Posted by blueboy on June 17, 2008, at 10:48:48
In reply to Nardil users/experts information needed, posted by Four Feathers on June 16, 2008, at 22:15:30
> I am nearing the end of my patience with this med go around which I have been on for the last 10+ years. I have tried a large number of meds singularly as well as certain combos. My current pdoc has recommended Nardil from the first meeting(last December) that I had with him. Honestly, I have been hesitant due to the concerns of food reactions and hypertensive crisis. While I understand that unfortunate experiences like what 4WD and Phoenix have had are rare, I am still a bit reluctant. I am well aware that negative experiences can occur with any medication, regardless of the type.
>I took Nardil for two years, 60mg/day. Like you, I took countless other drugs that didn't help or had intolerable side effects.
Nardil was a very dirty drug for me. I got almost all of the common side effects, but still, it was the only drug that helped me that I could tolerate. So my advice would be, give it a try.
Also, after I went off the Nardil, I got a diagnosis of Bipolar II. If you have had a lot of lack of success with AD's, you might want to double check with a really good diagnostician -- one that will listen more than three minutes before making a diagnosis. I would also suggest writing out two lists, one a historical list, one grouped by symptom type.
> My questions are these:
> 1) are male sexual side effects a given on this medication, or is it something that is often transient? I would like to have a family and anorgasma creates a bit of a problem with that. :)I had major problems with both erectile dysfunction and anorgasmia. It was not, however, completely impossible for me. Both went away immediately when I discontinued usage.
If I had wanted to have children during that period, I might have been able to do it. I'm sure a fertility doctor could manage it. It's a matter of how bad the underlying condition is.
Neither the sexual problems nor any other side effect improved over time. However, they would improve periodically. Like, say, for three days I might be totally impotent, then a couple of days of barely manage, then some days of impotence, then a day of almost normal function, and so on.
> 2) What are typical impacts on energy from this med? I am diagnosed GAD/depression with a definite hint of SP in there as well.
I think it is known as an "activating" drug. It definitely put my energy level WAY up. My problem was getting enough sleep to stay healthy.
> 3) I have always been athletic, at least up until this last round of depression where keeping up with work and every day living activities saps all of my energy. Are there any restrictions or things to be concerned about with exercise when on Nardil, besides the obvious concerns with low blood pressure in the early phases of the med or dosage increase?
In my experience, the low blood pressure subsided during exercise. I would get out of breath from bending over to pull a couple of weeds. Once I started exercising and got warmed up, however, I was pretty normal.
> 4) Is weight gain a given with this med?
Don't know. If you can exercise a lot, maybe you can control it. I did put on considerable weight.
> 5) What are your experiences with concentration on this med? One of my symptoms is definite cognitive impairment with a decrease in short-term memory when not on any meds. Clonazepam actually increases my ability to concentrate...hopefully the gabaergic effects of Nardil could do the same.
>My concentration and cognitive function was very good while I was taking Nardil. YMMV. Unfortunately, it tended to make my hypomanic.
This isn't a drug anyone WANTS to take. You sound like a younger man and I'm sure the prospect of weight gain and sexual problems is extremely worrisome. My guess is that you will have less of a problem actually conceiving children than with things like 1) attracting or keeping a woman happy when you are fatter and less sexually able, 2) embarrassment over perceived failure as a man, i.e. self-image, 3) sexual frustration, 4) social embarrassment over higher weight.
It's bad but perhaps not as bad as you think. I managed to stay married while taking it. (In fact, I would say overall the marriage was better off.) You just have to do the potential cost/reward ratio. I think, in most cases, the inability to hold onto a job, engage in social activities, hold a conversation, etc., would be more disabling to a male/female relationship than additional fat or sexual dysfunction.
I'd imagine that among women who want children -- and for sure among women who HAVE children -- they'd take a happy chubby guy with a job who can't have much sex over a depressed unemployed skinny sexual guy, any day of the week. I have talked to a number of young people who are amazed and distressed about "never" having sex after the baby comes.
I'm not saying that applies to everyone, but if you got married and had a baby or two, and gave your wife a choice between
A) unemployment-underemployement/depression and
B) fatter/less sexual,
I'm guessing she (and you) would choose option 2.Also, your dependence on sex for self-image is very likely distorted a bit by modern US culture. I found that life after gaining 20 pounds and losing 90% of my sex life was bad, but not as bad as I would have imagined. If the proof is in the pudding, I stayed on the drug as long as I could.
I would say that in my case I would once have put the importance of sexuality at a 10 out of 10 -- totally inconceivable that I could live without being sexual and sexually attractive -- whereas, in practice, once I started taking the Nardil, the sexual and weight problems were less distressing than the insomnia. Maybe a 5 or 6 out of 10.
poster:blueboy
thread:834999
URL: http://www.dr-bob.org/babble/20080617/msgs/835043.html