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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by roscopeeco on March 21, 2014, at 17:09:52
Hello all. I don't have much time to write but I am back on Nardil today. I don't have time to washout the Remeron I have been taking for 3 weeks at 15mg. The possibility of serotonin syndrome is scarey but I have too much at stake to play the 14 day waiting game. Are benzos good to take if these happens. I just took my first 15mg tablet 3 hours ago.
I need support from this great community. Thank you all.
Posted by stargazer2 on March 21, 2014, at 22:50:38
In reply to back on nardil, posted by roscopeeco on March 21, 2014, at 17:09:52
Hang in there. I just started back on the Nardil 60 I stopped a few weeks ago because of uncontrollable suicidal urges. Why more of us don't kill ourselves I'll never know but if this is how living feels death would be welcome.
I take Nardil with stims so although contraindicated it helps. Only on 15 mg and will probably stay at that. I just think coming off Nardil was too radical for my brain to handle.
Still on TMS, day 10 was today, 20 more treatments to go to decide if suicide wins over depression.
Posted by SLS on March 22, 2014, at 0:53:58
In reply to Re: back on nardil, posted by stargazer2 on March 21, 2014, at 22:50:38
> Hang in there. I just started back on the Nardil 60 I stopped a few weeks ago because of uncontrollable suicidal urges. Why more of us don't kill ourselves I'll never know but if this is how living feels death would be welcome.
>
> I take Nardil with stims so although contraindicated it helps. Only on 15 mg and will probably stay at that. I just think coming off Nardil was too radical for my brain to handle.
>
> Still on TMS, day 10 was today, 20 more treatments to go to decide if suicide wins over depression.What kind of TMS are you receiving (shallow versus deep)?
Will you remain on the same dosages of your medications throughout the TMS trial?
30 years is a long time, Stargazer. Remaining alive is a great achievement.
- Scott
Posted by SLS on March 22, 2014, at 1:04:21
In reply to back on nardil, posted by roscopeeco on March 21, 2014, at 17:09:52
> Hello all. I don't have much time to write but I am back on Nardil today. I don't have time to washout the Remeron I have been taking for 3 weeks at 15mg. The possibility of serotonin syndrome is scarey but I have too much at stake to play the 14 day waiting game. Are benzos good to take if these happens. I just took my first 15mg tablet 3 hours ago.
>
> I need support from this great community. Thank you all.I don't think serotonin syndrome is likely. Remeron might even prevent it in the same way cyproheptadine does (serotonin receptor blockade). It is also unlikely that the noradrenergic properties of Remeron will become problematic, especially at such a low dosage.
What dosage of Nardil will you be targeting first?
- Scott
Posted by Phillipa on March 22, 2014, at 10:29:51
In reply to Re: back on nardil, posted by stargazer2 on March 21, 2014, at 22:50:38
How is the TMS? What's it like? Phillipa
Posted by jpa on March 22, 2014, at 10:47:39
In reply to Re: back on nardil, posted by stargazer2 on March 21, 2014, at 22:50:38
I was on Nardil for 5 years at 120mg a day. I could not go on with it because I was getting no real sleep from it, and besides it was not very effective. Getting off Nardil cold turkey nearly killed me. I was out of operation for three months. It was hell. But I'm happy to be off it because Nardil does not offer any long term hope...you just can't take it very long. I was wish you all the best trying to get off it.
Posted by roscopeeco on March 22, 2014, at 14:00:17
In reply to Re: back on nardil » stargazer2, posted by jpa on March 22, 2014, at 10:47:39
I am shooting for 90mg which will be a little bit over 1mg/kg. Currently starting 45mg for one week, but I might be a little more aggressive in titrating up because I am in a demanding academic program. Dang. I was looking for a bit of a better response stargazer. I can definitely empathize with you and your thoughts. I don't remember having that much difficulty sleeping on nardil. I only took it briefly. I have a bad habit of stopping medications once I feel better.
Posted by SLS on March 22, 2014, at 14:29:44
In reply to Re: back on nardil » stargazer2, posted by jpa on March 22, 2014, at 10:47:39
> I was on Nardil for 5 years at 120mg a day. I could not go on with it because I was getting no real sleep from it, and besides it was not very effective. Getting off Nardil cold turkey nearly killed me. I was out of operation for three months. It was hell.
It was unnecessary for you to suffer that way. Why did you choose to not restart the Nardil and taper it once you started going through hell? Did your doctor encourage you to stop taking it abruptly?
> But I'm happy to be off it because Nardil does not offer any long term hope...
I disagree. This is not the experience of everyone who takes Nardil. Why did you stay on it for 5 years if it wasn't very effective?
> you just can't take it very long.
Why not?
How did you attempt to treat the insomnia?
Nardil is neither a savior nor a devil. It's a tool that apparently was not well suited to you.
For how long have you been medication-free?
- Scott
Posted by jpa on March 22, 2014, at 14:52:53
In reply to Re: back on nardil » jpa, posted by SLS on March 22, 2014, at 14:29:44
Hey Scott,
I had to go back on a TCA (clomipramine). Once I figured out that you get no stage 3 or 4 sleep on an MAOI (I had two sleep studies done), I understood why I was feeling progressively worst on Nardil. Based on my personal experience, I find it hard to believe someone could be on an MAOI long term and be well. Anything's possible though, and if its working for you, stay on it. I appreciate, as I am sure most people on this site do, how difficult it is to find a medication that can work well long term.
I suffer from GAD (it's bad), and have been for 25 years. The only med that has ever sent my disease into remission is clomipramine, but it lost its effectiveness my years ago. I've been searching for something else ever since. Sometimes I wonder if getting on clomipramine in the first place was a mistake.
Have you ever tried gabitril?
John
Posted by PeterMartin on March 22, 2014, at 15:22:48
In reply to Re: back on nardil » SLS, posted by jpa on March 22, 2014, at 14:52:53
Having total REM suppression isn't necessarily a bad thing from searching around.
I dunno. Been on Marplan for 4yrs and haven't seen a decline over time. Perhaps coming off if I have to at some point will be a different story (REM rebound)
http://archpsyc.jamanetwork.com/article.aspx?articleid=490393
Total Prolonged Drug-Induced REM Sleep Suppression in Anxious-Depressed Patients
Richard J. Wyatt, MD; David H. Fram, MD; David J. Kupfer, MD; Frederick Snyder, MD
Arch Gen Psychiatry. 1971;24(2):145-155. doi:10.1001/archpsyc.1971.01750080049007. Text Size: A A A
Article
References
Comments
ABSTRACT
ABSTRACT | REFERENCES
Monoamine oxidase inhibitors (MAOI) are a class of drugs which are capable of totally suppressing REM sleep. The MAOI phenelzine was given to six anxious-depressed patients while daily behavioral and EEG sleep records were made. REM sleep was completely suppressed for from 14 to 40 nights. Upon discontinuation of MAOI REM sleep increased as much as 250% above normal levels. The bipolar EEG changes were paralleled by similar changes in depression and anxiety. The behavior of all six patients markedly improved at times when REM sleep was completely absent. Two of the four patients studied after MAOI discontinuation became profoundly anxious with REM compensation. The morning recall of dreams also closely paralleled the presence or absence of REM sleep. Evidence from this study and others indicate that suppression of REM sleep might help to alleviate depression.
Posted by jpa on March 22, 2014, at 16:04:41
In reply to Re: back on nardil » jpa, posted by SLS on March 22, 2014, at 14:29:44
Scott,
I should add that when I was on Nardil, I was also taking clonazepam to help with insomnia. Sleep studies revealed that while on these two meds most of my sleep time was spent in stages 1 and 2. So very little REM and stage 3&4 sleep. Ultimately, it was not a sustainable situation for me. After 5 years on that combo I felt exhausted and my GAD symptoms were returning.
Posted by brk23 on March 22, 2014, at 22:46:57
In reply to Re: back on nardil » SLS, posted by jpa on March 22, 2014, at 16:04:41
Maois destroy rem sleep,so insomnia will not be a poss side effect but rather a EFFECT you might as well pre anticpate
Posted by PeterMartin on March 23, 2014, at 8:47:51
In reply to Re: back on nardil, posted by brk23 on March 22, 2014, at 22:46:57
I sleep a lot and I've been on a maoi since 2009.
Posted by PeterMartin on March 23, 2014, at 8:55:52
In reply to Re: back on nardil, posted by PeterMartin on March 23, 2014, at 8:47:51
Anyway back to the original post which asked for support. A lot of people have success in MAOis - I'm one of those people. Tried so many different meds between 2000 and 2009 but nothing seemed to keep me from feeling like I need to try something else......that was until early 2010 when I was allowed to add Parnate to a Lamictal/Lithium base that had kept me afloat. Parnate ended up raising my BP a lot after dosing so my doc and I decided to give Marplan a try. Four years later I'm still on the same med cocktail, no longer drink alcohol to help cope, and have made good strides toward becoming "well" and not constantly thinking of myself as I'll.
Whatever the mechanisms the MAOi class has been around since the 60s and they work we for some like me where other classes don't. I wish you the best.
-P
Posted by kirkglen on March 23, 2014, at 10:42:54
In reply to Re: back on nardil, posted by PeterMartin on March 23, 2014, at 8:47:51
Peter
I see that you sleep a lot on Nardil. I've been using it for 30+ years and have tried many things to halt the sleeping. I would/ still do document everything I did,ate, drank, etc.
For me the following helped a lot:
No peanuts, beer, definitely "NO SWEETS". When I do mess up I force myself to get up and take a cold shower. I've had times I would sleep for 2-3 days.
That all sounds easy but it's difficult to discipline ourselves. Hope this helps.
This is the end of the thread.
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