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Re: Hoping Nardil kicks in at 60 (wk3) - up to 90 PeterMartin

Posted by Tfeld on August 9, 2018, at 11:39:22

In reply to Re: Hoping Nardil kicks in at 60 (wk3) - up to 90, posted by PeterMartin on July 17, 2018, at 16:36:55

> Tfeld,
> Thanks for the in depth message and I'm sorry it took me so long to see it/reply. It means a lot to know that speaking out loud might help some others out there.
> The Zonegran trial didn't work. It started making me depressed and completely uninterested in things I like. I think I'm a bit lucky I decided to stop it before getting on a long run with it. Today is only my 3rd day off and it has an extremely long 60hr half life. Definitely wasn't feeling anything but sad this morning but I think I'm finally coming around a bit. In the 3weeks (200mg) I made it through it didn't lower the scale at all anyway.
> Nardil has an odd medicine for me. Maybe like you suggest I'm taking too much. My BP is really low like 89/59 most times. I have bad urinary retention too and I've been at 90 for months now. Perhaps I should try to step back to 75 at some point.....I just need to hold on that until the Zonegran is gone.
> Once Marplan is back (Quartet 4 2018 is the current listing on the FDA site) I'm pretty sure I'll switch right back over. This year has been a complete rollercoaster. It's been difficult. I definitely couldn't afford the overseas solution you found but luckily I think I'll be eligible for the assistance program when it's available again by Validus. Thatll he my only hope of getting it again in the US now...
> Hope you are doing great and sorry for any typos/rembles - typing on my phone but wanted to reply.

Hey Peter,

Thanks for your reply and my apologies for my late response -- been very active in my new life! (See my post above.) But I do feel responsible to give back to others who so freely share their experiences on here -- thanks for that too.

How have you been doing with the Nardil, other meds, and overall? Have you found a dosage regimen that works for you?

Nardil indeed is a tricky med, especially with its nonlinear pharmacokinetics (inhibits its own metabolism via MAO and CYP3A4). I sometimes miss the good-ol' Marplan and the ability to keep upping to see more results linearly without adversity. But I'm grateful to have found my "sweet spot" with Nardil (37.5mg; maybe try an intermediate dose -- half a pill can make a huge diff. bc of the nonlinear pK), and even more so that it's low and to be on considerably less antidepressant (vs. 90mg Marplan, the desipramine -- my new enemy -- etc).

While Nardil's working better for my psychopathology, I loved the "feeling" of Marplan, but I'm living for something entirely different these days. I'm no longer chasing drug-induced (including psych meds) "feelings" of well-being but the simplest, lowest-effective dosage regimen w/ meds that allows me to be of optimal *functioning* so I can experience the true joys of life. My doctor was reacted very pleasantly to this and my belief that it's only through *functioning* in life's domains can one experience its true beauty. A lot of this is influenced by my addiction recovery and desire for emotional sobriety as well as abstinence from street drugs, but I think it's highly applicable to pharmacotherapy in general, esp. TRD where we're constantly chasing relief.

Sometimes we indeed do need some numbing up... but at a certain point it becomes detrimental, I believe. To that effect my doc has even agreed to decr. or d/c my lithium (300mg --> 150 --maybe--> 0mg) as it prevents me from feelings excitement.

Excited to hear back from you on your progress. Progress not perfection!

Tom aka T-Feld




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