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Re: Nardil from Australia = 1950's version.

Posted by King Vultan on April 9, 2004, at 19:55:14

In reply to Re: Nardil from Australia = 1950's version., posted by SuzyQ1 on April 9, 2004, at 18:34:46

Well, the formula has definitely been changed, and the changes are all in the so-called inactive ingredients. The drug itself, phenelzine sulfate, is still the same. However, the inactive ingredients can have an effect on the absorption rate, which is apparently why some people are having difficulties.

From what my doctor said, it sounds like there were similar problems back when Tofranil (imipramine) went generic years and years ago. People would all of a sudden start having problems and complaining of reduced effectiveness. He would ask if the pill was the same, and they would reply no, it was different. With imipramine, it was a simple matter to run a blood plasma level and determine that the level of the drug in the blood had dropped. The reason was that the contents of the pill were passing through the system in a different manner, resulting in less ultimately getting absorbed into the blood.

From what you're saying about your experience since the new formulation came out, yes, it does sound like it would probably be a good thing to try going up by one pill, but I'm always in favor of including your doctor in this decision. I'm a newcomer to this drug and have only been on it for a month and half, so I do not know how the old formulation compared. I will say that for me, 45 mg/day had no effect at all, 60 mg/day started producing adverse effects (insomnia), as well as some slight therapeutic effects, and 75 mg/day is producing enough improvement in my mood that I want to hold it here for a while and see what the ultimate effect of the dosage will be. There is a school of thought that an effective Nardil dosage is related to one's weight, with a person needing to take at least 1 mg/kg/day, at least at the beginning of treatment (I am about 65 kg); however, this number is based on the old formulation. I have read that, yes, lowered maintenance dosages for Nardil are sometimes used.

As for Pfizer's responsibility in all this, I don't know what the root cause of their changing the formulation was. I've heard stuff about increasing shelf life, but you have to wonder why this would be necessary when the drug appears to have been working fine for decades. I tend to be cynical about what large companies say, but as someone who also works in the formulation industry, I can tell you that there are often legitimate reasons for changing a formulation. In any case, if a person happens to be one of the individuals who is sensitive to the formulation change but can restore the original effects just by taking an extra pill or two, that doesn't sound that horrible. Considering the fairly miniscule number of people taking Nardil, I think it's fortunate that it's still being produced.

Todd


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poster:King Vultan thread:283363
URL: http://www.dr-bob.org/babble/20040407/msgs/334642.html