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Dr. Bob is Robert Hsiung, MD,
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Posted by chiron on June 27, 2007, at 19:09:43
In reply to My remission, posted by GWA on June 27, 2007, at 8:54:38
Thanks, I always like to hear hopeful stories.
Questions:
-Did you ever try Emsam? I didn't like it (mostly because it made me feel crazy), but I haven't tried any other MAOIs.
-How quickly did you get to the 200mg on Lamictal and what happened along the way? I just started my 3rd trial a month ago, this time going very slowly.
-Have you tried Wellbutrin in the past? I found it to be helpful earlier in my life, but it seemed like on my last trial, I had an immediate good reaction, but then it seemed to make me worse. But I have thought about adding it to the lamictal at a low dose.
Posted by GWA on June 27, 2007, at 20:18:52
In reply to Re: My remission/GWA, posted by stargazer2 on June 27, 2007, at 10:52:48
I actually got mood remission on just Nardil, Lamictal and liothyronine (T3 thyroid hormone, 20 mcg of course rather than 20 mg). I take Rhodiola and zinc, too, and they helped me more than any of my previous antidepressants. For me, Wellbutrin just balances out the sleepiness and overwhelmingly serotonergic and GABAergic effects of Nardil. But it will have, I should think, greater antidepressant effect in the presence of an MAOI than it would alone, and even alone Wellbutrin is the most effective antidepressant other than MAOIs in bipolar-spectrum depression, if you should happen to have that. My doc didn't sanction Wellbutrin, I'm afraid, but it's safe with Nardil below 450mg if you've had no seizures or brain injury in the past. I think most docs would rather you get well than stick to the rules, even if they can't prescribe something themselves - had I keeled over on prescribed Wellbutrin + Nardil + the other stuff, my doctor would certainly have lost a malpractice suit.
But if Nardil's not having much effect at 60mg you should really try to raise the dose first. As a rule of thumb you need the dose that causes significant hypotension + an extra 15 mg. 60mg did nothing for me. 75mg brought me sudden euphoria that started to fade in only few days, and lots of hypotension; 90mg gave me no euphoria but quickly, though gradually, got me well, with no extra hypotension. (My Nardil is the decades-old British formula, incidentally.)
Posted by GWA on June 27, 2007, at 20:33:52
In reply to Re: My remission, posted by chiron on June 27, 2007, at 19:09:43
I haven't tried EMSAM, though it's so weighted towards MAO-B that it'll hit dopamine hard before it hits serotonin hard. Perhaps even raising the dose might make it less craziness-inducing?
I hadn't tried Wellbutrin before either. As for Lamictal, I spent two weeks each at 25mg, 50mg, 100mg, 150mg, and then stopped at 200mg. Actually i got itchy at 50 so hung back a few days before moving up again.
Posted by FredPotter on June 27, 2007, at 20:34:45
In reply to Re: My remission/GWA, posted by GWA on June 27, 2007, at 20:18:52
My pharmacist says my Nardil is from the UK too (I'm in NZ). It smells, like the stuff everyone's talking about, although it works. The psych said nobody uses Wellbutrin anymore! It kind of made me lose faith in him. It sure costs a lot here though. Perhaps that's why.
Posted by chiron on June 27, 2007, at 22:44:31
In reply to Re: My remission » chiron, posted by GWA on June 27, 2007, at 20:33:52
I gave Emsam a 6 week trial and I seemed to get worse when I went to 9mg...?
So did you start your successful med mixture at the same time? How long until you started to find relief? I thought I finally found a decent mix (lamictal, synthroid, celexa, and xanax) that I started a month ago, with a couple improved weeks. But I have tanked this last week and I can barely stand it.
You also mentioned zinc has helped. I started taking zinc about a month ago after I found out I had a high level of copper. How did you notice that it had helped (how long? signs?)
Thanks!
Posted by Jedi on June 28, 2007, at 3:23:44
In reply to My remission, posted by GWA on June 27, 2007, at 8:54:38
Hi,
I've used 90mg phenelzine (Nardil) with 300mg bupropion (Wellbutrin) with no problems. I did a lot of research on it before taking the combination. I actually started the combination myself and my PDOC, who was retiring, did not want to take me off of something that was working. The next doctor was the same way since by that time I had been taking the combination for months. The combination worked well for at least six months. Having to quit the combo is another story that happens sometimes when taking combinations that are contraindicated. Bupropion does make me agitated(mean) when I first start taking it. This side effect goes away for me within a couple of weeks.
Be well,
Jedi
> For what it's worth, as a long-term lurker with chronic, severe, atypical and utterly treatment-resistant depression, this combo recently brought me to remission within two weeks:
>
> Nardil 90mg does most of the work
> Lamictal 200mg
> Liothyronine 20mg
> And I've just added Wellbutrin 300mg, which has immediately made me feel better than well - my life-long tiredness is gone, and my brain is working again as it did before depression came.
>
> So there is hope. And anyone not yet on an MAOI should get moving ASAP.
Posted by shasling on June 28, 2007, at 4:51:00
In reply to Re: My remission/GWA, posted by stargazer2 on June 27, 2007, at 10:52:48
Ohmigosh, Stargazer, you are the first other perseon I have heard say Lamictal gave falling eposides. Dont want to derail the post, just to say i feel your pain on that one. While I was on lamictal I suffered the falling eposodes too, only to be tested and find out that the balance mechanism in one of my ears mysteriously DIED DEAD, never ever to come back, and I periodically suffer balance issues to this day as I will for the rest of my life. I always suspected the lamictal, and wondered if anyone else suffered falling episodes on that. Anyway, like i said dont want to derail the post, just found it VERY interesting that you said that.
Thanks, and best of luck with your Nardil augmentation. How much Abilify do they have you taking, by the way? Just curious...
Suzie
> Congrats, do you think it was the wellbutrin that was the answer. I'm also on nardil x 1 1/2 months with minimal effects so far at 60 mg and my pdoc put me on Abilify but I think wellbutrin might be the next med to try. Isn't Wellbutrin contrainidcated with a MAO? Did your doc officially sanction the use of wellbutrin with nardil?
>
> Are you also on Levothyroxine (Sp?) a thyroid medication? I can't take Lamictal as it made me have falling episodes but I would like to try wellbutrin if it is working so well for you.
>
> Best Wishes.
>
> Stargazer
Posted by GWA on June 28, 2007, at 7:08:46
In reply to Re: My remission » GWA, posted by chiron on June 27, 2007, at 22:44:31
I started Lamictal and liothyronine long before Nardil. Both helped only a little bit, it's the Nardil that's really special. Zinc worked in a week for me: not much, but noticably. I've tried pretty much every vitamin, mineral and supplement, and only zinc and rhodiola have been useful.
Posted by brooke484 on June 28, 2007, at 8:50:15
In reply to Re: My remission/GWA, posted by GWA on June 27, 2007, at 20:18:52
What does that mean? Doesn't Pfizer make yours also?
brooke
Posted by GWA on June 28, 2007, at 9:17:05
In reply to British formula?, posted by brooke484 on June 28, 2007, at 8:50:15
No, UK Nardil isn't made by Pfizer and has never had the same formula. It looks and smells more like Pfizer's New Nardil since it has no sugar coating, but it's as effective as Pfizer's Old Nardil, without the inconsistency. Tepiaca got worse when she switched from UK Nardil to New Nardil, just as many got worse moving from Old to New Nardil.
Posted by steel on June 28, 2007, at 12:05:19
In reply to Re: British formula? » brooke484, posted by GWA on June 28, 2007, at 9:17:05
> No, UK Nardil isn't made by Pfizer and has never had the same formula. It looks and smells more like Pfizer's New Nardil since it has no sugar coating, but it's as effective as Pfizer's Old Nardil, without the inconsistency. Tepiaca got worse when she switched from UK Nardil to New Nardil, just as many got worse moving from Old to New Nardil.
Are you certain of this,i read the other group and my understanding was that was it,although certain nardils might be better,the formulation changed affected everyone and the nardil of old was simply history,or id imagine youd have tons of people hurding that nardil in,people find ways.
If it is thats great,just again i even heard of people having more success on new nardil than others who simply could not at all.
To my knowledge the only way of obtaining a new that was of par to the old one was to obtain certain ingredients and contact a memeber who was helping with a compounding pharmacy to make LIQUID NARDIL which he believed was actualy better.
I tell you id love to switch from parnate to nardil as ive exhausted parnates options,but the u.s horror stories of high doses,long wait times,horrid side effects,and min benifit just dont sound inviting,tons of the u.s folks after literaly banging on pzifers door,meaning went through a lot of work even winning of a pzifer rep to there side still got the big NO from them on any future fix.
So i suppose i dont have that oppt you do to benifit from the med?
Posted by brooke484 on June 28, 2007, at 13:27:49
In reply to Re: British formula?, posted by steel on June 28, 2007, at 12:05:19
I agree. I think if it was as good as the old nardil, people would end up ordering it from the UK. They would find a way if they were desperate enough (and these people do sound desperate).
brooke
Posted by GWA on June 28, 2007, at 13:39:23
In reply to Re: British formula? Steel, posted by brooke484 on June 28, 2007, at 13:27:49
UK Nardil is certainly not New Nardil. Of course there are no studies comparing UK Nardil to Old Nardil, but there's no reason to believe that the UK Nardil is made as incompetently as New Nardil, and, as I've mentioned, we have Tepiaca's experience as a test case. Others have tried to get hold of UK Nardil in America; I don't know whether any succeeded. The manufacturer will refuse orders, since they have no Nardil license in America.
Posted by steel on June 28, 2007, at 14:07:57
In reply to Re: British formula? Steel, posted by GWA on June 28, 2007, at 13:39:23
> UK Nardil is certainly not New Nardil. Of course there are no studies comparing UK Nardil to Old Nardil, but there's no reason to believe that the UK Nardil is made as incompetently as New Nardil, and, as I've mentioned, we have Tepiaca's experience as a test case. Others have tried to get hold of UK Nardil in America; I don't know whether any succeeded. The manufacturer will refuse orders, since they have no Nardil license in America.
No insult here,truly,but are you aware of the board thats been around for what i know to be at least 5 years.
This board is soly nardil,ALL nardil users,veterans of the drug for 20 plus years.
They are in the hundreds with even chemicsts as part of the group.They had been working on a movement to confront pzifer and i believe failed.
In the meantime the people were not limited to U.S based patients,australian,uk and many others were part of it.
I do believe as you have stated that many did perfer at least the uk nardil over the U.S,HOWEVER it did not bring upon a fix.
The only closest they came to rebuilding the old nardil were
use a expensive various product for its specific capsule shell,and stuff crushed nardil in it instead so now the nardil has a new carrier.
second was the chemisct i believe,who upon emailing him would direct you to a compouding pharmacy to have the actual chemical made into a liquid,however it was quite expensive.
I followed close because i wanted to go on this drug badly.
Also i wont give a source,but a company with the first word masters i believe does provide the uk version of both maois.
Dont get me wrong,im very happy your having luck,in fact prob a bit envious lol,kidding,but i dont believe one person,tepcicia can be compared to an entire board of hundreds of users including 20 years vets,as you know nardil was called THE GOLD STANDERD.
Even so i believe every brand is thought to be better than the u.s,and there are those who get well with the u.s brand,however the likly hood has changed dramaticly since the reformulation.
i dont have the link,but if you dont know it,just google this exact term: nardil anxiety community and you should land on the site.
All aside keep us posted to how well youre doing,nardil has not left my mind totaly yet as far as options.Thanks
Posted by Sigismund on June 28, 2007, at 16:17:50
In reply to Re: My remission » chiron, posted by GWA on June 28, 2007, at 7:08:46
Rhodiola and Nardil sounds interesting.
Posted by stargazer2 on June 28, 2007, at 16:45:18
In reply to Re: My remission/GWA » stargazer2, posted by shasling on June 28, 2007, at 4:51:00
Shasling, Babble mail me about the falling episodes, yes I agree it is very interesting and why haven't more users had this as a side effect too.
Abilify 5 and 5, total of 10mg, didn't do squat before so not sure if will do anything w Nardil.
***GWA***I want to add wellbutrin but it is not officially sanctioned with Nardil although I have an article that says it can be given so I just need to know the dosage that is safe with Nardil. Did you start at 300 or a lower dose? Are you doing this on your own or under you pdoc's recommendation? Either way, I just want to know what dose is safe,although 300 is a higher dose than i have tried before so I may statrt at 75 and go to 150 mg if necessary.
Stargazer
Posted by GWA on June 28, 2007, at 17:23:56
In reply to Re: My remission » GWA, posted by Sigismund on June 28, 2007, at 16:17:50
Rhodiola for me lessens the spasms of depressive guilt. It seems a good mild augmentation for any antidepressant.
Posted by GWA on June 28, 2007, at 17:28:07
In reply to Re: My remission/Shasling/GWA, posted by stargazer2 on June 28, 2007, at 16:45:18
300 is meant to be the maximum safe dose, assuming you have no prior problems with seizures or head injuries. Since the seizure threshold will be doubly lowered by the combination, be careful at any dose, and if a lower dose works for you then I'd stick to it. I might drop to 150 myself.
Posted by chiron on June 28, 2007, at 20:46:07
In reply to Re: My remission » Sigismund, posted by GWA on June 28, 2007, at 17:23:56
I've never even heard of Rhodiola. I just looked it up on Wikepedia which says it is very effective for improving mood and alleviating depression. Why haven't I heard of it then?
Posted by Sigismund on June 28, 2007, at 21:44:31
In reply to Re: My remission - Rhodiola, posted by chiron on June 28, 2007, at 20:46:07
It works.
The reason I don't take it is that it lightens my (already too light) sleep. Too long acting.
It feels like deprenyl, more or less.
It's a herb from Siberia, Golden Root, and also grows in Tibet.
A variant is used in Traditional Chinese Medicine.
Posted by stargazer2 on June 30, 2007, at 11:46:46
In reply to Re: My remission - Rhodiola » chiron, posted by Sigismund on June 28, 2007, at 21:44:31
I see GWA is taking a combination of Nardil 90 and Wellbutrin 300 and is getting good results. Is anyone else taking this combination for TRD, treatment resistent depression?
Are there any precautions with this combo I should be aware of and what doses are you taking and what time do you take the meds?
I think the combo could be very effective for me. I will ask my pdoc about this combination at my next visit.
Stargazer
Posted by Honore on June 30, 2007, at 12:43:10
In reply to Wellbutrin and Nardil...anyone taking this?, posted by stargazer2 on June 30, 2007, at 11:46:46
In general, the PDR says not to take wellbutrin with nardil. There are exceptions to lots of rules with MAOIs, but I wouldn't take them together without a doctor's careful supervision.
Honore
Posted by stargazer2 on June 30, 2007, at 14:25:45
In reply to Re: Wellbutrin and Nardil...anyone taking this? » stargazer2, posted by Honore on June 30, 2007, at 12:43:10
Honore...Despite the PDR warning, there is an article in the "Current Psychiatry" journal, Vol.1, No. 6/June 2002 that says certain meds are OK with MAOI's including Wellbutrin, Trazadone and the Tricyclics, with the exception of Anafranil, "can be safely administered with MAOIS". These AD's do not involves significant serotonin reuptake inhibition.
http://www.dr-bob.org/babble/20061003/msgs/693453.html
What I'm interested in is who is taking them besides the poster here so I know how many patients have been advised by their pdocs that this is a safe combination.Stargazer
Posted by stargazer2 on June 30, 2007, at 14:25:56
In reply to Re: Wellbutrin and Nardil...anyone taking this? » stargazer2, posted by Honore on June 30, 2007, at 12:43:10
Honore...Despite the PDR warning, there is an article in the "Current Psychiatry" journal, Vol.1, No. 6/June 2002 that says certain meds are OK with MAOI's including Wellbutrin, Trazadone and the Tricyclics, with the exception of Anafranil, "can be safely administered with MAOIS". These AD's do not involves significant serotonin reuptake inhibition.
http://www.dr-bob.org/babble/20061003/msgs/693453.html
What I'm interested in is who is taking them besides the poster here so I know how many patients have been advised by their pdocs that this is a safe combination.Stargazer
Posted by GWA on June 19, 2008, at 17:04:38
In reply to My remission, posted by GWA on June 27, 2007, at 8:54:38
Hi everyone,
I actually had some ups and downs since posting that I'd reached remission. After some tweaks, I've now been truly and entirely well for eight months, and thought I ought to correct the listing I originally gave of my working combo.It's now:
90mg UK Nardil in two, not three doses per day; changing the dosing schedule made a huge difference. Taking it at the same times each day is also good, though I'm not obsessive about it.
200mg Lamotrigine/Lamictal
20mcg Liothyronine sodium (T3 thyroid hormone)
200mg 5-HTP
500mg Rhodiola rosea extract, at 3% rosavin
25mg zinc
Adding Bupropion/Wellbutrin actually made me worse after a good initial response. Some time earlier I'd had the same experience with SAMe. In fact I went through many, many supplements, and zinc and 5-HTP were the only ones that helped.
I began taking zinc, lamotrigine and T3 at various times before starting Nardil; each provided a small boost, though for all I know I could get away with giving them up now. Since fixing what works is never a good idea with psych meds, I'd never consider doing so.
I did try removing, separately, 5-HTP and Rhodiola, and the results were bad. 5-HTP seems a simple augmentation for Nardil, while Rhodiola rosea greatly reduces rejection sensitivity. I think RS is generally believed to be untreatable, though Attentional Training Therapy can limit one's rumination over rejection. I can strongly recommend Rhodiola for RS.
Before getting fully well, transcendental meditation, minus its original "spiritual" content, was dramatically effective: within ten seconds of beginning my mood would shoot up. Its benefits only come after about four weeks' effort, though, and I've foolishly let it slip since full recovery.
I hope for each of you that you're doing OK, and if you aren't then, for what it's worth, you have all my sympathy. I got a lot out of lurking here when I was ill.
George
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