Posted by zonked on June 17, 2011, at 22:47:24
In reply to Re: ... And all things Nardil ... Re: Morning dread... » zonked, posted by Questionmark on June 17, 2011, at 19:12:52
> Whenever the psychiatric or medical industry make gross overgeneralized, oversimplified claims like that a quick titration to 60mg, or 1mg/kg body weight, are ideal and recommended, it leaves me a little dumbfounded. If everyone who needed Nardil had the exact same neurochemical make-up, then this might have some rationale. Of course, if we lived in a fantasy world where everything was that simple and wonderful, we wouldn't need Nardil in the first place. The reality is, neurochemistry and its manipulation are far too complicated to warrant these kinds of generalizations.
I couldn't agree more.
> I'm not at all directing this frustration toward you. It's reasonable to believe that something tossed around a lot by the experts should be valid. But if you think about, it's really a gross oversimplification.
It is.
> I do have no doubt though that it could probably take some people at least 90mg to get sufficient MAO inhibition for their needs.
> Also, aside from an opinion (and even that is rare), i rarely ask a psychiatrist anything. i tell him. OK, well i don't mean to sound like i'm that bold and assertive about it -- not at all -- but it's essentially true. It's important for us to remember that they are serving us, not vice versa.Yep. Good shrinks either:
1. Already know whatever it is you're coming into the appointment with
OR
2. Appreciate that you're proactive about your condition and genuinely consider whatever it is you want to bring to the table
Bad shrinks let their egos or lack of knowledge interfere with patient care, and can become very uncomfortable with patients who may have learned something they know *nothing* about.
I am fortunate to have good providers right now, but that hasn't always been the case.
Being on government insurance, I do not have much choice about where I go for care. When you pay out of pocket and your shrink is an *ssh*l*, you can say "See ya! I'm taking my money elsewhere--to the best psychopharmacologist money can buy, who is not you." But when you are stuck with whomever takes your government health insurance *and* they are *ssh*l*s, *AND* you can't afford to pay someone out of pocket you're kinda screwed if you don't get lucky, as I have been. I have someone awesome who does take the coverage I have now though. And if things continue improving I should be able to return to work and become self supporting again anyway. :D
> ...
> It is strange, i admit: i know there is no drug more helpful for me. And i have been in so much misery and pain this past half-year, esp. And i know where this relief. Yet i still can't get myself to go there. .... i dunno. It's too complicated too adequately discuss i guess. ... Also, though i have no moral objections to it for others, the self-identity confusion that comes from being totally changed by a drug is very psychologically conflicting for me (though i don't seem to care much while consistently ON a full dose of the drug). I dunno. It's a real philosophical dilemma, in any case. ... But that is a minor factor compared to the side effects. Anyhoo....Believe it or not, I understand your dilemma. I have faced the same conflicts and concluded that, ultimately, it's a quality of life decision; and my quality of life on psychotropics is exponentially better than off them--even with the side effects.
Had I not discontinued Nardil my first time around, I may never have had an interruption in my life/career/etc.
The worst side effect, in Nardil's case, is the weight gain. This can be overcome, I believe jedi has kept it at bay with regular, intense exercise; and not giving into the Nardil munchies--which are good, healthy things anyway.
> Oh, interesting. OK maybe i was wrong then, in regard to a lot of people. See, i first noticed the "dread" when i withdrew from Paxil years ago. But it wasn't only in the morning, it was whenever i woke from sleep at any time -- including daytime naps. The same has been true w Nardil withdraw or insufficient Nardil. So for me the dread was definitely precipitated by medication.
Hmm. Interesting. I should clarify: the dread was (I use the past tense because it's mostly gone now) present whether I woke up in the morning, *or* from a nap. It's been a feature of my depression ever since my first episode..
> And due to the subjectively short-acting nature of Nardil, I would still experience the morning dread even on a "fully" effective dose if I slept more than like 8 hours.
If I sleep too much I almost always feel awful. If I sleep too little I may be tired, but don't feel awful in the same way. If I sleep too little but do *not* feel tired, *and* have lots of energy, and my bank account starts to drain rapidly it's time to call the doctor. (Heh.) (Sorry Parnate, you helped me a bit too much...)
> Oh good! That's very good to know.
> Take care, and good luck, with the greatest antidepressant class known to Man.Isn't it though? BTW, do you take anything else besides Nardil? Are you in the US or elsewhere?
By the way, I didn't mean to be pedantic about your Nardil dose. Hope you weren't offended.
-z
poster:zonked
thread:987723
URL: http://www.dr-bob.org/babble/20110610/msgs/988611.html