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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by anxious_in_fargo on September 12, 2009, at 7:45:56
I am starting Nardil for GAD and panic. For all of week 3 (2x15mg at 7am-ish, 1x15mg at noon-ish) I have had peaks of uncomfortable overstimulation in the first half of the day followed by a trough of complete exhaustion ("must...sleep...") starting in late afternoon.
Yesterday, on recommendation of the on-call doctor at my clinic, I switched the afternoon dose to later in the day (4 pm) and successfully avoided the exhaution; however, I felt overstimulated most of the day.
My questions: Can I expect the overstimulation to pass? Should I continue with my scheduled increase to 2x15mg twice per day even while I'm feeling this way?
The overstimulation feels very uncomfortable because of the similarities to panic in the early stages. Fortunately I have a Xanax prescription and taking half of a pill (0.25 mg) does help get me through it, but I don't want to continue that throughout my course of Nardil.
Thanks in advance for any knowledge you can share on this subject!
Posted by atypical on September 12, 2009, at 9:56:01
In reply to Nardil overstimulation at wk. 3 - will it pass?, posted by anxious_in_fargo on September 12, 2009, at 7:45:56
Welcome to the Nardil club! Seems like a lot of people are taking this med. What I can tell you (having been on Nardil for 2.5 months) is that the first month or so is a ROLLER COASTER in terms of side effects -- it was for me and I have observed other people saying similar things. My suggestion is to continue as recommended. For me, the roller coaster has subsided and most of my side effects have gone away. And now I feel more comfortable. Be careful with what you eat. I had the dreaded hypertensive crisis from eating Monterey Jack cheese.
So I believe things will get smoother for you. Good luck to you!
Atypical
Posted by anxious_in_fargo on September 12, 2009, at 12:42:03
In reply to Re: Nardil overstimulation at wk. 3 - will it pass?, posted by atypical on September 12, 2009, at 9:56:01
Thank you, Atypical. That's very helpful!
I was actually on Nardil for 1.5 yrs. 20 yrs. ago for major depression. Combined with therapy it worked wonders and I was depression-free for a long time. Looking back I cannot not remember any side-effects like this; hence, my question.
Thanks, again. I will continue to push ahead with the treatment. Therapy starts in a week, so that will help too, I'm sure. Good luck to you also.
Posted by bulldog2 on September 12, 2009, at 12:57:32
In reply to Re: Nardil overstimulation at wk. 3 - will it pass?, posted by atypical on September 12, 2009, at 9:56:01
> Welcome to the Nardil club! Seems like a lot of people are taking this med. What I can tell you (having been on Nardil for 2.5 months) is that the first month or so is a ROLLER COASTER in terms of side effects -- it was for me and I have observed other people saying similar things. My suggestion is to continue as recommended. For me, the roller coaster has subsided and most of my side effects have gone away. And now I feel more comfortable. Be careful with what you eat. I had the dreaded hypertensive crisis from eating Monterey Jack cheese.
>
> So I believe things will get smoother for you. Good luck to you!
>
> AtypicalIn some ways it sounds like nardil is a better med than parnate. Especially for people with anxiety and for people with social anxiety and panic attacks.
However from what I've read it nardil has more side effects. It seems to work on gaba more than parnate.
The big side that stopped me was everyone seems to put on weight. Did you?
Good luck in your journey!
Posted by Sunbath on September 12, 2009, at 13:14:52
In reply to Re: Nardil overstimulation at wk. 3 - will it pass?, posted by bulldog2 on September 12, 2009, at 12:57:32
Hi Bulldog2,
I also read that all the time, the prominent weight gain with Nardil that put me off. Otherwise it would have been my first choice since my problems are more anxiety related and ocd.
Also Dr. Gillman in his very interesting and remarkable article http://www.psychotropical.com/maois_full.shtml
says: "Although monoamine oxidase inhibitors are usually lumpted together in discussions there are many important differences between tranylcypromine and phenelzine. Tranylcypromine is so superior in relation to side effects that, in my opinion, it is difficult to justify the use of phenelzine, in most clinical situations, unless tranylcypromine has been tried first. "
Posted by bulldog2 on September 12, 2009, at 13:29:57
In reply to Re: Nardil overstimulation at wk. 3 - will it pass? » bulldog2, posted by Sunbath on September 12, 2009, at 13:14:52
> Hi Bulldog2,
>
> I also read that all the time, the prominent weight gain with Nardil that put me off. Otherwise it would have been my first choice since my problems are more anxiety related and ocd.
>
> Also Dr. Gillman in his very interesting and remarkable article http://www.psychotropical.com/maois_full.shtml
> says: "Although monoamine oxidase inhibitors are usually lumpted together in discussions there are many important differences between tranylcypromine and phenelzine. Tranylcypromine is so superior in relation to side effects that, in my opinion, it is difficult to justify the use of phenelzine, in most clinical situations, unless tranylcypromine has been tried first. "Yes I read that. I did try parnate and worked my way up to 60 milligrams over a eight week period. I was at that dose for about 10 days and stopped. I didn't feel I was getting enough positive effects from the drug.
I realize now I didn't give the med enough time. I will try it again and add nortriptyline low dose from the beginning as some are getting a good result from that addition. Also I feel sometimes this med needs more time and the possibility of going to higher doses.
However I have a hip replacement sheduled for the end of sept so I have to wait until that is over to try parnate again.
Posted by Sunbath on September 12, 2009, at 13:35:31
In reply to Re: Nardil overstimulation at wk. 3 - will it pass?, posted by bulldog2 on September 12, 2009, at 13:29:57
You are surely absolutely right, also considering Gayle's experience with Parnate.
Now I remember you saying that in another thread!
Good luck with your surgery!!
Posted by bulldog2 on September 12, 2009, at 13:54:03
In reply to Re: Nardil overstimulation at wk. 3 - will it pass? » bulldog2, posted by Sunbath on September 12, 2009, at 13:35:31
> You are surely absolutely right, also considering Gayle's experience with Parnate.
> Now I remember you saying that in another thread!
> Good luck with your surgery!!Thank you. I've battled depression on and off my entire life. Probably bi polar as I have had times when I felt great.
But I'll tell you this chronic pain and inability to walk without a cane has made this depression much deeper. I do have percocet for pain but I have immediate release so i have a couple good hours followed by a miserable crash. I take two to three doses a day.
Wish I could start the parnate!
Posted by Sunbath on September 12, 2009, at 16:57:08
In reply to Re: Nardil overstimulation at wk. 3 - will it pass? » Sunbath, posted by bulldog2 on September 12, 2009, at 13:54:03
Ouch that really sounds tough, I'm sorry that you are going through this! Cannot imagine how that feels (I guess I'm very lucky that I haven't had any orthopedic problems yet) But your surgery isn't far away now and you can start the parnate soon? Do you know anything about Parnate having analgesic properties btw?
Good luck to you and think of it: there is "only" about half a month left!!
Posted by bulldog2 on September 12, 2009, at 17:30:29
In reply to Re: Nardil overstimulation at wk. 3 - will it pass? » bulldog2, posted by Sunbath on September 12, 2009, at 16:57:08
> Ouch that really sounds tough, I'm sorry that you are going through this! Cannot imagine how that feels (I guess I'm very lucky that I haven't had any orthopedic problems yet) But your surgery isn't far away now and you can start the parnate soon? Do you know anything about Parnate having analgesic properties btw?
>
> Good luck to you and think of it: there is "only" about half a month left!!Yes when I started parnate my fibromyalgia went away. My left hip felt better also. I started doing exercise and my left hip flared up.
That's when they did an x-ray of the hips and found bone on bone as the cartilage was worn away.Also bone spurs in left hip and a cyst inside the bone. so the left hip is a mess and needs to be replaced. Kind of feels like broken glass in the hip when I move. But when I use percocet and neurontin the hip is okay to move around. Probably a time release like oxycontin would be better.
Posted by Phillipa on September 12, 2009, at 21:37:11
In reply to Re: Nardil overstimulation at wk. 3 - will it pass?, posted by bulldog2 on September 12, 2009, at 17:30:29
Bulldog so no fibromyalgia? Ever try cymbalta? Seriously my arthritic back pain didn't exist. Phillipa
Posted by bulldog2 on September 13, 2009, at 10:10:29
In reply to Re: Nardil overstimulation at wk. 3 - will it pass? » bulldog2, posted by Phillipa on September 12, 2009, at 21:37:11
> Bulldog so no fibromyalgia? Ever try cymbalta? Seriously my arthritic back pain didn't exist. Phillipa
Never tried cymbalta. Fibro went away the first week on parnate.
Posted by pedr on September 15, 2009, at 12:27:56
In reply to Re: Nardil overstimulation at wk. 3 - will it pass?, posted by bulldog2 on September 12, 2009, at 17:30:29
>
> Yes when I started parnate my fibromyalgia went away. My left hip felt better also. I started doing exercise and my left hip flared up.
>Maybe this is an MAOI thing. I´ve been suffering with IBS-C (Irritable Bowel Syndrome Constipation subtype) for many years. On a daily basis it ranges from uncomfortable to agony. Nardil has really blunted that pain and helped to control it. It's an unexpected and most fabulous side-effect!
Pete
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