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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by blueboy on September 24, 2007, at 16:08:04
Well, I started myself back on Nardil yesterday. I stopped taking it 6 months or so ago, due to a body rash that freaked out my doctor. I've been resisting starting it up again, wanting to maybe try something else.
But the depression is just too bad. I can't work worth a damn. I finally started to sleep 8 hours without medication, I've lost 20 pounds, and it's nice to have normal sex functioning, but it's not worth it. I'm just a lump.
Keep your fingers crossed for me. I popped awake and got out of bed at 5.30 this morning, and that's after one day of 30 mg!
Posted by stargazer2 on September 24, 2007, at 17:00:14
In reply to Back on Nardil, posted by blueboy on September 24, 2007, at 16:08:04
Good luck, I've been on Nardil since May, initially with Abilify, then with Wellbutrin, then we tried adding amphetamine salts which eventually caused a hypertensive reaction which scared me and my doc pretty good.
Then I dropped the Abilify and the Wellbutrin and started Nortriptyline at 50 mg at night.
I take 15 mg of Nardil in the Am and 30 mg at night, along with the nortrip. When I took higher doses of Nardil, I had severe hypotension and constipation. I also had a reaction when I first tried Nardil of swollen feet which eventually went away.
Overall, I think the Nardil is helping me. I still have alot of low motivation and interest in things but at least I'm not crying or feeling suicidal like I had been before nardil.
Although Notriptylline was not advised with nardil, it was done based on an article written by the experts at McLean Hospital in Mass saying TCA's, except Anafranil, were used successfully with nardil. That article also said low levels of stimulants were OK too but I had a reaction with amphetamine salts (generic Adderall) so all combinations need to be carefully monitored.
I would get a BP monitor to check your BP if you are feeling very lightheaded (sign of hypotension) or if you have a headache (sign of hypertension). Both can be extremely dangerous but the hypertension is probably worse since you usually have to go to the hospital for treatment.
Nardil can be one tricky med but it can work better than many of the other AD's especially when you have failed the more routine AD's.
Stargazer
Posted by blueboy on September 24, 2007, at 21:36:50
In reply to Re: Back on Nardil, posted by stargazer2 on September 24, 2007, at 17:00:14
Yar, thanks. I was on Nardil 4x15mg for two and a half years until about six months ago, LOL.
The last thing I would need with it is a stimulant. It's very "activating", in psycho-lingo. I read somewhere recently that some MAOI is metabolized partly as methamphetimine, which would explain a lot.
> Good luck, I've been on Nardil since May, initially with Abilify, then with Wellbutrin, then we tried adding amphetamine salts which eventually caused a hypertensive reaction which scared me and my doc pretty good.
>
> Then I dropped the Abilify and the Wellbutrin and started Nortriptyline at 50 mg at night.
>
> I take 15 mg of Nardil in the Am and 30 mg at night, along with the nortrip. When I took higher doses of Nardil, I had severe hypotension and constipation. I also had a reaction when I first tried Nardil of swollen feet which eventually went away.
>
> Overall, I think the Nardil is helping me. I still have alot of low motivation and interest in things but at least I'm not crying or feeling suicidal like I had been before nardil.
>
> Although Notriptylline was not advised with nardil, it was done based on an article written by the experts at McLean Hospital in Mass saying TCA's, except Anafranil, were used successfully with nardil. That article also said low levels of stimulants were OK too but I had a reaction with amphetamine salts (generic Adderall) so all combinations need to be carefully monitored.
>
> I would get a BP monitor to check your BP if you are feeling very lightheaded (sign of hypotension) or if you have a headache (sign of hypertension). Both can be extremely dangerous but the hypertension is probably worse since you usually have to go to the hospital for treatment.
>
> Nardil can be one tricky med but it can work better than many of the other AD's especially when you have failed the more routine AD's.
>
> Stargazer
Posted by cumulative on September 24, 2007, at 21:46:26
In reply to Re: Back on Nardil, posted by stargazer2 on September 24, 2007, at 17:00:14
"Off" the record, if you want a stimulant besides amphetamine you might consider transdermal nicotine. There should be no direct interactions of metabolism with the MAOI, unlike is possible with amphetamine (although psychostimulation, like the dopaminergic effect, in general will be potentiated, and this has been studied with nicotine), and the vasoconstriction will definitely offset hypotension, allowing you to try a higher dose.
Nicotine is already combined with MAOI in tobacco, which contains beta-carbolines.
Posted by blueboy on September 25, 2007, at 10:39:26
In reply to Re: Back on Nardil ((stargazer2, posted by cumulative on September 24, 2007, at 21:46:26
Nardil makes me hyperactive. The last thing I want is another stimulant.
I have to take Klonopin and sleeping pills when I'm on it.
Posted by cumulative on September 25, 2007, at 11:25:20
In reply to Re: Back on Nardil ((stargazer2, posted by blueboy on September 25, 2007, at 10:39:26
I suspect if I were on it (soon, soon) I would want a stimulant for attention, since this is one of the few things Nardil by itself isn't reported to take care of completely, by most.
And then, yes, heavy sedatives at night.
Posted by Jedi on September 28, 2007, at 2:00:43
In reply to Re: Back on Nardil » stargazer2, posted by blueboy on September 24, 2007, at 21:36:50
...
> The last thing I would need with it is a stimulant. It's very "activating", in psycho-lingo. I read somewhere recently that some MAOI is metabolized partly as methamphetimine, which would explain a lot.
...I've researched phenelzine(Nardil) extensively over the past ten years. I have seen no evidence that it is metabolized at all into methamphetamine. The jury is still out on whether tranylcypromine(Parnate) might have an amphetamine as a minor metabolite.
Jedi
Posted by blueboy on September 28, 2007, at 10:37:58
In reply to Re: Back on Nardil » blueboy, posted by Jedi on September 28, 2007, at 2:00:43
Thanks, that's a very helpful post.
On the other hand, I have to say, Nardil does seem to affect me (subjectively) like speed. I haven't taken a lot in my life, but I did take a little decades ago.
I was in the Army (in Vietnam) and I'd pull CQ duty every once in a while, which means staying awake and alert all night to check the guard posts, check radio communications periodically, and operate the radio in case of trouble. This after a full hard day of work. Most of us would take speed, as staying awake/alert was obviously a high-stakes proposition. (Not to mention that going to sleep would have constituted a felony.)
Anyway, I do subjectively feel some "speed" component to Nardil. In fact, sometimes I wonder if that is the basic therapeutic effect in my case. Which worries me a bit, considering the deleterious long-term effects of amphetamines and other "speed" drugs.
>
> I've researched phenelzine(Nardil) extensively over the past ten years. I have seen no evidence that it is metabolized at all into methamphetamine. The jury is still out on whether tranylcypromine(Parnate) might have an amphetamine as a minor metabolite.
> Jedi
>
Posted by Jedi on September 28, 2007, at 12:16:59
In reply to Re: Back on Nardil » Jedi, posted by blueboy on September 28, 2007, at 10:37:58
> On the other hand, I have to say, Nardil does seem to affect me (subjectively) like speed. I haven't taken a lot in my life, but I did take a little decades ago.Blueboy,
How long have you been back on Nardil? When I first started the medication, many years ago, I would get a hypomania feeling - similar to amphetamine type drugs. For me, this feeling, only lasted a few weeks and then I settled back down into just a less depressed and less anxious state. Many people will interpret this initial euphoria on Nardil as the true antidepressant response, but it is just a side effect. I must admit, that after many years of depression and dysthymia, that this euphoria felt very good. If this is what is what is going on with you, be careful with it. You can feel very omnipotent, spend money where you shouldn't, take chances you shouldn't, etc. This feeling should pass, don't interpret it as poop-out. Some doctors will try to have you quit Nardil because of this euphoria or hypomania. I would stick with it. It will pass. Some people have been on Nardil for 30+ years. It is the only medication that has worked for my treatment resistant atypical depression and dysthymia(double depression) plus social anxiety.
Be Well,
Jedi
Posted by blueboy on September 28, 2007, at 12:42:50
In reply to Re: Back on Nardil » blueboy, posted by Jedi on September 28, 2007, at 12:16:59
I took it for three years, LOL. I've been off it for a few months due to a full-body rash that scared my docs a bit.
I've never gotten manic, although a touch of hypomania is possible. I'm aware of bipolar symptoms and I think I'd recognize them in myself, at least in retrospect. The only time I've ever really gotten a nutso omnipotent-type delusion was when I tried another white powder in the 80s, LOL.
Actually, though, you do raise a point of difference, which is I don't get that constant rush of ideas from Nardil that you would associate with speed (or mania). Only the energy to focus on something, without concomitant increase in anxiety.
It's a productive thing, not manic. The primary difference isn't how I feel, but how much productive work I get done. Really, that's my biggest concern, being able to work.
> Blueboy,
> How long have you been back on Nardil? When I first started the medication, many years ago, I would get a hypomania feeling - similar to amphetamine type drugs. For me, this feeling, only lasted a few weeks and then I settled back down into just a less depressed and less anxious state. Many people will interpret this initial euphoria on Nardil as the true antidepressant response, but it is just a side effect. I must admit, that after many years of depression and dysthymia, that this euphoria felt very good. If this is what is what is going on with you, be careful with it. You can feel very omnipotent, spend money where you shouldn't, take chances you shouldn't, etc. This feeling should pass, don't interpret it as poop-out. Some doctors will try to have you quit Nardil because of this euphoria or hypomania. I would stick with it. It will pass. Some people have been on Nardil for 30+ years. It is the only medication that has worked for my treatment resistant atypical depression and dysthymia(double depression) plus social anxiety.
> Be Well,
> Jedi
>
>
This is the end of the thread.
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