![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 31 to 55 of 97. Go back in thread:
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
Posted by PeterMartin on April 4, 2018, at 8:17:46
In reply to Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin, posted by SLS on April 2, 2018, at 21:12:12
I've been on lamictal since 2007. Going above 225 always made me flat/fatigued. On Marplan I could never take more than 125 or I'd get really tired. I was fine for years on Marplan 30(sometimes 40) + lamictal 100.
I was up on lamictal a bit I think since I was taking modafinil/armodafinil all last year. I figured I could handle the extra. Was s high as 200 for a few weeks but again just didn't like it. Modafinil/armodafinil didn't work for me....some don't respond to it....I guess I'm one of those people (could sleep after taking it / would often make me tired or just spaced out).
Anyway I'm definitely feeling Nardil this morning. First time since a tinge of it after a month on 60. I've been on 75 for just under a month. Feel very much like I did on Marplan - up early and ready to go. The trend has been to crash in a few hrs though before actually being productive. Hopefully today will be different.
Thanks for the discussion as always.
Posted by PeterMartin on April 4, 2018, at 8:23:34
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 4, 2018, at 8:17:46
Also of note Teva brand Metformin ER seems to be helping with the weight again. I started this Nardil journey on Jan 25 at 216.9. Have been on a few different generics + immediate and extended after reading tons of discussion about vastly different effects per brand (10+ companies make it).
Today (after 5days on Teva) I'm at 217.1. Was 221 at a point early last week. Have been making the gym too but I think Metformin is def helping w the carb cravings and going to the bathroom (been doing that quit a bit where constipation was a big issue in the past w Marplan and other meds).
Posted by SLS on April 4, 2018, at 8:51:31
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 4, 2018, at 8:23:34
> Also of note Teva brand Metformin ER seems to be helping with the weight again. I started this Nardil journey on Jan 25 at 216.9. Have been on a few different generics + immediate and extended after reading tons of discussion about vastly different effects per brand (10+ companies make it).
>
> Today (after 5days on Teva) I'm at 217.1. Was 221 at a point early last week. Have been making the gym too but I think Metformin is def helping w the carb cravings and going to the bathroom (been doing that quit a bit where constipation was a big issue in the past w Marplan and other meds).Thanks for reporting your experience with metformin. I'm going to the doctor later in the month to see if I can get a prescription.
- Scott
Posted by PeterMartin on April 6, 2018, at 22:43:49
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by SLS on April 4, 2018, at 8:51:31
Awesome- I hope it works for us both. Please update if you take it.
Nardil definitely kicked in last night and this morning. Feels very much like Marplan did but maybe a touch stronger. Up very early + getting the woosh sound in my ear if I sit down after standing for a bit (blood pressure changes)
Mood is very positive and I'm definitely more chatty. I'm slightly more spacey than I'd like to be but I'm not sure I can blame that on the Nardil. I just hope the progress continues and I find balance through the day (seems to still be a bit up and down perhaps due to my dosing schedule).
Posted by PeterMartin on April 8, 2018, at 11:17:19
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by SLS on April 4, 2018, at 8:51:31
ther meds).
>
> Thanks for reporting your experience with metformin. I'm going to the doctor later in the month to see if I can get a prescription.
>
>
> - ScottNew study out today (Rats) shows Metformin may help w/ quitting nicotine too (if you smoke): https://medicalxpress.com/news/2018-04-animal-common-diabetes-drug-nicotine.html
--
My weight has been up a touch the past few days (only to 219.6). It's frustrating because everytime it fluctuates I assume I'm on a bad generic and want to switch back to the previous one I still have pills of (or find internet support for others). I need to just forget about it and see the changes weekly or monthly.
I'm still only on 1500 and most people get to and stick w/ 2000 for full effect.
Posted by Lamdage22 on April 8, 2018, at 13:47:35
In reply to Re: Metformin may help w/ Nicotine w/d (New study), posted by PeterMartin on April 8, 2018, at 11:17:19
The word needs to go out about Metformin. I think it is a really good thing for those of us that only tolerate those "weight gain" meds.
Need those kidney checks though. Its very rare but you could get in trouble if your kidney doesnt work while taking Metformin.
Posted by PeterMartin on April 15, 2018, at 15:26:36
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 6, 2018, at 22:43:49
Back to the bottom again. Terrible.
Had two days of nonstop sleep. Finally snapped out of it yesterday but now I don't really feel like myself. Not interested in doing anything but going back to bed.
I feel like I'm going to lose the weight battle. Haven't gained a ton but bloating now....up to 220 or so from 116. That's with making the gym every morning and trying offset with metformin. It's helped and maybe my mood is just caving me in bad food but I feel sorta helpless. 230 is the max I've ever been. If I cross there I'm sure I'll quit.
I miss Marplan. Hate that only one company makes it and it costs $1500+ a month w.o. insurance....
Maybe Nardil still hasn't kicked in.....doubt it.
Posted by PeterMartin on April 15, 2018, at 15:27:31
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 15, 2018, at 15:26:36
220 from 216 (obviously a typo - ~4lbs)
Posted by PeterMartin on April 17, 2018, at 2:09:17
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 15, 2018, at 15:27:31
And tonight was great. Dunno. I took half of my lamictal in the morning (50) which I don't usually do and took 75 tonight. Maybe you are right SLS and I should head back to 150 at least until I get Nardil figured out.
I've also switched back to Metformin ER by Sun (not Teva) and my BMs seem to be more frequent which is definitely what I want. I'd switched to Teva Metformin on March 28 and then tried an IR brand as well for a few days when I started obsessing over weight.
I know I need to stop fiddling with this stuff. Luckily I see my doctor next week. My hope is to go to 2000 on Metformin (I'm sticking w Sun ER now) and prob leave the Nardil at 75 unless i get depressed yet again.
It's been extremely up and down since I began Nardil. There have been other changes though: Discontinuing Marplan (have heard that can cause mania), Discontinuing Nuvigil (felt o had a minor addiction to that but was ineffective), starting Metformin (and trialing different brands), and reducing Lamictal from 150 to 100. If I continue to feel like tonight I definitely won't make any adjustments. My problem is that when I get down I seek something to fix it.....I do keep a notebook (have for 3yrs now) and while that helps I still need to focus on being letting meds settle in. Weight gain might be the one thing that would still push me to rock the boat......I'm really afraid of gaining at this point...
Thanks for letting me vent a bit. I feel good tonight and that's really nice after a couple days of depersonalization and complete lack of interest in anything.
Posted by SLS on April 17, 2018, at 8:49:14
In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 17, 2018, at 2:09:17
> And tonight was great. Dunno. I took half of my lamictal in the morning (50) which I don't usually do and took 75 tonight. Maybe you are right SLS and I should head back to 150 at least until I get Nardil figured out.
Supposedly, Lamictal has a 24 hour half-life. It feels shorter than that to me, though. Regardless, you can simply skip doses if 150 mg/day ends up being too much. You should be okay within 24 hours. If you increase the dosage of Lamictal, it might take a week or so for side effects to disappear. I would still push it to 200 mg/day gradually. There are some people who experience "brain-fog" cognitive and memory disturbances at low dosages, but this reaction does not occur steadily in the majority of people. Of course, you might be in the minority.
> Thanks for letting me vent a bit. I feel good tonight and that's really nice after a couple days of depersonalization and complete lack of interest in anything.Do you experience both anhedonia and anxiety?
- Scott
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.