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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 gilmourr on January 6, 2013, at 17:09:11
I used it a 3rd time, but it was less than great, but there could've been some interactions because of highly elevated levels of B6 and because of other reasons.
I was thinking of a 2-3 month wait period and then restart Nardil @ 30 mg.
Have any of you guys ever had it lose it's efficacy over time and then come off it, restart and found that it worked again?
Posted by order and chaos on January 6, 2013, at 19:27:42
In reply to Anyone restart Nardil after it pooped out?, posted by gilmourr on January 6, 2013, at 17:09:11
(I'm sorry for responding with a question, rather than an answer, since Nardil has pooped out on me as well...)
Have you tried any meds to augment the Nardil? My dr. added Ritalin a few months ago, which has helped with concentration, but not that much for the depression (I'm still gradually increasing the dose and am up to 15mg now).
I've heard of the concept of stopping and then restarting an antidepressant, but have no experience myself. I'm worried about my depression getting even worse (along with anxiety/OCD) if I go off the nardil...
Can I ask what happened the first 2 times you took it? Did you stop b/c of side effects or did it stop working?
Good luck - I hope you find something that helps soon - I know how frustrating it is to finally have a medication help, and then not be able to get back to that place...
Posted by jono_in_adelaide on January 6, 2013, at 20:10:23
In reply to Re: Anyone restart Nardil after it pooped out? » gilmourr, posted by order and chaos on January 6, 2013, at 19:27:42
I'd be inclined to augment with nortriptyline rather than Ritalin, start off with 25mg at night, and increase by 25mg per week.
A simple blood test helps determine the correct dose of nortriptyline for a given individual
Posted by gilmourr on January 6, 2013, at 20:30:52
In reply to Re: Anyone restart Nardil after it pooped out? » gilmourr, posted by order and chaos on January 6, 2013, at 19:27:42
I've only used klonopin and seroquel with Nardil. They were for sleep and during the stages of initial anxiety when I start up Nardil.
I'm thinking of using lithium this time or amitryptiline with Nardil because of Nardil causing some insomnia and Nardil also makes me cold which I think is because it's so potent on norepinephrine.
The first time it was working, but I went to 75 mg and it caused mood swings and no sleep plus massive urinary retention so I had to stop it.
Second time it worked REALLY well at 45 mg, so I tried 60 mg, mood swings started and developed A LOT OF COLDNESS right when I started 60 mg. So from then on I knew 45 mg was what I needed. Or less.
> (I'm sorry for responding with a question, rather than an answer, since Nardil has pooped out on me as well...)
>
> Have you tried any meds to augment the Nardil? My dr. added Ritalin a few months ago, which has helped with concentration, but not that much for the depression (I'm still gradually increasing the dose and am up to 15mg now).
>
> I've heard of the concept of stopping and then restarting an antidepressant, but have no experience myself. I'm worried about my depression getting even worse (along with anxiety/OCD) if I go off the nardil...
>
> Can I ask what happened the first 2 times you took it? Did you stop b/c of side effects or did it stop working?
>
> Good luck - I hope you find something that helps soon - I know how frustrating it is to finally have a medication help, and then not be able to get back to that place...
Posted by gilmourr on January 6, 2013, at 20:32:03
In reply to Re: Anyone restart Nardil - orer and chaos, posted by jono_in_adelaide on January 6, 2013, at 20:10:23
If I was having hyperreflexia and shivers at 60 mg, it makes me think that I don't need more norepinephrine with Nardil. I need something serotonergic, so either amitryptiline or lithium.
> I'd be inclined to augment with nortriptyline rather than Ritalin, start off with 25mg at night, and increase by 25mg per week.
>
> A simple blood test helps determine the correct dose of nortriptyline for a given individual
Posted by order and chaos on January 6, 2013, at 21:07:46
In reply to Re: Anyone restart Nardil - orer and chaos, posted by jono_in_adelaide on January 6, 2013, at 20:10:23
Unfortunately I'm a poor metabolizer of tricyclics (tested positive for CYP2D6), so even low doses caused toxicity...
For a period of time I had hyperreflexia/problems with gate from the nardil, but it went away over time, and I'm on 90mg now. The ritalin helps the orthostatic hypotension though. (I'm on seroquel too and a whole cocktail of other meds...)
Posted by gilmourr on January 6, 2013, at 21:53:24
In reply to Re: Anyone restart Nardil - orer and chaos » jono_in_adelaide, posted by order and chaos on January 6, 2013, at 21:07:46
What do you mean you had hyperreflexia with gate? Do you mean you had hyperreflexia from the start?
The first time I took Nardil I had orthostatic hypotension. I had some the 2nd time and I didn't have any the 3rd time.
> Unfortunately I'm a poor metabolizer of tricyclics (tested positive for CYP2D6), so even low doses caused toxicity...
>
> For a period of time I had hyperreflexia/problems with gate from the nardil, but it went away over time, and I'm on 90mg now. The ritalin helps the orthostatic hypotension though. (I'm on seroquel too and a whole cocktail of other meds...)
Posted by Phillipa on January 6, 2013, at 22:39:40
In reply to Re: Anyone restart Nardil - orer and chaos, posted by gilmourr on January 6, 2013, at 21:53:24
I've not taken the med but don't understand shivers and cold with a med you sure your thyroid is okay? Phillipa
Posted by gilmourr on January 6, 2013, at 22:44:18
In reply to Re: Anyone restart Nardil - orer and chaos » gilmourr, posted by Phillipa on January 6, 2013, at 22:39:40
> I've not taken the med but don't understand shivers and cold with a med you sure your thyroid is okay? Phillipa
Yeah my thyroid has been tested twice. both came back fine
Elevated norepinephrine can cause hyperreflexia, coldness and shivers.
Posted by order and chaos on January 6, 2013, at 23:08:53
In reply to Re: Anyone restart Nardil - orer and chaos, posted by gilmourr on January 6, 2013, at 21:53:24
> What do you mean you had hyperreflexia with gate? Do you mean you had hyperreflexia from the start?
I didn't have these side effects until I got to 60-75mg. I was having problems w/jerking movements in my legs which caused occasional falling (mostly very late at night - and my dr. checked my reflexes b/c of this) - but I also have an eating disorder (I'm in recovery now and am physically healthy), and my side effects worsened when I relapsed, and dissipated as I got healthier - so I'm not sure how much was from the Nardil v the ED.
This is the end of the thread.
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