posted by Nardilstarted2007 on November 28, 2007, at 17:59:44
In reply to What else with Nardil ? Sugesstions, posted by tepi on November 25, 2007, at 14:06:03
> Hi all friends
> Just wanted to ask you for some advice. Do not
> feel presured that Im gonna take the med you tell me. Just would like to hear some thougths
>
> I am currentnly on
>
> Nardil 45mg/day + 3 mg Xanax + 1 Centrum( vitamins)
>
>
> Ok Im going to do this
>
> Try again Nardil 90mg/day + 3 xanax + 1 vitamins
>
>
> I havent done many combos with Nardil, I have just tried it with Epival ER and did not work
>
> I dont know what else could try. Im always
> thinking in an stimulant ( with a lot of care)
>
> What combos you have heard that works the most
> with Nardil
>
> ALready took it with klonopin , Valium , but Xanax works better for me
>
> I could also stop Nardil and give a full trial to Parnate , last time I did was for only 9 days
>
> Im desperately looking for a real life, so Im not gonna waste my time halfliving.
> My real problem is social fear , and depression but more social phobia I think
>
> dont worry I always think alot before start a new med
> Just looking for your opinion and different ideas
>
> Thank you all
> Tepi
>
>Hi, I'm not to educated on combos. Ive only mixed ssri's with benzos and provagil. Now I'm on 75mgs of Nardil + xanax (four .5's a day) I tried some provagil with it just last week (because I still have some left), and at just 100 mgs in the morning I felt awake, clear, focused, more interested... More clarity and took away my zomby like feelings. With provagil, 100 mgs wont do you for long , maybe a couple days.. Then you need more just like the benzos (in my experience) but one you hit 2-400 hunrdred mgs/day that will last quite a long time(its like tolerance slows down at that point). I felt no SE's even though its a stimulant and its a no no with maoi's but its a special stimulant. totally different then others and really has no SE's. Its worth a try if you start low and titrate up. It acts immediately like benzos, so youl know in a couple days if it will work for you or not, e.x. hypertention, something else, ive never had an SE from it and took 600mgs/day at one time while on effexor. Just a thought. Oh but its really realy expensive, hope you have a med plan if you ever decide to try it. (its quite a neet pill with many properties, like mood enhancing, SOMETIMES antianxiety for some people, it really improves memore nad how fast you can think and remember stuff and motivation. Ill probably use it on as need basis for the mornings after where I cant sleep), oh and for some people it does nothing at all.
>NardilStarted2007
Posted by tepi on November 28, 2007, at 22:25:20
In reply to Re: What about stimulants ??? any comment, posted by shasling on November 27, 2007, at 14:21:34
hi suzie , can your send me your email
all was deleted in my mail by a mistakeTepi
Go forward in 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.