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Dr. Bob is Robert Hsiung, MD,
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Posted by Lamdage22 on March 11, 2018, at 4:49:13
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on March 10, 2018, at 2:30:01
I think i would try to leave the Metformin away for a few days and see if you are more hungry when you dont take it. Otherwise you wont know.
Posted by Lamdage22 on March 11, 2018, at 5:09:39
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on March 10, 2018, at 2:30:01
I often go to bed early to end the day. It comes with depression i guess.
Posted by Lamdage22 on March 11, 2018, at 6:28:15
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by Lamdage22 on March 11, 2018, at 4:49:13
For me the difference was profound.
Posted by PeterMartin on March 13, 2018, at 12:54:57
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by Lamdage22 on March 11, 2018, at 6:28:15
The last few days have bsen really good. I seem to dip a little after my morning dose and gym but I keep reminding myself it's going to be a long process.
I also think the metformin ER (Sun Pharma at 1500) is helping. I has a couple weeks of sweets cravings but that's gone. My appetite the last few days has probably been less than the last few years. I kept myself busy and made it through the day with limited amount. Also using the bathroom a lot daily. On Maprlan (w/o metformin) I would go days w.o. due to severe constipation.
Weight at start of Nardil was 216.9. After 6wks of Nardil(Gavis) at 60 + a few days of 70 my wt this morning was 215.8. it's been as high as 218.7 but so far weight gain (probably thanks to Metformin) hasn't been a problem.
Posted by PeterMartin on March 15, 2018, at 0:52:52
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on March 13, 2018, at 12:54:57
After another down day I tried taking a tiny piece of B6 (~10mg) last night. This morning was difficult. I have poor reaction to vitamins & supplements so I'm not surprised my reaction was negative.
I saw my doctor today (regularly scheduled monthly apt) and I suggested I try ceasing the Nuvigil. It's never provided the awakeness it's supposed to for me. I can sleep right after taking it.
There is a curiously addictive part of Nuvigil that has kept me from dropping it on my own. I've been on it a year and it makes me kinda zone out but I don't get things done. I do think about it in the morning if I try to take a day off though.
Telling my doctor I want off and giving my remainder to my GF to put away should force me to finally give it up. There's a good chance it was holding me back from remission.
I just need to keep waiting and hope that there's more to come from Nardil. Today I was pretty melancholy, unmotivated to do anything, and fatigued.
Posted by Lamdage22 on March 15, 2018, at 3:34:08
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on March 13, 2018, at 12:54:57
Thats awesome. I wonder what Scotts doctor says about Metformin. He also has metabolic syndrome as far as i know.
Posted by Lamdage22 on March 15, 2018, at 3:37:31
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by Lamdage22 on March 15, 2018, at 3:34:08
and the Nardil is working do you think? I wish i could get thr Metabolite that inhibits Gaba-T in a pill. Thats an awesome mechanism.
Posted by Lamdage22 on March 15, 2018, at 7:26:20
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by Lamdage22 on March 15, 2018, at 3:37:31
i would get regular kidney checks with Metformin though just to make sure. blood sample is fine. This is to avoid a rare side effect
Posted by ed_uk2010 on March 16, 2018, at 8:04:24
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by Lamdage22 on March 15, 2018, at 3:37:31
>and the Nardil is working do you think? I wish i could get thr Metabolite that inhibits Gaba-T in a pill. Thats an awesome mechanism.
There are medications, such as vigabatrin, which are specific Gaba-T inhibitors. Plenty of side effects though, so never used in mental health.
Posted by PeterMartin on March 16, 2018, at 8:56:53
In reply to Re: Hoping Nardil kicks in at 60 (wk3) » Lamdage22, posted by ed_uk2010 on March 16, 2018, at 8:04:24
I feel a lot better this morning. 2days off the Nuvigil. 75 has brought back some urinary retention but I'm used to that. 4:30 wake up but I'm kinda used to that too. Definitely nardil effect so far today. Hope it continues.
Btw Walgreens tried to give me half Gavis & half Greenstone but I complained. The lady said one of them was on backorder. I got scared for a second as I want to stick w Gavis(Lupin)....thankfully ?for me) it's Greenstone that's on backorder. I'm not sure if it's all over or just at Walgreens but figured I'd mention.
Posted by Lamdage22 on March 16, 2018, at 9:54:55
In reply to Re: Hoping Nardil kicks in at 60 (wk3) » Lamdage22, posted by ed_uk2010 on March 16, 2018, at 8:04:24
> >and the Nardil is working do you think? I wish i could get thr Metabolite that inhibits Gaba-T in a pill. Thats an awesome mechanism.
>
> There are medications, such as vigabatrin, which are specific Gaba-T inhibitors. Plenty of side effects though, so never used in mental health.That is extremely unfortunate. I guess most people tolerate Nardil so there would be no need to develop the Nardil metabolite.
Posted by PeterMartin on March 16, 2018, at 19:29:13
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on March 16, 2018, at 8:56:53
> I feel a lot better this morning. 2days off the Nuvigil. 75 has brought back some urinary retention but I'm used to that. 4:30 wake up but I'm kinda used to that too. Definitely nardil effect so far today. Hope it continues.
>
> Btw Walgreens tried to give me half Gavis & half Greenstone but I complained. The lady said one of them was on backorder. I got scared for a second as I want to stick w Gavis(Lupin)....thankfully ?for me) it's Greenstone that's on backorder. I'm not sure if it's all over or just at Walgreens but figured I'd mention.
>12hrs later (nap and some work) I feel pretty crappy. Grumpy. Maybe Nuvigil withdrawal but so far this trial of Nardil has been a rollercoaster......blah
Posted by Lamdage22 on March 20, 2018, at 12:38:24
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on March 16, 2018, at 19:29:13
any paranoia or suspiciousnes?
Posted by PeterMartin on March 21, 2018, at 2:34:30
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by Lamdage22 on March 20, 2018, at 12:38:24
Nope. I've been manic before but not since getting clean in 2010 (and was in Marplan for the past 7yrs).
Today was a very good day. Productive and I definitely felt more comfortable around the few people I see daily. I've made the gym very frequently for rides of the bike and perhaps that's helped my mood too. I really think I suffered from 5 or so days of withdrawal from Nuvigil. That's over and I've only thought about it on rare occasion. While taking it i would look forward to my morning or afternoon dose.
I have lots zyprexa if any mania comes about but so far I've been down to earth. It's been Avery bumpy ride "here" though so hopefully my mood will stay positive.
Urinary retention / complete sexual disfunction at the moment. Also early wake ups (I take seoquel to sleep so no prob there but 5ish up). I don't mind though.....out to the gym.
Posted by PeterMartin on March 31, 2018, at 18:57:07
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on March 21, 2018, at 2:34:30
Still up and down over here.
Decided to try to cut my lamictal back to 100 (from 150). When I was on Marplan I almost always kept it at 100. Been dealing w a really bad day + half of only wanting to sleep but I know that's withdrawal.
Overall mood is pretty bad but hopefully once everything settles ikl be better
Posted by SLS on March 31, 2018, at 20:49:53
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on March 31, 2018, at 18:57:07
75 mg/day?
Posted by PeterMartin on April 1, 2018, at 10:02:01
In reply to Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin, posted by SLS on March 31, 2018, at 20:49:53
> 75 mg/day?
Yea 75mg for ~3weeks now. Off Nuvigil for 2.5 and don't think I'm still w/ding from that (unless it changed things after a year of use).
Severe w/d dropping lamictal from 150 to 100 a few days ago (slept almost all day yesterday) but kinda expected that. Think I'm on the other side there.
Metformin seems to be helping but I've been so uptight about which generic works. Currently taking Teva ER and I think ill stick with it. Smooth release I think (Sun ER seemed to make me depressed a couple times a day so I think it's time release was really just twice vs gradually over hrs). Weight this morning was 218.3 so up 1.4 since I started Nardil on Jan 25.
Mood sucks today though. Completed ED / no feeling / anorgasmia. Would be ok w that if I felt good. Marplan was never this bad. Bp is down but not more than Marplan put it. No standing up dizzy/light-headed.
So anyway today sucks. Probably feel that way about but due to the lamictal drop (it's always been tough for me). I tend to do better on 100 of lamictal though and since Nardil hasn't pushed through at 150 I'm hoping maybe it was the lamictal blunting it
I'd go to 90 on Nardil but won't see my doc for another month or so. He doesn't have a lot of patients on Nardil and I only started seeing him in Jan. Don't want to seem problematic. Part of me wants to try 90 w.o. consoltating but I'll hold here andtwiddle my thumbs hoping 75 + the drop in lamictal + metformin ER settle in an I get some consistent relief.
It's been a rollercoaster and not fun.
Thanks Scott for the follow-up.
Posted by SLS on April 1, 2018, at 11:01:26
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 1, 2018, at 10:02:01
Why did you reduce the dosage of Lamictal?
Most people need 200 mg/day. I need 300 mg/day. Perhaps your taking so little Lamictal explains your mood lability. I can't be sure, of course.
- Scott
Posted by PeterMartin on April 1, 2018, at 11:34:46
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by SLS on April 1, 2018, at 11:01:26
> Why did you reduce the dosage of Lamictal?
>
> Most people need 200 mg/day. I need 300 mg/day. Perhaps your taking so little Lamictal explains your mood lability. I can't be sure, of course.
>
>
> - ScottI've been on lamictal since 2007 and I've always floated between 100 and 225. When I was on Marplan it was almost always 100 (7yrs). A few attempts to go to 150 always made me tired so I just waited out the depression.
On 150 now I'm having a lot of writing/typing issues online. I drop a lot of words and make badly written sentences. Even if I mull over them for a while I still seem to make errors. This may not be all.lamictal but it got bad last year and that's a period I was on 150 for a while. My memory is also pretty poor regarding what gf is doing this week or when I have apts coming up.
So going down to 100 is my attempt to be sure lamictal isn't "blunting" Nardil and also hopefully help my cognitive issues. If I had to guess 200 might make me more sedated to things but I'm hoping to find motivation and the productivity I used to get from Marplan and when I was feeling optimistic.
I took another HR nap and feel slightly better. Hopefully I just need to wait a little longer for the lamictal w/d tonease (and Nardil to finally kick back in)
Posted by PeterMartin on April 1, 2018, at 11:37:36
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 1, 2018, at 11:34:46
Sls:
Taking a day or two of 90 to try to kick start Nardil would not be worthwhile would it? To knock out some extra Mao?
I'm also taking it spread throughout the day pretty much 1 at time (6/8/10/12/4). Marplan k always too all at once at night......maybe that did better kicking out Mao and not affecting me in other ways.
Posted by SLS on April 1, 2018, at 22:39:39
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 1, 2018, at 11:37:36
> Sls:
>
> Taking a day or two of 90 to try to kick start Nardil would not be worthwhile would it? To knock out some extra Mao?
>
> I'm also taking it spread throughout the day pretty much 1 at time (6/8/10/12/4). Marplan k always too all at once at night......maybe that did better kicking out Mao and not affecting me in other ways.I usually take Nardil as 30 mg t.i.d. - 9 AM / 12 PM / 3 PM. I did it that way because I thought this would minimize the insomnia that it gave me. I don't think you should take extra Nardil at this juncture. It might confound your ability to evaluate your present dosage and could trigger side effects unnecessarily. My main concern is urinary retention.
- Scott
Posted by PeterMartin on April 2, 2018, at 2:01:48
In reply to Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin, posted by SLS on April 1, 2018, at 22:39:39
> > Sls:
> >
> > Taking a day or two of 90 to try to kick start Nardil would not be worthwhile would it? To knock out some extra Mao?
> >
> > I'm also taking it spread throughout the day pretty much 1 at time (6/8/10/12/4). Marplan k always too all at once at night......maybe that did better kicking out Mao and not affecting me in other ways.
>
> I usually take Nardil as 30 mg t.i.d. - 9 AM / 12 PM / 3 PM. I did it that way because I thought this would minimize the insomnia that it gave me. I don't think you should take extra Nardil at this juncture. It might confound your ability to evaluate your present dosage and could trigger side effects unnecessarily. My main concern is urinary retention.
>
>
> - Scott
>
>
Thanks that's helpful. Insomnia is never really an issue for me thanks for a small 25mg dose of Seroquel (been taking that as well since 2007.So of course I actually had a pretty good night. One great sign is that I actually forgot about taking my last Nardil of the day (only by an HR or so) instead of dying for the time to come hoping for relief.
It's odd but I seem to bitch about it not working just before it kicks a little. I really do have hope that the timing and the lower dose of lamictal might finally get me to a good (and consistent) place. Im sure I'll feel ok in the morning but it's usually short after that (9/10am) that I don't feel like doing things I'd usually do at that time.....hopefully tomorrow will be different.
Thanks for the discussion.
Posted by SLS on April 2, 2018, at 7:52:05
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 2, 2018, at 2:01:48
What time do you take Lamictal?
- Scott
Posted by PeterMartin on April 2, 2018, at 20:23:55
In reply to Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin, posted by SLS on April 2, 2018, at 7:52:05
> What time do you take Lamictal?
>
>
> - ScottNighttime.
I take TEVA on that too. I find different lamictal generics affect me differently.
Another not so great day. Did manage to get some stuff done this morning (artistic project) but was tired the whole time. Took a nap at 1, woke up at 3:30, ate, and now I'm a little irritable/don't want to do anything but go back to bed.
I'm sure the lamictal drop is part of this but I'm beginning to think the metformin (recently switched generics on that) could be at play too. I'm taking all of that (extended release 1500) at night for the past couple days but was spliting it prior. Also was taking a different generic (Sun). I think there may be minor interaction w lamictal levels - have to look that up again.
Notwithstanding the Nardil doesn't seem to be helping much at all. I used to get very driven w Marplan and there's non of that right now. No interest in doing what I'd usually do at this time of day in past months/weeks.....
Posted by SLS on April 2, 2018, at 21:12:12
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 2, 2018, at 20:23:55
How long did you stay at 150 mg/day of Lamictal before cutting back?
You were optimistic and described feeling better up until now.
I remain suspicious that you need to return to higher dosages of Lamictal. I think it is a worthwhile experiment. I appreciate your being concerned with cognition and memory. These things happened to me at first with Lamictal and at every dosage increase - but they disappeared.
- Scott
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