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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 gilmourr on October 2, 2012, at 21:22:52
So I came off of 60 mg to 45 mg because 60 mg screwed me up and 45 mg gets rid of a lot of my depression + anxiety and stabilizes me. Or at least it did when I started it at 45 mg and stayed there for like 4-10 weeks.
My anxiety still isn't really improving (when it should be, 45 mg rocks my world) and I'm so jumpy when anything rings or dings or snaps/buzzes etc.
Is it possible that going from 60 mg to 45 mg won't get me back to where I was and that I might have to stop taking Nardil and then start it again at 45 mg? I'm on day 24 of 45 mg and it should be getting better. Of course I'm going to give it 6 weeks, but is there any reason I might have to restart it to get the effect back?
BTW, if it matters, I am lactose intolerant and dairy intolerant. I don't take calcium to supplement it and I hardly take B vitamins. Is there a chance a vitamin B or calcium deficiency can cause this anxiety?
Posted by phidippus on October 2, 2012, at 22:44:49
In reply to Nardil Anxiety/Hyperrflexia, posted by gilmourr on October 2, 2012, at 21:22:52
>is there any reason I might have to restart it to get the effect back?
I think you might have to switch the Nardil for something else. It seems like the Nardil is actually increasing your anxiety. Antidepressants can do this.
Eric
Posted by phillipa on October 2, 2012, at 23:18:58
In reply to Re: Nardil Anxiety/Hyperrflexia » gilmourr, posted by phidippus on October 2, 2012, at 22:44:49
Yes the can. Phillipa
Posted by gilmourr on October 3, 2012, at 0:01:19
In reply to Re: Nardil Anxiety/Hyperrflexia » phidippus, posted by phillipa on October 2, 2012, at 23:18:58
If you read the post, I said I've been on 45 mg in the past where it has done wonders for my anxiety. My question was, wait for the 45 mg to balance out, or go off and restart it at 45 mg.
Posted by jono_in_adelaide on October 3, 2012, at 1:01:10
In reply to Re: Nardil Anxiety/Hyperrflexia, posted by gilmourr on October 3, 2012, at 0:01:19
Given the halflife of nardil and the time it takes for mao to regenerate, i thik that if it was going to balance out, it would have by now.
If you arnt feeling it within another week or so, I'd consider a change to a different class of drug
(mirtazapine might be a good first choice?)
Posted by phidippus on October 3, 2012, at 10:11:17
In reply to Re: Nardil Anxiety/Hyperrflexia, posted by gilmourr on October 3, 2012, at 0:01:19
What's the point of going off of it to come back on it?
Eric
Posted by gilmourr on October 3, 2012, at 11:39:04
In reply to Re: Nardil Anxiety/Hyperrflexia » gilmourr, posted by phidippus on October 3, 2012, at 10:11:17
It worked the first time I went on it 45 mg.
(by just starting the med)I tested out other drugs later afterwards
Came back to it a 2nd time and it worked on 45 mg.
(by just starting the med)I tested out 60 mg later afterwards
Came back to 45 mg a 3rd time and its not working as well
(by NOT just starting the med, this time I am moving from high nardil dose to low. It's a different scenario)
Posted by phidippus on October 3, 2012, at 12:37:19
In reply to Re: Nardil Anxiety/Hyperrflexia, posted by gilmourr on October 3, 2012, at 11:39:04
>Came back to 45 mg a 3rd time and its not working as well
That is a little strange. Could it be part of a withdrawal syndrome?
What happens if you go back up to 60 mg?
Eric
Posted by gilmourr on October 3, 2012, at 20:04:52
In reply to Re: Nardil Anxiety/Hyperrflexia » gilmourr, posted by phidippus on October 3, 2012, at 12:37:19
What's withdrawal syndrome?
And if I go to 60 mg I begin to get severe mood swings once a week, then it becomes once every 4-5 days, then once every 1-2 days.
It's not depression but it's like having severe depression for 4-5 hours at that frequency, it's not good at all.
Posted by phidippus on October 4, 2012, at 16:56:20
In reply to Re: Nardil Anxiety/Hyperrflexia, posted by gilmourr on October 3, 2012, at 20:04:52
How long before you just give up and try another MAOI?
Eric
Posted by gilmourr on October 5, 2012, at 11:38:00
In reply to Re: Nardil Anxiety/Hyperrflexia » gilmourr, posted by phidippus on October 4, 2012, at 16:56:20
I'm not giving up because I've been on 45 mg of Nardil twice now.
Both times 70% of my depression and anxiety go away.
This time though I've gone to 45 mg from 60 mg instead of starting Nardil from scratch. For some reason because of that, my anxiety isn't being helped to the same degree. It might still be that I need to wait longer, I'm now on day 27.
Last time it took 30 days for the anxiety to reach 70% remission.
I've tried Parnate and it's a side effect nightmare.
If Nardil doesn't work at 45 mg after 8 weeks or so after coming
down from 60 mg, then I'll go off it for 2 weeks and start from 0 again. It will 100% work that way.But I still strongly believe it has to work coming down from 60 mg. I don't see why it wouldn't.
** And I don't think a reversible MAO inhibitor would cut it. Maybe selegiline might, but Nardil works, it's just being weird this time.
Posted by ChicagoKat on October 5, 2012, at 11:57:58
In reply to Re: Nardil Anxiety/Hyperrflexia, posted by gilmourr on October 5, 2012, at 11:38:00
> I'm not giving up because I've been on 45 mg of Nardil twice now.
>
> Both times 70% of my depression and anxiety go away.
>
> This time though I've gone to 45 mg from 60 mg instead of starting Nardil from scratch. For some reason because of that, my anxiety isn't being helped to the same degree. It might still be that I need to wait longer, I'm now on day 27.
>
> Last time it took 30 days for the anxiety to reach 70% remission.
>
> I've tried Parnate and it's a side effect nightmare.
>
> If Nardil doesn't work at 45 mg after 8 weeks or so after coming
> down from 60 mg, then I'll go off it for 2 weeks and start from 0 again. It will 100% work that way.
>
> But I still strongly believe it has to work coming down from 60 mg. I don't see why it wouldn't.
>
> ** And I don't think a reversible MAO inhibitor would cut it. Maybe selegiline might, but Nardil works, it's just being weird this time.Nardil is a truly wonderful drug, but it certainly can behave strangely. Probably due to the way it inhibits those enzymes, then takes it's own sweet time disinhibiting them. Not to mention that it self-metabolizes. I have to say, almost the minute I start Nardil my anxiety disappears, and it stays that way all the while I'm on it. It's wonderful. But, on my first try with it I developed ataxia (incoordination) from it and suffered falls when I was at 60mg/day. We stopped it and tried absolutely everything else we could think of including stimulants, but nothing worked or I developed bad side effects, eg, severe anxiety from Ritalin, which had helped for several months. Who knows why drugs turn on us? Maybe Scott has some input. And I do know he said something (I think it was him) that Nardil is the only MAOI that has anti-anxiety properties, something to do with how it interacts with GABA, plus another mechanism. I can't remember now. But maybe your problem has something to do with these mechanisms being saturated or something, I do not know, but it must have something to do with these mechanisms. Maybe Scott will chime in; that would help..he really know his stuff. Hope things work out for you.
Kat
Posted by gilmourr on October 6, 2012, at 12:07:09
In reply to Re: Nardil Anxiety/Hyperrflexia..SLS? » gilmourr, posted by ChicagoKat on October 5, 2012, at 11:57:58
Thanks.
And if I do remember myself I think it's because it inhibits GABA-T which metabolizes GABA, so when you take Nardil it allows GABA to accumulate.
Something like Lyrica on the other hand just ADDS GABA, but it still allows it to be metabolized since GABA-T isn't inhibited. Which might make sense why Nardil helps anxiety and it helps it almost permanently as long as you take it.
I just can't decide if in 50-60 days I don't like the effect whether to drop down to 30 mg or 15 mg and come back to 45 mg or just go off of it.
Going off of it is horrible though. I have nightmares of being experimented on by nazis and stuff and I become suicidal very quickly. It's messed.
Posted by ChicagoKat on October 8, 2012, at 12:44:27
In reply to Re: Nardil Anxiety/Hyperrflexia..SLS?, posted by gilmourr on October 6, 2012, at 12:07:09
> Thanks.
>
> And if I do remember myself I think it's because it inhibits GABA-T which metabolizes GABA, so when you take Nardil it allows GABA to accumulate.
>
> Something like Lyrica on the other hand just ADDS GABA, but it still allows it to be metabolized since GABA-T isn't inhibited. Which might make sense why Nardil helps anxiety and it helps it almost permanently as long as you take it.
>
> I just can't decide if in 50-60 days I don't like the effect whether to drop down to 30 mg or 15 mg and come back to 45 mg or just go off of it.
>
> Going off of it is horrible though. I have nightmares of being experimented on by nazis and stuff and I become suicidal very quickly. It's messed.Hi Gilmourr,
How's it going with the Nardil?
And I'm sorry to hear you have such bad side effects when you go off of it.
Kat
Posted by gilmourr on October 11, 2012, at 19:03:53
In reply to Re: Nardil Anxiety/Hyperrflexia..SLS? » gilmourr, posted by ChicagoKat on October 8, 2012, at 12:44:27
Cold intolerance, urinary retention and tiredness randomly still.
I think the antibiotic screwed my dosage reduction up, so technically I'm on day 22 of 45 mg. I might just need more time. It sucks when I had it pretty good on 45 mg and then 60 mg screwed it up.
My depression is doing well though. It's just my anxiety and side effects that aren't restoring to 45 mg levels.
I JUST GOT NORTRYPTILINE TOO :)
Posted by ChicagoKat on October 11, 2012, at 20:44:07
In reply to Re: Nardil Anxiety/Hyperrflexia..SLS?, posted by gilmourr on October 11, 2012, at 19:03:53
> Cold intolerance, urinary retention and tiredness randomly still.
>
> I think the antibiotic screwed my dosage reduction up, so technically I'm on day 22 of 45 mg. I might just need more time. It sucks when I had it pretty good on 45 mg and then 60 mg screwed it up.
>
> My depression is doing well though. It's just my anxiety and side effects that aren't restoring to 45 mg levels.
>
> I JUST GOT NORTRYPTILINE TOO :)Sorry to hear that the anti-anxiety effect of Nardil has left you. That amazes me since it works on my anxiety from day 1 and never leaves. But maybe the Nortryptiline will help with your anxiety.
My best,
Kat
Posted by gilmourr on October 12, 2012, at 7:12:41
In reply to Re: Nardil Anxiety/Hyperrflexia..SLS? » gilmourr, posted by ChicagoKat on October 11, 2012, at 20:44:07
I don't think the anti-anxiety feature has entirely left me, it's just not as good as when I was side effect free on 45 mg.
It's weird, I have like anxious physical symptoms where when I'm sitting my feet are curled and my body is rigged. It's like typical whenever I have anxiety. Also there is the mental avoidance part of things too. So yeah, it does kind of suck. But I'm still hoping it changes fairly soon because I was on an antibiotic which may have screwed with it.
Posted by SLS on October 12, 2012, at 9:02:37
In reply to Re: Nardil Anxiety/Hyperrflexia..SLS?, posted by gilmourr on October 12, 2012, at 7:12:41
Hi.
I'm sorry that I never got around to commenting on your situation. I don't know what it is that occurs with you at a dosage of 60 mg/day of Nardil that you feel is counterproductive. It is unusual. However, it is not unusual for it to take several days for MAO inhibition to recover after a reduction in dosage if Nardil. This is less of a problem with Parnate.
What exactly happens at 60 mg/day?
Why do you feel the need to add another drug to Nardil?
I know you have answered these questions before, but I am still unclear on them.
Adding nortriptyline has really helped me in the past. I would just add it gradually so as not to trigger a worsening of hypotension and urinary retention.
It is great that you remain responsive to Nardil. It is a good sign. Be patient. You will definitely be able to tweak your treatment and find an optimal regime.
- Scott
Posted by gilmourr on October 12, 2012, at 15:41:00
In reply to Re: Nardil Anxiety/Hyperrflexia..SLS? » gilmourr, posted by SLS on October 12, 2012, at 9:02:37
> Hi.
>
> I'm sorry that I never got around to commenting on your situation. I don't know what it is that occurs with you at a dosage of 60 mg/day of Nardil that you feel is counterproductive. It is unusual. However, it is not unusual for it to take several days for MAO inhibition to recover after a reduction in dosage if Nardil. This is less of a problem with Parnate.
>
> What exactly happens at 60 mg/day?
>
> Why do you feel the need to add another drug to Nardil?
>
> I know you have answered these questions before, but I am still unclear on them.
>
> Adding nortriptyline has really helped me in the past. I would just add it gradually so as not to trigger a worsening of hypotension and urinary retention.
>
> It is great that you remain responsive to Nardil. It is a good sign. Be patient. You will definitely be able to tweak your treatment and find an optimal regime.
>
>
> - Scott
That's fine, I don't mind restating it.What happens at 60 mg is that my anxiety starts to incrementally come back (mildly) but I start having SEVERE depressive mood swings. Every 2-3 days for 4-6 hours I would become severely depressed. I knew it was bad when one night it hit me at 12 AM and I had to wander the streets till morning because I felt so bad and had to do anything.
When I came off the 60 back to the 45 mg the mood swings went away. But this time, coming back to the 45 mg I had massive cold intolerance, my anxiety wasn't helped as much and I had hyperreflexes to noises.
I think yesterday I figured out that the cold intolerance is due to a B12/B6 deficiency, because I took a lot 48 hours ago and I'm much more regular in respect to body heat. I'm sure the hyperreflexes might take some time. I also am starting to feel more sleepy/relaxed taking the B6/B12.
Apparently B6 is a MUST for GABA-T to be metabolized which is the enzyme that metabolizes GABA. So with B6 supplemented, GABA-T might be inhibited more, thus more GABA.
I wanted to add the Nortryptiline because even when I was at 45 mg with NO side effects, it helped my depression remit by 60% tops, and the anxiety was like 70%. I figured I can get higher, thus, lets augment it. Right?
Hopefully the B6/B12 brings my 45 mg back to what it felt like before.
This is the end of the thread.
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