Posted by Tomatheus on September 21, 2008, at 22:56:24
In reply to Nardil Dosage, posted by AZLIZZY on September 21, 2008, at 0:38:57
AZLIZZY,
Your response to Nardil sounds similar to my response to the Australian Nardil before I started putting the contents of my Nardil tablets into enteric capsules. When I just took 75 mg/day of the Australian Nardil as it was manufactured, I responded for about two weeks before losing the antidepressant response. And after the antidepressant response faded, I did notice some irritability.
After I started preparing my Australian Nardil tablets in emptied-out enteric capsules, I went into full remission on 75 mg/day of the medication for a month (which is admittedly still a short period of time, but longer than the mere two-week response that I had before I tried using the capsules). I then switched to the version of Nardil that Pfizer manufactures for the U.S. market and started preparing those tablets in the enteric capsules, and I responded to the medication at 60 mg/day for two months.
When it comes to the film-coated Nardil, responses seem to vary from one individual to the next. A lot of patients found Nardil to be significantly less effective and less tolerable after Pfizer changed the medication from an enteric-coated product to a film-coated product in 2003. Still, some patients did not notice a difference. Other patients reported that it took a higher dose of the "new" Nardil to get the same effects of the "old" Nardil. It could very well be the case that you might respond to Nardil on a long-term basis if you increase your dose to 90 mg/day. I think that this option is definitely worth trying.
I do, however, suspect based on my experiences with Nardil that if you increase your dose that you very well may experience more of the same: a good response for about a week and a half, followed by a loss of efficacy and the emergence of irritability. I'm not saying that increasing the dose to 90 mg/day isn't worth trying. I think it is. I guess what I'm trying to do is anticipate what might happen next so you could take the next step if things don't work out at 90 mg. I know that this course of action sounds extreme, but I would actually recommend putting the contents of your Nardil tablets into enteric capsules if you could afford to do so. Of course, I'd completely understand if you were uneasy about taking this course of action.
If you're interested in using the enteric capsule approach, I'll give you the links of two old Psycho-Babble posts that describe how it's done:
http://www.dr-bob.org/babble/20050527/msgs/505052.html
http://www.dr-bob.org/babble/alter/20050510/msgs/506644.htmlAs far as I know, Psycho-Babble member Michael Bell is the first person to try transferring the contents of Nardil tablets into emptied-out enteric-coated PlasminPlus capsules to protect the medication from chemical degradation in the stomach. As I mentioned in a previous Psycho-Babble post, a Ph.D. thesis written by Gan-Lin Chen (1986) showed that Nardil's active ingredient undergoes chemical degradation 463 times as rapidly in stomach-like conditions (pH 1.94, hydrochloric acid buffer, aerobic conditions) than in conditions more similar to those in the small intestine (pH 7.33, phosphate buffer, anaerobic conditions).
Whatever you decide to do, I wish you luck in your trial with Nardil. I know that it can be a wonderful medication when its effectiveness is harnessed, but I also understand how frustrating it can feel when it stops working. I hope you find some of what I wrote to be helpful.
Tomatheus
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REFERENCE
Chen, G.-L. (1986). The chemical kinetics of phenelzine degradation. Unpublished doctoral dissertation, University of Iowa, Iowa City.
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> Hi. I was hoping someone who has taken Nardil would be able to help me. I have been slowly increasing the dosage of Nardil I was prescribed by 15 mg since I began taking it in the middle of August. I am currently at 75 mg and have been for about 3 weeks. After the first 1 1/2 weeks on 75 mg, I felt better than I have in years. However, the last week has been really tough. I have become increasingly irritable and have had problems with anxiety cropping up again. I was wondering if anyone else has experienced this problem. Should I increase my dosage to 90 mg? What is the regular effective dosage? It seemed so hopeful. I'm really scared that I have run out of options. Any help or suggestions would be appreciated.
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poster:Tomatheus
thread:853198
URL: http://www.dr-bob.org/babble/20080915/msgs/853353.html