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Re: Strange side effects from Nardil, eg loud sounds » PilledOut

Posted by SLS on July 9, 2016, at 7:04:49

In reply to Re: Strange side effects from Nardil, eg loud sounds, posted by PilledOut on July 8, 2016, at 21:41:14

> I actually got an EXTREME, TERRIFYING experience this afternoon. All of a sudden, I could barely breathe, I was going to faint, my heart was beating super fast, my face was sickly, and my hands were cold and clammy. I thought I needed to be rushed to the ER asap. But I sat down and got better. It was over in less than 10 minutes. But it was horrific, and I really thought I was dying. I had a similar experience when I was on clomipramine a few months ago.

Do you think it was an attack of low blood pressure? This is not uncommon with Nardil when getting up from a seated position (orthostatic hypotension). This was a big problem for me when I take Nardil, but it got about 50% better over time. When the blood pressure drops, the heart must beat faster and more forcibly to compensate for this. This can result in rapid heartbeat and palpitations. Tricyclics can do this too, but not as bad.

Anyway, I think you are doing the right thing by stopping Nardil and talking to your doctor. Despite your very detailed descriptions, I don't think anyone here can guarantee that you can safely take this drug. If your doctor is unfamiliar with MAOIs, he will probably want you to stop taking it indefinitely.

> Was that a hypertensive crisis?

If it were a common headache, I doubt it. However, if your headache presented as a rhythmic and painful pounding in the back of your head, then a hypertensive reaction is the likely explanation for your reaction.

It is important to recognize that the effect on total MAO inhibition produced by Nardil is latent and involves a lag time. This happens both on the way up and on the way down in dosage. That said, I am all but sure that Nardil has properties other than MAO inhibition. It seems to be an acute stimulating effect that is different from Parnate. I experienced this 0.5 to 1.5 hours after dosing. I really screwed around with Nardil more than I should have because I was misinterpreting this effect. Because of this, I may have more experience with the personality of this drug than most other people. When I was going up and down in dosage, I experienced changes in the size of my pupils (I think they became bigger), sweating without feeling hot, tachycardia and palpitations. In other words, I experienced a kind of transient dysautonomia when I raised the dosage after having reduced it.

A few ideas:

1. Restart Nardil at 15 and increase the dosage by 7.5 mg every 2 weeks. Some people do respond to 30-45 mg/day, but not many. I would say that 45 mg/day might be a good dosage to target first. You could maybe give it 3 or 4 weeks to work. From there, you could then try to move up to 60 mg/day; increasing the dosage by 7.5 mg at a time.

2. Try taking Marplan (isocarboxazid). It is similar to Nardil, but much more tolerable.

3. While taking Nardil, take a beta-blocker to prevent or lessen the intensity of sympathetic nervous system stimulation. You can take propranolol, atenolol or pindolol. Atenolol might be best, as it does not cross the blood brain barrier and has fewer side effects. You could then discontinue it gradually once you are able to establish a therapeutic dosage of Nardil.

I guess you need to weigh cost versus potential benefit of taking Nardil - or any other drug.

Other than clomipramine, what other tricyclics have you tried, and what were the results?

Do you think you need to take a break from trying medication at this point?

Is perfectionism or obsessiveness a problem?


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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