Posted by ed_uk2010 on May 26, 2013, at 9:40:30
In reply to Nardil agitation, depression, suicidal thoughts, posted by Daniell on April 30, 2013, at 15:27:46
Your reaction on 60mg Nardil does resemble serotonin syndrome. Have you taken any other antidepresssants recently? Or tramadol (Zydol, a painkiller), or any other prescription medicines, over the counter medicines (esp. cough/cold medicines), supplements or herbal medicines?
On the day you woke up so unwell, or in the days before, had you taken any other tablet/capsule of any type? The apparently abrupt onset of your severe symptoms is suggestive of a drug interaction. Might you have taken a venlafaxine or SSRI tablet by mistake? That might cause a similar reaction for a person on Nardil.
Nardil has some serious drug interactions so you need to be very careful before taking other medications whilst on it, and for 2 to 3 weeks after stopping it. Similarly, certain other medicines such as SSRI antidepressants need to be stopped for several weeks before starting Nardil (the exact time depending on the specific medication).
>I must have had a mild case of serotonin syndrome, which surely means that MAO is inhibited to quite a high degree?
Yes, I expect that it was.
>I'm only around 55 Kg and I was thinking quite possibly I am sensitive to this medicine such that a lower dose might be better?
Your reaction to 60mg suggests that 45mg would be the maximum safe dose for you to take, unless your reaction to 60mg was due to a drug interaction.
>Also, people say that once 80-90% MAO inhibition is achieved, therapeutic response will be seen.
They do, but I wouldn't really consider that too much because it's impossible to know exactly what Nardil is doing in your brain. You can only assess response according to your symptoms.
>Will Nardil work for me if I wait for the agitation/severe depression to go away then stick it out at a lower dose?
Your symptoms on 60mg suggest either of 2 possibilities:
1. That 60mg was far too much for you personally.
2. You experienced a drug interaction.You should not have to endure such severe symptoms. If you wish to restart Nardil, you should start at a low dose such as 15mg twice a day and then increase gradually up to a maximum of 15mg three times a day. Considering your low bodyweight and previous reaction, I would not take more than 15mg three times a day during your initial trial. Avoid other medicines before, during and for 2-3 weeks after your trial of Nardil unless you have checked with your doctor and pharmacist that they are safe.
poster:ed_uk2010
thread:1042961
URL: http://www.dr-bob.org/babble/20130501/msgs/1044250.html