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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 swim on February 2, 2016, at 8:48:50
i'm wondering here why does Nardil stop working after time(usally few years for me), is it because of the receptor down regulation or because of DE, NE depletion through its metabolite PEA or maybe something else? Any ideas how to prevent it? I'm just about to start it again and already thinking of augmenting vitamin b6 as suggested on the Wikipedia article.
Posted by john locke on February 3, 2016, at 19:17:55
In reply to way to prevent nardil tolerance?, posted by swim on February 2, 2016, at 8:48:50
> i'm wondering here why does Nardil stop working after time(usally few years for me), is it because of the receptor down regulation or because of DE, NE depletion through its metabolite PEA or maybe something else? Any ideas how to prevent it? I'm just about to start it again and already thinking of augmenting vitamin b6 as suggested on the Wikipedia article.
Maybe you should try augmentation. I've read about augmenting Nardil with lamictal...wellbutrin...lithium...lyrica...to name a few, in order to prevent poop out. I think I remember reading about lithium working well for someone in this respect.
Posted by paulb on February 3, 2016, at 19:33:25
In reply to way to prevent nardil tolerance?, posted by swim on February 2, 2016, at 8:48:50
My guess would be that there is a certain degree of downregulation at the receptor level. Your unlikely to get the boost you get from it initially again unless you take a fairly long break from it however id bet that you can keep it working at an even keel just to keep you at a level playing field i.e normal. How? Well theres many augmentation atrtegies and im not recommending this unless under the guidance of a qualified physician but the use of amino acids and SAM-E to work with the amino acids. They convert directly to sertonin, noradrenaline and dopamine. Aumentation stategies like buspirone, pindolol, etc works only so so "IMO" however please do seek guidance if you consider the combination of an amino acid with MAOI. Augmentation strategies with other medications may, however, work better for you. Everyone is different. If you want the boost I have heard tell of skilled psychopharmacologists using amphetamine in small doses with MAOI's with good results. Take care. PB
Posted by swim on February 4, 2016, at 5:49:52
In reply to Re: way to prevent nardil tolerance?, posted by paulb on February 3, 2016, at 19:33:25
thanks pb, i will look in to the amino-acid augmentation
Posted by SLS on February 4, 2016, at 7:08:06
In reply to way to prevent nardil tolerance?, posted by swim on February 2, 2016, at 8:48:50
Maybe methylfolate (Deplin)? Methylfolate is the active form of folic acid and is found naturally in the body. Supposedly, it helps to accelerate neurotransmitter synthesis. Who knows? In any event, the crew at Harvard/Mass G. worked with folate for quite awhile and deemed it useful in the treatment of depression. Blood levels of folate are often low in depression.
The suggestion to remain abstinent from Nardil for at least three months before restarting it has been practiced by some doctors in the past. I knew one doctor who found it necessary to cycle a patient by switching him back and forth between Parnate and Nardil. Have you tried Parnate?
For me, adding a selective noradrenergic tricyclic antidepressant TCA (desipramine, nortriptyline) to Nardil is necessary for me to maintain a response.
- Scott
Posted by Lamdage22 on February 5, 2016, at 5:24:45
In reply to Re: way to prevent nardil tolerance? » swim, posted by SLS on February 4, 2016, at 7:08:06
Scott what dosage of methylfolate?
10mg?
thx
Posted by SLS on February 5, 2016, at 7:43:13
In reply to Re: way to prevent nardil tolerance?, posted by Lamdage22 on February 5, 2016, at 5:24:45
> Scott what dosage of methylfolate?
>
> 10mg?
>
> thxThe Deplin brand of L-methylfolate is supposed to be taken as 7.5-15.0 mg/day.
L-methylfolate is also available as a non-pharmaceutical grade supplement, which is much less expensive.
I added Deplin to Nardil and experienced a significant and rapid improvement in depression. It just didn't last for very long, but this is nothing new in my case.
- Scott
Posted by Lamdage22 on February 5, 2016, at 7:45:36
In reply to Re: way to prevent nardil tolerance? » Lamdage22, posted by SLS on February 5, 2016, at 7:43:13
I ordered 5mg pills from Thorne research.
Good brand i think.
The benefits of Methylfolate where subtile but evident in the past.
Posted by PeterMartin on February 11, 2016, at 1:55:02
In reply to Re: way to prevent nardil tolerance? » swim, posted by SLS on February 4, 2016, at 7:08:06
I didn't have great success with deplin but I recently came across this study that may explain why. It suggests it can block some of the benefits of Lamictal (which I've taken for a number of years):
http://www.ncbi.nlm.nih.gov/pubmed/26687300
Posted by SLS on February 11, 2016, at 8:06:18
In reply to Re: way to prevent nardil tolerance?, posted by PeterMartin on February 11, 2016, at 1:55:02
> I didn't have great success with deplin but I recently came across this study that may explain why. It suggests it can block some of the benefits of Lamictal (which I've taken for a number of years):
>
> http://www.ncbi.nlm.nih.gov/pubmed/26687300Nice find.
- Scott
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