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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by J Kelly on May 18, 2016, at 5:17:57
Two nights with hardly any sleep. I had trouble falling asleep last night initially and I woke up maybe 4 times. In looking at melatonin I've found articles that say its safe and some that say it isn't. Can someone tell me if melatonin is okay with Nardil?
I'm also wondering about dose. One site I was looking at said more is not better. I have 5mg capsules.
Thanks,
Jade
Posted by Christ_empowered on May 18, 2016, at 10:49:28
In reply to Nardil Insomnia, posted by J Kelly on May 18, 2016, at 5:17:57
hi. I don't know how melatonin mixes with MAOI drugs. Its a potent antioxidant. High-ish doses have been used to treat tardive dyskinesia for this reason.
Ummm...information on dosing seems kinda scant. Some sources say go as low as you can, others basically say its innocuous and take however much you need. Some drugs...Prozac, amphetamines...reduce melatonin levles.
I used to take 3mgs for a while. Then I took 10mgs, because that's how much was used in one small study for TD (I don't have TD, but I thought I could fix the insomnia and prevent TD with one pill...). Its OK. I got weird dreams and a strange sense of unease upon awakening, so I ditched it. Plus...I now take high dose niacinamide, which indirectly boosts melatonin.
Oh, yeah...that brings me to my suggestion...high dose niacinamide. Unlike niacin, it won't cause a flush. Its has some kind of effect on GABA receptors, and over time it also spares trypothan, leaving more for serotonin synthesis. Interestingly enough...its also been used in high oral doses for skin problems (Nicomide).
So, yeah. That's my main suggestion. I take 3 grams/day, which is fairly minimal for my set of issues. I take time release, but the instant release is cheaper and more readily available. 500mgs is a standard dose per capsule. Maybe 1 or 2 of those with an evening meal/snack? If it works, you may want to consider adding in C and a B-50 or B-100 for some synergy+overall health benefits.
Ummm...aside from my usual Orthomolecular advice, all I can think of would be a high dose of taurine on an empty stomach towards the end of the day. Its an amino acid...higher doses have a mild sedative effect and also some anticonvulsant and mood-stabilizing effects. Its also used to help w/ alopecia, lol.
Other than that...there's always the Rx route. Short term Restoril helps a lot of people. One poster on here take Halcion. Ambien, Sonata, Lunesta. Maybe...neurontin, lyrica?
Good luck!
Posted by Lamdage22 on May 18, 2016, at 10:53:00
In reply to Re: Nardil Insomnia, posted by Christ_empowered on May 18, 2016, at 10:49:28
Latuda?
Probably too weak. What about Trazodone?
Posted by Lamdage22 on May 18, 2016, at 13:20:28
In reply to Re: Nardil Insomnia, posted by Christ_empowered on May 18, 2016, at 10:49:28
The Zyprexa 5mg is not sufficient?
Posted by J Kelly on May 18, 2016, at 14:58:10
In reply to Re: Nardil Insomnia, posted by Christ_empowered on May 18, 2016, at 10:49:28
Hey CE, thanks for all the suggestions...your brain is working much better than mine today! I'm gonna print this out and take it with me to my pdoc appt Friday.
If this is my new Nardil sleep pattern something's gotta give. I got almost zero sleep last night :(
Thanks again for the ideas,
Jade
Posted by J Kelly on May 18, 2016, at 15:04:10
In reply to Re: Nardil Insomnia, posted by Lamdage22 on May 18, 2016, at 13:20:28
> The Zyprexa 5mg is not sufficient?
I took 7.5mg Zyprexa plus 1.5mg klonopin and still no sleep! Could be I just had an off night but I kinda doubt it. I believe insomnia is a common s/e with Nardil.
I'll deff look into the latuda..I'm seeing my pdoc Friday so I'll run it by him then.
Thanks Lamdage,
Jade
Posted by J Kelly on May 18, 2016, at 15:08:42
In reply to Re: Nardil Insomnia, posted by Lamdage22 on May 18, 2016, at 10:53:00
> Latuda?
>
> Probably too weak. What about Trazodone?Oh, and Trazadone works well for me for sleep but leaves me with a nasty hangover in the morn. Isn't trazadone an SSRI? Serotonin syndrome?
Jade
Posted by linkadge on May 18, 2016, at 20:10:00
In reply to Re: Nardil Insomnia » Lamdage22, posted by J Kelly on May 18, 2016, at 15:08:42
Hi,
MAOI insomnia can be nasty. Biochemically, MAOs can increase endogenous tryptamine, which activates 5-ht2a and disrupts sleep and melatonin cycles. I would reduce the dose of nardil (if at all possible) and try augmenting with Seroquel (or other non-serotonergic 5-ht2a blocker).
trimipramine, cyproheptadine perphenazine, or possibly the herb feverfew might work.
I would personally avoid melatonin. I find melatonin doesn't work well with monoamine enhancers. It does mix well with monoamine blockers like remeron, however.
Linkadge
Posted by J Kelly on May 18, 2016, at 23:21:08
In reply to Re: Nardil Insomnia, posted by linkadge on May 18, 2016, at 20:10:00
> Hi,
>
> MAOI insomnia can be nasty. Biochemically, MAOs can increase endogenous tryptamine, which activates 5-ht2a and disrupts sleep and melatonin cycles. I would reduce the dose of nardil (if at all possible) and try augmenting with Seroquel (or other non-serotonergic 5-ht2a blocker).
>
> trimipramine, cyproheptadine perphenazine, or possibly the herb feverfew might work.
>
> I would personally avoid melatonin. I find melatonin doesn't work well with monoamine enhancers. It does mix well with monoamine blockers like remeron, however.
>
> Linkadge
Hello,Perphenazine is a med I was gonna look at. I think its Zyprexa (the poster) that said she has had a good experience with it and I believe she combines the two (Zyprexa and perphenazine).
Any thoughts as to how this med will get along with Zyprexa, klonopin, and Nardi?
I think it has sedative properties and I didn't see weight gain as a side effect. Weight gain and insomnia are both becoming problems.
Thanks for the advice,
Jade
Posted by TriedEveryMedication on May 19, 2016, at 2:12:23
In reply to Re: Nardil Insomnia, posted by Lamdage22 on May 18, 2016, at 10:53:00
> Latuda?
>
> Probably too weak. What about Trazodone?Warning - I've read clinical reports of deaths from Trazodone + MAOI.
I was prescribed ambien when I took Nardil. The Z-drugs and ativan are ok with MAOIs
Posted by Lamdage22 on May 19, 2016, at 7:43:39
In reply to Re: Nardil Insomnia » Lamdage22, posted by J Kelly on May 18, 2016, at 15:08:42
Yes insomnia is incredibly common with MAOI.
I dont know about Serotonin Syndrome.
Posted by Lamdage22 on May 19, 2016, at 7:44:07
In reply to Re: Nardil Insomnia, posted by Lamdage22 on May 19, 2016, at 7:43:39
Gabapentin or Lyrica?
Posted by J Kelly on May 19, 2016, at 8:57:50
In reply to Re: Nardil Insomnia » Lamdage22, posted by TriedEveryMedication on May 19, 2016, at 2:12:23
> > Latuda?
> >
> > Probably too weak. What about Trazodone?
>
> Warning - I've read clinical reports of deaths from Trazodone + MAOI.
>
> I was prescribed ambien when I took Nardil. The Z-drugs and ativan are ok with MAOIsHello,
Gosh thanks for the warning! I don't usually take trazodone cause it gives me an unpleasant morning hangover. But I do have some and I can see myself taking it out of desperation for some sleep. I won't now!
I see pdoc tomorrow, I'll ask about Ambien. Not sure if it plays nice with Nardil, Klonopin, and Zyprexa. You'd think those alone would knock out an elephant and yet i'm still dealing with insomnia.
Thanks,
Jade
Ps-what are the "Z" drugs?
Posted by J Kelly on May 19, 2016, at 8:59:43
In reply to Re: Nardil Insomnia, posted by Lamdage22 on May 19, 2016, at 7:44:07
> Gabapentin or Lyrica?
I'll add them to my list to bring up with pdoc tomorrow. I know a lot of people like these meds.
Jade :)
This is the end of the thread.
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