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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Justherself54 on January 25, 2008, at 4:15:30
I just increased my dosage to 60 mg today with my last dose at 7 pm. Tonight I took .5 clonazapam, 50 mg. seroquel and 14 mg of zopiclone before bed, my usual nite meds..within 1/2 an hour I knew it wasn't going to work and just expected a night of insomnia..instead I've had 5 plus hours of racing thoughts, suicidal ideation, tears, over and over again..I finally got up at 4 am and took .05 clonazapam, hoping it will slow the racing thoughts..
Has anybody had this happen? Any input would be greatly appreciated as this has me very concerned and scared..
Posted by Phoenix1 on January 25, 2008, at 9:09:21
In reply to Nardil-Help please!, posted by Justherself54 on January 25, 2008, at 4:15:30
> I just increased my dosage to 60 mg today with my last dose at 7 pm. Tonight I took .5 clonazapam, 50 mg. seroquel and 14 mg of zopiclone before bed, my usual nite meds..within 1/2 an hour I knew it wasn't going to work and just expected a night of insomnia..instead I've had 5 plus hours of racing thoughts, suicidal ideation, tears, over and over again..I finally got up at 4 am and took .05 clonazapam, hoping it will slow the racing thoughts..
>
> Has anybody had this happen? Any input would be greatly appreciated as this has me very concerned and scared..
>
>Oh no, that's not fun at all! I noticed an increase in insomnia the night after each increase, but then the next night things seemed to go better. I didn't have any problems with increased side-effects other than daytime sedation.
I know you're stressed out about refilling your prescription. When I was going through that last weekend, I noticed that I had a few bad days in a row. I was worried the drug was pooping out or something. Could this maybe have something to do with your level of stress over running out and refilling your prescription?
My advice is to see how you are feeling today. If you think you can handle another day at the higher dose, give it a try. If not, back down to the lower dose. And then try again tomorrow. If you have the same reaction, maybe you have reached your dose ceiling? That's not necessarily a bad thing. And remember, that once you are on a stable dose, it may take as long as a few months to see the full benefits of the drug. It would be worth it IMO to try the higher dose again if you can handle another night like last night. If you can't, then no harm has been done other than a couple of rough nights. Let me know how it goes. Good luck!
Phoenix1
Posted by Justherself54 on January 25, 2008, at 10:45:27
In reply to Re: Nardil-Help please! » Justherself54, posted by Phoenix1 on January 25, 2008, at 9:09:21
> > I just increased my dosage to 60 mg today with my last dose at 7 pm. Tonight I took .5 clonazapam, 50 mg. seroquel and 14 mg of zopiclone before bed, my usual nite meds..within 1/2 an hour I knew it wasn't going to work and just expected a night of insomnia..instead I've had 5 plus hours of racing thoughts, suicidal ideation, tears, over and over again.. .05 clonazapam, hoping it will slow the racing thoughts..
> >
> > Has anybody had this happen? Any input would be greatly appreciated as this has me very concerned and scared..
> >
> >
>
> Oh no, that's not fun at all! I noticed an increase in insomnia the night after each increase, but then the next night things seemed to go better. I didn't have any problems with increased side-effects other than daytime sedation.
>
> I know you're stressed out about refilling your prescription. When I was going through that last weekend, I noticed that I had a few bad days in a row. I was worried the drug was pooping out or something. Could this maybe have something to do with your level of stress over running out and refilling your prescription?
>
> My advice is to see how you are feeling today. If you think you can handle another day at the higher dose, give it a try. If not, back down to the lower dose. And then try again tomorrow. If you have the same reaction, maybe you have reached your dose ceiling? That's not necessarily a bad thing. And remember, that once you are on a stable dose, it may take as long as a few months to see the full benefits of the drug. It would be worth it IMO to try the higher dose again if you can handle another night like last night. If you can't, then no harm has been done other than a couple of rough nights. Let me know how it goes. Good luck!
>
> Phoenix1I'm going to keep trying the increase. I feel better today, other than I'm very tired.. the clonazapam did help and stopped the racing thoughts and I did get a bit of sleep..if it happens again tonite, I won't lie there as long..I'll try to address it sooner. ..I'll take an extra dose of clonazapam and maybe an extra seroquel..I'm hoping it was a one night thing..insomnia I can handle but not with all the other stuff running amok in my head!
I have been under a lot of stress this past week, so maybe the comination of that plus the increase caused it..I didn't think I would have any SE's for a few days doing the increase, but sure found out differently..
Thanks for your response Phoenix1..I appreciate it..
>
Posted by Jedi on January 26, 2008, at 2:22:08
In reply to Re: Nardil-Help please!, posted by Justherself54 on January 25, 2008, at 10:45:27
> > > I just increased my dosage to 60 mg today with my last dose at 7 pm. Tonight I took .5 clonazapam, 50 mg. seroquel and 14 mg of zopiclone before bed, my usual nite meds..within 1/2 an hour I knew it wasn't going to work and just expected a night of insomnia..instead I've had 5 plus hours of racing thoughts, suicidal ideation, tears, over and over again.. .05 clonazapam, hoping it will slow the racing thoughts..
> > >
> > > Has anybody had this happen? Any input would be greatly appreciated as this has me very concerned and scared..
> > >Hi Jusherself,
It seems like most of my side effects returned after each increase in dosage. I am on 90mg of phenelzine, 2mg of clonazepam, and 25mg of quetiapine. It takes a while for the side effects to decrease again after each increase in dosage.
Be Well,
Jedi
Posted by Justherself54 on January 26, 2008, at 10:22:00
In reply to Re: Nardil-Help please! » Justherself54, posted by Jedi on January 26, 2008, at 2:22:08
Thank you both for responding. I did sleep last night, although it took close to 2 hours for the meds to work..at least I didn't have another episode like I did the night before..Phew! I thought that night I was having some sort of weird mixed episode or ultra rapid cycling and I think that's what caused my fear and distress..cause that's what happened to me for weeks before I was hospitalized..mind you not just at night but every day..so I'm much relieved now..thanks again!
Posted by tecknohed on January 27, 2008, at 7:38:30
In reply to Nardil-Help please!, posted by Justherself54 on January 25, 2008, at 4:15:30
Instead of taking your 4th Nardil pill at night why not take it in the morning? Say 30mg morn, 15mg lunc & 15mg no later than 6pm?
teck
Posted by tecknohed on January 27, 2008, at 7:40:02
In reply to Nardil-Help please!, posted by Justherself54 on January 25, 2008, at 4:15:30
Ok, make that last dose 5pm latest.
Posted by Justherself54 on January 27, 2008, at 8:42:40
In reply to Re: Nardil-Help please! » Justherself54, posted by tecknohed on January 27, 2008, at 7:38:30
> Instead of taking your 4th Nardil pill at night why not take it in the morning? Say 30mg morn, 15mg lunc & 15mg no later than 6pm?
>
> teckI used to take almost all my parnate at one time when I was on it but wasn't sure if I could double up a dose with Nardil cause it's so different from the other..
When you double a dose do you feel different? Thanks so much for responding..I know I have to do something .I take my last Nardil at around 7 and then I don't feel like going to bed til 1 am and am pretty restless through the nite..but at least no more weird cycling..I'm already feeling calmer but no little bout of hypomania, like when I first started (dang it) cause I sure got a lot done!
On the lighter side, from staying awake all that one nite, I realize my dog, who sleeps with me, may be contributing to my poor sleep..she grinds her teeth, chases something fierce in her dreams with legs twitching, and moans and groans all nite..oh and she snores too..
Posted by tecknohed on January 27, 2008, at 15:39:51
In reply to Re: Nardil-Help please!Teck, posted by Justherself54 on January 27, 2008, at 8:42:40
I'm sure its possible that your dog's noises may be being picked up by your subconscious during your sleep. I go night fishing (camping) alot and I've noticed that if I fall asleep with the radio on I have some very bizzare dreams and can wake up exhausted!
With Nardil there is nothing wrong with taking the whole dose in one go! Or take 30mg morn & 30mg lunch. You may get some sedation taking larger doses at once but seeing as you're getting insomnia from it at the moment you might not. Try it, it wont harm you.
Good luck ;)
teck
Posted by Phoenix1 on January 27, 2008, at 17:44:31
In reply to Re: Nardil-Help please!Teck » Justherself54, posted by tecknohed on January 27, 2008, at 15:39:51
> I'm sure its possible that your dog's noises may be being picked up by your subconscious during your sleep. I go night fishing (camping) alot and I've noticed that if I fall asleep with the radio on I have some very bizzare dreams and can wake up exhausted!
>
> With Nardil there is nothing wrong with taking the whole dose in one go! Or take 30mg morn & 30mg lunch. You may get some sedation taking larger doses at once but seeing as you're getting insomnia from it at the moment you might not. Try it, it wont harm you.
>
> Good luck ;)
> teckWhat is the best dosing strategy for Nardil when you are on a higher dose. Taking it later in the day can worsen insomnia, but taking it all at once can worsen side effects. I take 45mg in the morning at 30mg around 3pm. I expect next week to raise the dose to 90mg, unless my pdoc disagrees. But maybe I should take the second dose earlier. What seems to work best for those of you on it or who have taken it before?
Phoenix1
Posted by tecknohed on January 27, 2008, at 18:34:30
In reply to Re: Nardil-Help please!Teck » tecknohed, posted by Phoenix1 on January 27, 2008, at 17:44:31
> What is the best dosing strategy for Nardil when you are on a higher dose. Taking it later in the day can worsen insomnia, but taking it all at once can worsen side effects. I take 45mg in the morning at 30mg around 3pm. I expect next week to raise the dose to 90mg, unless my pdoc disagrees. But maybe I should take the second dose earlier. What seems to work best for those of you on it or who have taken it before?
>
> Phoenix1For myself (and for most others I think) Nardil's insomnia dissapeared completely once I reached a steady dose for a week or so. Increasing the dose could inevitably bring it back & if you've been continuously raising the dose since you've been on it then no wonder the insomnia is still there.
Once you've been at your effective dose for a while you're more likely to fall asleep EASILY than have insomnia.
Whilst on 90mg my dosing was 30mg morn, midday & eve. I would often fall asleep during the day if I wasn't busy - one of the most common complaints with Nardil.So how long have you been taking Nardil for?
teck
Posted by Phoenix1 on January 27, 2008, at 19:23:36
In reply to Re: Nardil-Help please!Teck » Phoenix1, posted by tecknohed on January 27, 2008, at 18:34:30
> > What is the best dosing strategy for Nardil when you are on a higher dose. Taking it later in the day can worsen insomnia, but taking it all at once can worsen side effects. I take 45mg in the morning at 30mg around 3pm. I expect next week to raise the dose to 90mg, unless my pdoc disagrees. But maybe I should take the second dose earlier. What seems to work best for those of you on it or who have taken it before?
> >
> > Phoenix1
>
> For myself (and for most others I think) Nardil's insomnia dissapeared completely once I reached a steady dose for a week or so. Increasing the dose could inevitably bring it back & if you've been continuously raising the dose since you've been on it then no wonder the insomnia is still there.
> Once you've been at your effective dose for a while you're more likely to fall asleep EASILY than have insomnia.
> Whilst on 90mg my dosing was 30mg morn, midday & eve. I would often fall asleep during the day if I wasn't busy - one of the most common complaints with Nardil.
>
> So how long have you been taking Nardil for?
>
> teckHi teck,
Thanks for the response. And Justherself, sorry for "hijacking" your post. Haven't heard from you in a couple of days, but it sounds like you are doing a bit better with the dose increase?
Teck, I've been on Nardil for about 2 months. Yes, my dose has been increased once a week or more often since then. (started at 15 mg, now at 75) I definitely notice an increase in minor side effects after each increase. But overall, far more effective, and far fewer side effects than SSRIs for me.
I sleep well right now, but can't reduce seroquel (50mg) or zopiclone (7.5mg) or else the insomia returns. I've also recently eliminated clonazepam from the mix. I think once I stabilize on my 90mg (if the pdoc raises it next week), I will wait a month or so and then try to reduce the sleep meds. I would like to eliminate the seroquel if possible, then see if I still need the zopiclone. Did you find the 3x a day dosing to be the best strategy?
Thanks,
Phoenix
Posted by tecknohed on January 27, 2008, at 19:49:34
In reply to Re: Nardil-Help please!Teck » tecknohed, posted by Phoenix1 on January 27, 2008, at 19:23:36
> Teck, I've been on Nardil for about 2 months. Yes, my dose has been increased once a week or more often since then. (started at 15 mg, now at 75) I definitely notice an increase in minor side effects after each increase. But overall, far more effective, and far fewer side effects than SSRIs for me.
>
> I sleep well right now, but can't reduce seroquel (50mg) or zopiclone (7.5mg) or else the insomia returns. I've also recently eliminated clonazepam from the mix. I think once I stabilize on my 90mg (if the pdoc raises it next week), I will wait a month or so and then try to reduce the sleep meds. I would like to eliminate the seroquel if possible, then see if I still need the zopiclone. Did you find the 3x a day dosing to be the best strategy?
>
> Thanks,
>
> PhoenixSounds like an excellent plan to me! Its great that you've already eliminated the Klonopin, which may well have been the hardest of the lot to stop, though with Nardil acting on GABA anyway it helps with coming off benzos. Zopiclone may still be a bit tricky, just do it SSSLOWLY! Never been on seroquel myself but you'd probably want to do that slowly too.
If this is you're first time on Nardil then you really want to be on nothing else - Nardil can do it ALL for you ;)
And yes, 3 x day was allways best. Its best to spread it out 'cause of its short half life - you want those metabolites circulating evenly throughout the 24hrs for a steady GABA effect.
Best of luck mate!
teck
Posted by Justherself54 on January 27, 2008, at 21:04:29
In reply to Re: Nardil-Help please!Teck » Phoenix1, posted by tecknohed on January 27, 2008, at 19:49:34
You didn't hijack the thread..was glad to know that I could "double up" on dosage if I had to, cause I've just gone up to 60 mg after being on 45 since November..sleep is still really bad, but no further cycling or whatever I had that one night..it was pretty horrible..
What really feels strange is that I know within a 1/2 hour of taking my sleep meds whether or not they're going to work..I feel sleepy or I feel like I've taken nothing and am awake and alert..hope it straightens itself out it time..and I hope I get some of that nice energy back..
Posted by tecknohed on January 28, 2008, at 6:59:18
In reply to Re: Nardil-Help please!/Phoenix1, posted by Justherself54 on January 27, 2008, at 21:04:29
> What really feels strange is that I know within a 1/2 hour of taking my sleep meds whether or not they're going to work..I feel sleepy or I feel like I've taken nothing and am awake and alert..hope it straightens itself out it time..and I hope I get some of that nice energy back..
Hint: take your Nardil JUST before food, not on an empty stomache. This way seems to make the med work faster. Whereas if you take it on an empty stomache I've found that you dont 'feel' it untill you actually eat something, even if its 4hrs later.
teck
Posted by tecknohed on January 28, 2008, at 7:00:49
In reply to Re: Nardil-Help please!/Phoenix1, posted by Justherself54 on January 27, 2008, at 21:04:29
Sorry, just realised you were talking about your sleep meds, not Nardil.
Posted by Justherself54 on January 28, 2008, at 11:30:58
In reply to Re: Nardil-Help please!/Phoenix1 » Justherself54, posted by tecknohed on January 28, 2008, at 7:00:49
That's OK..any tips about Nardil are appreciated..I actually slept like a log last nite and was still sleeping soundly at 9:30 am when a phone call woke me up..wonder how long I would have slept..I'm still pretty groggy..my increased sleep meds hit me like a ton of bricks last night to the point where I literally staggered off to bed..quess I'll wait and see what happens tonight..might have to decrease them..which would be nice..
Would be nice to get this sleep med issue sorted out before I have one of my grandkids stay the nite..they'll think grandma's been into the sauce!
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