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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by zonked on June 3, 2011, at 23:54:52
Either placebo is a VERY powerful drug or I am beginning to respond to Nardil therapy at day two. And only on 45mg!
(This happened the very first time I was on Nardil - within a week it began to kick in.)
Nothing dramatic, but I noticed I have started to enjoy music again. Verbal fluency is improved, and a friend of mine who saw me today noticed a change - he said that when I'm depressed I have trouble looking people in the eye...
This very well could be a false alarm. I'll keep you guys posted.
(For the record, this also happened to me when I started Zoloft therapy in 2001 - it started working within 3 days.)
I guess what I want to know is: Does this mean anything clinically if this is a true AD response and not a placebo response? ADs are NOT supposed to take effect this quickly, are they? It isn't as though everything seems magic, perfect, and fixed (and that's not what I want anyway) - but
I have felt more like myself today than I have in a LONG time. Not 100%, but significant.Hoping this is not a placebo response,
-z
Please, please let this continue. I need to start rebuilding my life...
Posted by SLS on June 4, 2011, at 5:15:41
In reply to Nardil: Placebo response? Am I nuts? Opinions plz, posted by zonked on June 3, 2011, at 23:54:52
> Either placebo is a VERY powerful drug or I am beginning to respond to Nardil therapy at day two. And only on 45mg!
>
> (This happened the very first time I was on Nardil - within a week it began to kick in.)
>
> Nothing dramatic, but I noticed I have started to enjoy music again. Verbal fluency is improved, and a friend of mine who saw me today noticed a change - he said that when I'm depressed I have trouble looking people in the eye...
>
> This very well could be a false alarm. I'll keep you guys posted.
>
> (For the record, this also happened to me when I started Zoloft therapy in 2001 - it started working within 3 days.)
>
> I guess what I want to know is: Does this mean anything clinically if this is a true AD response and not a placebo response? ADs are NOT supposed to take effect this quickly, are they? It isn't as though everything seems magic, perfect, and fixed (and that's not what I want anyway) - but
> I have felt more like myself today than I have in a LONG time. Not 100%, but significant.
>
> Hoping this is not a placebo response,
>
> -z
>
> Please, please let this continue. I need to start rebuilding my life...
It is very likely not a placebo response.Do not be surprised if your response fades in the short-term. Nardil can be activating at first. You should look at your early response as a positive "blip" that might very well indicate a stable response to emerge a few months from now. Some people don't experience a stable response to Nardil for four months. If you have nothing else promising to treat with immediately, you might as well stick with the Nardil. My first true success was using a combination of desipramine and Parnate. There are augmentation alternatives. Unfortunately, a doctor screwed up the works.
Currently:
Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 10mg
lithium 300mg- Scott
Posted by jono_in_adelaide on June 4, 2011, at 8:46:27
In reply to Nardil: Placebo response? Am I nuts? Opinions plz, posted by zonked on June 3, 2011, at 23:54:52
Placebo effect is very powerful - the mind is always in charge!
Posted by SLS on June 4, 2011, at 9:55:15
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz, posted by jono_in_adelaide on June 4, 2011, at 8:46:27
> Placebo effect is very powerful - the mind is always in charge!
No way.
- Scott
Posted by zonked on June 4, 2011, at 10:34:44
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz » zonked, posted by SLS on June 4, 2011, at 5:15:41
>
> It is very likely not a placebo response.
SLS,If I trust anyone about this kind of thing, it would be you - thanks for the encouraging words. :-)
Woke up with the dreaded Klonopin hangover, but this time it wasn't coupled with a sense of dread... (I *really* want to change my benzo back to Xanax, but I may have to continue to fight for it - Xanax never gave me a hangover.)
It's interesting, I have used the term "waves" to describe the same concept I think you did with "blip" - I remember when Zoloft first began to work, it came on in "waves". I would feel better, it would fade, feel better, until I got up to the effective dosage and the effect was constant, and I returned to being myself.
** As a side note it's too bad Zoloft pooped out on me, when it did work it was a lifesaver. **
-z
Posted by sigismund on June 4, 2011, at 11:01:35
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz » SLS, posted by zonked on June 4, 2011, at 10:34:44
I took *one* Nardil pill 40 years ago and I swear it affected that day very positively.
I still remember it.
Posted by zonked on June 4, 2011, at 11:15:34
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz, posted by sigismund on June 4, 2011, at 11:01:35
> I took *one* Nardil pill 40 years ago and I swear it affected that day very positively.
>
> I still remember it.Just curious, do you still take it today?
-z
Posted by sigismund on June 4, 2011, at 11:19:33
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz » sigismund, posted by zonked on June 4, 2011, at 11:15:34
No. That was a once only thing.
If I became properly depressed, Nardil would be my choice though.
I still have no real idea of what depression is. I can say of someone (with a dx of depression) 'That person is distressed or tormented'.
Posted by Phillipa on June 4, 2011, at 11:29:51
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz » zonked, posted by sigismund on June 4, 2011, at 11:19:33
In no disrespect this happens to me all the time I get something new via hormones or medical and the next day feel great and then gone. I feel for me that it's the thought that oh this might be it. Phillipa
Posted by zonked on June 4, 2011, at 11:50:39
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz, posted by Phillipa on June 4, 2011, at 11:29:51
> I feel for me that it's the thought that oh this might be it.
No disrespect felt. :-)
That's exactly what I'm trying to determine - whether it's what you've described or a genuine chemical change. Could be a combo of both. Time will tell...
-z
Posted by SLS on June 4, 2011, at 15:03:00
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz » Phillipa, posted by zonked on June 4, 2011, at 11:50:39
Ideally, there is a positive feedback loop for which better biology leads to better psychology, which leads to better biology, etc. It certainly can't hurt to think positive, whereas it can hurt to think negative. Depression is self-reinforcing. There is no need to make it easier for the depression to take hold. Of course, early intervention is important. If left untreated, many cases will become chronic or recurrent, and have been demonstrated to be harder to treat.
- Scott
Posted by Christ_empowered on June 4, 2011, at 18:02:56
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz » zonked, posted by SLS on June 4, 2011, at 5:15:41
I wouldn't worry about it. Maybe its largely psychological, like you're doing something about your depression and that in and of itself has an anti-depressant and empowering effect on you. Maybe its a mix of psychological and biochemical factors; mild stimulation+more positive thinking=pronounced antidepressant response early in the game. I don't think there's any way to know for sure, and I don't think you'll benefit by analyzing the situation.
Posted by floatingbridge on June 4, 2011, at 18:10:08
In reply to Nardil: Placebo response? Am I nuts? Opinions plz, posted by zonked on June 3, 2011, at 23:54:52
Posted by Phillipa on June 4, 2011, at 20:24:46
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz, posted by Christ_empowered on June 4, 2011, at 18:02:56
CE well said was what I wished to communicate. Phillipa
Posted by zonked on June 5, 2011, at 12:23:12
In reply to Re: Nardil: Placebo response? Am I nuts? Opinions plz, posted by Christ_empowered on June 4, 2011, at 18:02:56
That little blip or wave I felt did fade but I am not discouraged. It is this board, and you MAOI veterans, that help keep me hopeful as I go through the retrial.
There will be a time when I no longer spend most of my energy thinking about my depression or evaluating how depressed I am at a particular moment, whether or not treatment is working or starting to work...
Been waking up with terrible "hangovers" I attribute to the Klonopin I'm taking. I can't wait to get rid of this junk - it's a variable I don't need. (The effect Klonopin has on me is distinct. Anxiety is improved, depression is worsened, wake up with a nasty "hangover" every day no matter *how* low the dose or what time of day I took it the previous day.)
Patience...hoping I can make a strong case for a switch to Xanax (IR or XR) at the next appointment, plus a Nardil increase.
-z
Posted by Lamdage on June 10, 2011, at 8:48:33
In reply to Re: Nardil: Placebo response? update! » Christ_empowered, posted by zonked on June 5, 2011, at 12:23:12
Zonked, placebo i dont think so.. 45mg was an effective dosage for me.
It is powerful indeed
Posted by zonked on June 10, 2011, at 9:35:45
In reply to Re: Nardil: Placebo response? update!, posted by Lamdage on June 10, 2011, at 8:48:33
> Zonked, placebo i dont think so.. 45mg was an effective dosage for me.
> It is powerful indeedHow long did it take at 45 before the effect was consistent, do you remember?
-z
Posted by SLS on June 10, 2011, at 9:48:17
In reply to Re: Nardil: Placebo response? update! » Lamdage, posted by zonked on June 10, 2011, at 9:35:45
> > Zonked, placebo i dont think so.. 45mg was an effective dosage for me.
> > It is powerful indeed
>
> How long did it take at 45 before the effect was consistent, do you remember?
>
> -z
In my experience, the effective range for Nardil is 60-90mg. 45mg doesn't usually do the trick.
- Scott
Posted by zonked on June 10, 2011, at 10:34:54
In reply to Re: Nardil: Placebo response? update! » zonked, posted by SLS on June 10, 2011, at 9:48:17
> In my experience, the effective range for Nardil is 60-90mg. 45mg doesn't usually do the trick.
>
>
> - ScottScott,
It's good to hear from you...
Due to insurance hassles (which has been acknowledged by my carrier as a recent bug in their billing system about which I, my provider, and the carrier can do NOTHING--they don't even know the source of the problem yet.) I can't see my doctor until this glitch is fixed... I have to stay at 45 until I receive a new Rx and instructions. (If you are wondering why this situation is playing out in a non-third-world country, it's because I get my coverage through a whacky combination of federal, state, and county governments.)
While it'd be tempting to raise the dose on my own, since I tolerate this drug fine, if I run out "early" my insurance will refuse to pay for a refill, so I am sort of stuck. Frustrating. My blip seems to have faded.
And it took 90mg for the effect to be consistent when this drug has worked for me in the past.
If you were faced with this situation, what would you do? Despite your struggles over the years, your advice has always seemed sensible to me.
-z
This is the end of the thread.
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