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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 Cseagraves on May 9, 2009, at 13:01:07
Hi to all,
I have been on Nardil now for about a week and a half at 45 mgs per day. Just wanted opinions if others have had same experiences.
Other than feeling generally crappy, this is what else is going on.
Constant nausea (having to force food down)
agitation
get irritated easily
skin itching (woke up the other morning with a rash on right arm, but it went away during the day)
More depressed (having thoughts of just wanting to end it all)
No motivation whatsoever
more agoraphobic
more nervousness (on and off)
Blood pressure has been stable
Just feeling in general out of itMyco says most of whats going on is normal and should start easing up. Haven't even been on med two weeks yet. Was hoping to feel at least a little lift, but every day seems to be worse right now. Others experiences would be helpful.
Thanks,
Courtney :-(
Posted by jedi on May 9, 2009, at 14:11:17
In reply to Questions about Nardil Experience, posted by Cseagraves on May 9, 2009, at 13:01:07
Hi Courtney,
If Nardil is right for you, when it kicks in you will know it. There is nothing subtle about Nardil. When I first used it, I had to get up to 75mg daily for about five weeks before it kicked in. However, when it started working, it was like flipping a switch. You may not need as large a dose to get 90% MAO inhibition, but it will probably take more than 45mg. I am a large man, over 250 lbs., so 90mg was the usual effective dosage for me.I doubt if all of your side effects are directly related to Nardil. The major side effects for me were: insomnia, delayed orgasm, massive carbohydrate cravings, weight gain and hypomania-when it first started working. Ironic that some of the side effects of Nardil are the same as the symptoms of atypical depression.
Hang in there. You may need to get up to 60mg and then hold on for a month. If your depression is atypical, don't give up on this one. It will most likely work where others have failed.
I used high dosage clonazepam to survive while giving the Nardil a chance to work.
Be Well,
Jedi
Posted by Phillipa on May 9, 2009, at 16:14:28
In reply to Questions about Nardil Experience, posted by Cseagraves on May 9, 2009, at 13:01:07
Courtney you did it. I'd believe the others and myco as well. Good luck and sorry you feel so badly. Love Phillipa
Posted by ColoradoSnowflake on May 9, 2009, at 16:20:55
In reply to Re: Questions about Nardil Experience » Cseagraves, posted by jedi on May 9, 2009, at 14:11:17
Courtney, I've been wondering how you've been doing on the nardil. I'm sorry it's not kicking in sooner, but I bet it will like Jedi said! I'm on my 4th day of parnate/10mg. So far it's only making me tired, which I can live with. I'll go to 20mg in a couple of days, then 30mg. So many people here do well on the maoi's I'm hoping it will for me too, as I'm sure you really are too! Good luck and I hope it kicks in SOON!! gayle
Posted by greywolf on May 9, 2009, at 23:28:16
In reply to Questions about Nardil Experience, posted by Cseagraves on May 9, 2009, at 13:01:07
I was on Nardil at 60mg for awhile and found that it had very few side effects. Of course, everyone's different, but I would really try to stick with Nardil a little longer to see if the SEs go away. Nardil was one of the few meds that had any real efficacy for me, and I hope it will for you, too.
Greywolf
Posted by stargazer2 on May 12, 2009, at 23:17:14
In reply to Questions about Nardil Experience, posted by Cseagraves on May 9, 2009, at 13:01:07
Hi Courtney,
Perhaps the starting dose is too high for you. Although everyone here seems to aim for higher doses, I am on Nardil and started on 15 mg and gradually increased to 45 where I am holding for right now. So you may not be able to tolerate that level right away. I am someone that believes in slower starts on meds, at least that is what have learned in 20 years on meds for depression. I have tried most meds with the exception of the newest ones.
That would be my recommendation anyway.
I wouldn't give up yet, but I would not go to a higher dose first. Ask your pdoc if a lower dose might be what you need.
SG
Posted by Questionmark on May 17, 2009, at 5:27:46
In reply to Questions about Nardil Experience, posted by Cseagraves on May 9, 2009, at 13:01:07
Myco is right. Give it time. This is a common (though typically short, fortunately) phase when first beginning an antidepressant, at least or especially a highly/predominantly serotonergic antidepressant, as Nardil is. It's the initial receptor adaptation.
You will soon experience the lift of the miracle that is Nardil, i believe.
> Hi to all,
>
> I have been on Nardil now for about a week and a half at 45 mgs per day. Just wanted opinions if others have had same experiences.
>
> Other than feeling generally crappy, this is what else is going on.
>
> Constant nausea (having to force food down)
> agitation
> get irritated easily
> skin itching (woke up the other morning with a rash on right arm, but it went away during the day)
> More depressed (having thoughts of just wanting to end it all)
> No motivation whatsoever
> more agoraphobic
> more nervousness (on and off)
> Blood pressure has been stable
> Just feeling in general out of it
>
> Myco says most of whats going on is normal and should start easing up. Haven't even been on med two weeks yet. Was hoping to feel at least a little lift, but every day seems to be worse right now. Others experiences would be helpful.
>
> Thanks,
>
> Courtney :-(
>
>
>
Posted by Questionmark on May 17, 2009, at 7:55:24
In reply to Re: Questions about Nardil Experience, posted by stargazer2 on May 12, 2009, at 23:17:14
I completely agree with you. This is a very good and important observation. I strongly believe that most doctors frequently prescribe psychiatric drugs in doses that are too high-- often way too high-- for the individual. I'm especially referring to maintenance doses, as opposed to start-up doses (before reaching the maintenance dose), although the start-up doses are probably often too high as well. This is partially a consequence of many drugs not being available in lower doses-- which is relevant with start-up doses, individuals who are overly sensitive or slow metabolizers of the drug or substances in general, and when a drug is being used to augment another drug/s. But i don't think these are usually even the case when this excessive-dose prescribing occurs. Most doctors prescribing psychiatric drugs seem to be entirely ignorant and-- at times, seemingly apathetic even-- to the extreme importance of using what is, as i like to call it, the minimum sufficiently effective dose. This is important for many reasons-- and far more than for just limiting direct side effects, which is extremely important in itself.
{{ The most recent example i have witnessed is the following-- which you can ignore if uninterested. A friend of mine, whom i know quite well, just started on an antidepressant recently-- her only trial besides a ~6 month SSRI + Wellbutrin stint several years ago. After a brief start (about a week or so) on Requip, she requested, at my urging (since... she noticed nothing whatsoever except nausea; she is without insurance and Requip is on patent and therefore significantly more expensive; i do not consider Requip to be generally any more superior to any of the SSRIs) an alternative, preferably a generic SSRI.So what does he do? He writes a Rx for 40mg generic citalopram (brand name Celexa for those unaware). Now mind you my friend did not like her only previous SSRI trial because she felt too.. well of flat affect basically. Most of you experienced and observant enough with this stuff realize that, for an individual susceptible to that effct, it's more likely to occur the higher the dose. But my guess would be that he probably didn't ask about any of this. Regardless, I did think she should be on something, probably an SSRI (she was/is quite often very depressed-- an extremely emotional "Atypical"-type depression) and I was happy with the choice of citalopram. But 40 mg?? Come on! For some people that [or more] may be necessary. But to basically start her off on that high of a dose? There was no good reason for it. ... And numerous potentially bad reasons not to.
Granted this involved her general practitioner and not a psychiatrist, but it is still ridiculous and, in my opinion, unacceptably & irresponsibly haphazard (note i am NOT saying it is law-suit worthy by any means-- just so there are no assumptions or misunderstandings). Also i know from experience that many psychiatrists (not just GPs) often do this sort of thing as well.
... So i was very angry upon hearing this (not at my friend of course), and i strongly suggested that she split the pills in half and only take 20mg/day-- and to even seriously consider 10mg, at least to start-- and explained all the reasons why. Many of you, *very* many others, and probably almost every single medical doctor in the country, would criticize this and say things like "but you're not a doctor" and "but she needs to discuss this with her doctor" and various other such cliche lines. The fact of the matter is i trust my judgment on these matters more than i do the average doctor-- certainly the average general practitioner-- and certainly this guy. I am largely ignorant about drug metabolism and all the liver enzyme involvement and what not-- and hence various drug interactions. But as far as... well, everything else related to all this (at least regarding the classes of psychiatric drugs of which i'm knowledgeable), i trust myself more. I also know my friend and her situation well, and had time to talk with her about many of the relevant details. U.S. Medical System Guy gets what 10, 15 mins to talk to her and decide on a prescription? He obviously is also far less concerned than i am. And it is obvious he knows very little about the complexities of antidepressant use. I, on the other hand, through *first hand* experience and years of too much analyzing and obsessing and discussing, and "PsychoBabble: Medications" reading/conversing-- etcetera-- know quite a lot about these complexities. I am no scholar-- of course. But my knowledge, and ability to use that knowledge most effectively, far exceeds that of many if not most medical doctors.
So please: Spare me your cliches. }}(That's my rant and i'm sticking to it.)
> Hi Courtney,
>
> Perhaps the starting dose is too high for you. Although everyone here seems to aim for higher doses, I am on Nardil and started on 15 mg and gradually increased to 45 where I am holding for right now. So you may not be able to tolerate that level right away. I am someone that believes in slower starts on meds, at least that is what have learned in 20 years on meds for depression. I have tried most meds with the exception of the newest ones.
>
> That would be my recommendation anyway.
>
> I wouldn't give up yet, but I would not go to a higher dose first. Ask your pdoc if a lower dose might be what you need.
>
> SG
Posted by jedi on May 17, 2009, at 19:29:50
In reply to Re: Questions about Nardil Experience » stargazer2, posted by Questionmark on May 17, 2009, at 7:55:24
Hi Questionmark,
Of course there are two sides to this issue. When a person is in suicidal depression, getting the medication up to an effective dose is critical. Many of these meds, especially the MAOIs take weeks to work once an effective dosage is achieved.When enduring the pain of severe depression, and most of us have been there, then putting up with a few minor side effects is minor indeed. I've almost died multiple times from suicidal depression and getting that dosage up where it will do some good is much more important that having a little nausea. Just the other side!
Ge Well,
Jedi
Posted by desolationrower on May 18, 2009, at 14:41:36
In reply to Re: Questions about Nardil Experience » Questionmark, posted by jedi on May 17, 2009, at 19:29:50
could be 5ht3 overactivation...lots of drugs are antagonists, ginger is otc and something you could get. candied ginger is a nice snakc
-d/r
This is the end of the thread.
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