Posted by Justherself54 on April 20, 2008, at 1:21:16
In reply to Re: Husbands Suggestion of Nardil for me/racer, posted by undopaminergic on April 20, 2008, at 0:06:30
> Thanks for the advice. I do appreciate it but I'm not talking about waking up and vomiting..I'm talking about vomiting during a dead sleep, and choking on it. The last episode was very frightening as I was gasping for air and choking while it was shooting out my mouth and nose (sorry to be so graphic)...the risk of aspiration into my lungs was too great and I'm just not willing to try an anti-emetic in case is doesn't work...the next time, especially with that kind of severity, I may not have been so lucky. I think 7 months is a reasonable amount of time to determine whether you feel safe on a medication. There were many other side effects which I haven't discussed, and with all combined my pdoc and I made a decision that I must go off it. I trust his judgment and I believe if he felt that trying to treat the vomiting was worth a try he would have suggested that. In his opinion and mine it was just too dangerous.
I'm very happy when Nardil works well for someone. It is a wonderful AD. Initially it was like a miracle and then side effect after side effect started to crop up..and I couldn't tolerate them. I must admit I feel a bit angry right now. When someone has a failed Nardil trial I wish there would be more support for the decision they've reached with their doctors.
I don't mean to sound harsh but I am very irritable and feel unwell due to the continual brain zaps I've been experiencing ever since the first titration and if I sound a little ratty, it's because right now I am! Four weeks of intense zaps are driving me up the wall and they aren't getting any better. To those that it has worked for, I am so happy for them...but for those who have given it a fair trial but can't tolerate the side effects and have to come off it, I hope they can simply accept that Nardil is not for everyone and be at peace with their decision.
> I think creativity is indeed what you need more of. Many of the side effects you mentioned can be treated, if they don't go away by themselves in a reasonable period of time. Treating the adverse effects is particularly worthwhile if the drug is otherwise effective, as in the case of Nardil, for example.
>
> For vomiting, there are a number of anti-emetic drugs. For example, the -setron serotonin 5-HT3-receptor antagonists (granisetron, tropisetron, ondansetron, etc.). Another major class of antiemetics are dopamine antagonists (domperidone, sulpiride, metoclopramide, chlorpromazine, etc.). There are also anticholinergics (scopolamine, atropine, etc.) and anticholinergic antihistamines (cyclizine, diphenhydramine, promethazine, etc.). Last, but possibly not least, cannabinoids (dronabinol, nabilone) may be effective.
>
> For sedation, stimulants (modafinil, methylphenidate, amphetamines) are usually effective.
>
> For hypotension, some stimulants (methylphenidate, amphetamines) and noradrenergic agents (ephedrine, pseudoephedrine, phenylephrine, etc.) are usually effective. While stimulants are typically contraindicated with MAOIs, when you're suffering from severe hypotension, the risk of hypertensive crisis from the introduction of a stimulant is minimal.
>
> For weight gain, metformin, stimulants, and beta2-adrenergic agonists (clenbuterol, salbutamol, etc.) may be worth trying.
>
> For anxiety, benzodiazepines are often useful.
poster:Justherself54
thread:823803
URL: http://www.dr-bob.org/babble/20080412/msgs/824371.html