Psycho-Babble Medication Thread 283363

Shown: posts 57 to 81 of 95. Go back in thread:

 

Re: posting policies

Posted by Dr. Bob on January 12, 2004, at 22:48:50

In reply to Re: please be civil, posted by Dave Hammond on January 10, 2004, at 17:10:21

> I'm sorry I posted this, since it's a carry over from another board and it's not a polite statement.

Thanks.

> > PS: Follow-ups regarding posting policies should be redirect to Psycho-Babble Administration
>
> I'm sorry but I honestly do not understand what you are saying

Just that if there's any further discussion about civility or related issues, I'd rather it took place at PBA (another board) than here, that's all. Best wishes,

Bob

 

Re: posting policies

Posted by Dave Hammond on January 12, 2004, at 23:21:17

In reply to Re: posting policies, posted by Dr. Bob on January 12, 2004, at 22:48:50

Certainly Dr. Bob. I am sorry I allowed this incident to occur at all.

 

Re: Just Tell Me the Excipients, Please?

Posted by Spotcheck on January 27, 2004, at 17:33:13

In reply to Just Tell Me the Expients, Please? (nm), posted by Dave Hammond on January 8, 2004, at 19:54:24

Excuse me for misspelling this word, Ace. We were both incorrect but this is correct.

 

Re: COMPAINTS REGARDING NEW NARDIL

Posted by luther on January 31, 2004, at 6:11:59

In reply to COMPAINTS REGARDING NEW NARDIL, posted by ace on November 24, 2003, at 18:59:51

> PLEASE COMPLAIN TO BOTH THE FDA AND PFIZER...
>
> YOU CAN COMPLAIN ONLINE OR BY PHONE- PHONE IF POSSIBLE.
>
> THE NEW NARDIL IS NOT EFFECTIVE. THE OLD NARDIL IS EXTREMELY EFFECTIVE.
>
> CHECK OUT 'ANXIETY COMMUNITY- NARDIL MEDICATION' IN GOOGLE SEARCH FOR MORE DETAILS.
>
> C'MON GUYS! LETS FIGHT THIS BATTLE AND WIN!
>
> ACE.

I'm behind ya 100% ACE, but what can we do? I did call Pfizer in October and was mad as hell to have my life taken away from me after 12 years of Nardil. They gave me a refund on my prescription, but no explanation on why the new stuff doesn't work other than the Gluten coating being removed. They then contacted my doctor and asked him why he was giving me Nardil when I said to Pfizer it doesn't work, do believe that BS!! I had to explain to my doctor what really transpired and showed him my refund as well. He actually agreed with me that they are up to something! We know the pharmaceutical companies, it must have something to do with money, I just haven't figured it out yet. I'm sorry to say they will never change it back, only possibly discontinue it if we complain. Somehow I feel this is really their objective. They are afraid of lawsuits because of all the side-effects that are way overrated! Remember they just took over Park Davis and some idiot bean counter that knows nothing about psychology probably looked at the side effects and figured they had better do something. I'm just out guessing because I really can't figure out why they would make something ineffective and loose money on a product when patients will stop purchasing it. I would really would like to hear any comments anyone has, because I would like to do something about it as well, maybe a jail break for the unibomber, lol, just kidding for the Homeland Security folks out there monitoring this stuff. My e-mail is:luthermeeks@peoplepc.com and I would really like to hear any ideas, if I get some good one's we will follow through on them!!
Sincerely,
Luther

 

Re: Thank You Shy! Dave Hammond

Posted by luther on January 31, 2004, at 7:20:03

In reply to Thank You Shy!, posted by Dave Hammond on January 11, 2004, at 10:32:18

> Shy, you stick with this now. Have your Pharmacist find out where Link is and who distributes their product. It should allow you to start living a much better life again, which is exactly what I hope happens for you, because I remember the pain and agony I suffered until I finally found Nardil.
>
> As for me, the story remains problematical. If the ingredients in Link's Nardil are close enough to the original 1959 Lake Pharmaceutical specifications (there should be about 15 of them in it) then I'll fly to Australia to get my prescriptions filled. Perhaps later I could work something else out that is more convenient.
>
> However, if they are closer to the "new" Nardil that Pfizer now makes (9 ingredients only -- only 3 of which are the same as the old formula), then it will not help me for the same reason the "new" Nardil doesn't. My body cannot take have that high a concentration of Phenelzine in my blood stream without it causing me serious trouble.
>
> Now, this might actually be a hybrid of these two,
> in which case I'll simply have to try it to see how my body metabolizes it. Yes, I could clobber Pfizer for changing this, but they did and they are not going to change it back.
>
> So, while you have your pharmacist on the telephone, please have him/her find out what the "inactive ingredients" are in Link's Nardil and then we will have some idea of what it really is. Just make sure they do it, because in America everything is becoming so depersonalized, that one can barely get a word out of one's pharmacist these days.
>
> Still, it is the inactive ingredients that finally determine how any drug is metabolized and that is the key.
>
> But believe me, people can and do bail out of these fora the once they start feeling better, because everything is all right for them again. And that is a perfectly natural act to commit -- one I would also do once I figured this out -- if I ever do, that is. However, now that I have been dealt this setback, I am going to start coming back to the two places I frequent, and see how people are doing, so I can help them if that's possible. Because there is nothing worse than not getting any help when one genuinely needs it.
>
> Shy, I cannot adequately express to you how grateful I would be if you would follow up on your promise to assist me. I mean I truly would not know what to say, but I would most assuredly be elated. That much I promise. And if there is anything that I can help you with all you have to do is ask me, and I will do my very best to help you too!
>
> An overly verbose,
>
> Dave

Hello Dave,
I'm sorry you are still suffering like the rest of us, it really sucks to put it mildly. I replied to you once before and didn't you say you were taking 37 & 1/2 mg. of Nardil? This is a very low dose and I remember you said you were taking something along with it, possibly a Tricyclic? Nardil comes in 15 mg. tablets, how do you take 37 & 1/2 mg? Did you get it mixed up with your other med? What have you been diagnosed with, I'm not saying I know more than all the doctors, just most of them. I did graduate from Ball State University and had to diagnose myself as my doctor was incapable of doing so. Then after I found the medications that would work for my Atypical Depression, Social Anxiety Disorder and Generalized Anxiety Disorder she was reluctant to write the prescriptions. Only after I threatened to see someone else did she give in, $$$. Now I have nothing that works, Nardil was changed by Pfizer for the worst, read my new posting. We need to take some of the old and some of the new to an independent lab and have the stuff analyzed. If it really it different we need to all get together and file a Class Action Law Suit! It doesn't matter if the FDA approved it or not, they are not above the law either. The only people above the law is Budweiser Bush Skywalker and all his Texas friends and Enron-WorldCom buddies. Did you know Tipper Gore has been treated for depression most of her life? Guess what med? Nardil, you got it. Is Martha Stewart as bad as the Enron guys that stold all the employee's savings, hell no? She did contribute a large amount of money to the Gore campaign though. Enough about all that, a few different votes in Florida and we wouldn't even be dealing with this, I promise. We can't change the past though, so we must work like hell on the future and make Pfizer pay. I'm just not so sure what they have done is by accident. They are greedy and want to make more money, but if something doesn't work how can they do that? Something is in the wind, I just can't put the pieces together, like the JFK assination, which I consider myself to be an expert. Take Care! Hope I can be of some help.
Sincerely,
Luther

 

Hey there Luther........ luther

Posted by Spotcheck on January 31, 2004, at 11:51:09

In reply to Re: Thank You Shy! Dave Hammond, posted by luther on January 31, 2004, at 7:20:03

Hello Brian. I changed my online name for this forum, so this one you will not recognize, but we did e-mail each other a couple of times, about one month ago - I would estimate -- so we are familiar with each other cases more or less:

"Hello Dave,I'm sorry you are still suffering like the rest of us, it really sucks to put it mildly. I replied to you once before and didn't you say you were taking 37 & 1/2 mg. of Nardil?

Yes, I certainly did.

"This is a very low dose and I remember you said you were taking something along with it, possibly
Tricyclic?"

100 mg of Amitriptyline along with it -- my primary antidepressant anti-anxiety medication.

"Nardil comes in 15 mg. tablets, how do you take 37 & 1/2 mg? Did you get it mixed up with your other med?"

No, and all you have to do is take 2, 15 mg tablets and cut another 15 mg in half. It's not hard to do at all.

"What have you been diagnosed with......"

Atypical depression, Brian, remember?

"Now I have nothing that works,"

I know it, and I have been worried about you as well as myself and several other people ever since we first talked, Brian.

"Nardil was changed by Pfizer for the worst, read my new posting. We need to take some of the old and some of the new to an independent lab and have the stuff analyzed. If it really it different"

Brian the Phenelzine Sulfate in the "new" Nardil is identical to the same active ingredient in the "old" Nardil -- Phenelzine sulfate. It is the inactive ingredients known also as the excipients that have radically altered so that a less expensive and more stable medication could be made. It is these excipients that actually determine how any drug is metabolized - not the Phenelzine per se. Does that make sense to you at all yet, because I am throwing allot at you?

"we need to all get together and file a Class Action Law Suit! It doesn't matter if the FDA approved it or not, they are not above the law
either."

But Pfizer broke no laws, Brian. She, and other drug companies, are free to change any drug they manufacture any time they want to. So you will get nowhere attempting to sue Pfizer. You will not even be able to find a lawyer who will take the case. All Pfizer has to do is produce something that is "in vitro" not "in vivo" bio-equivalent to the "old" Nardil. Well, guess what? The "new" Nardil really is in vitro bio-equivalent to the "old." It's simply metabolized differently because of the radical chance in excipients now being used. That is why we are in such trouble, and that is also why Pfizer is not.

"Enough about all that, a few different votes in Florida and we wouldn't even be dealing with this, I promise."

This is quite simply incorrect, Brian, even though I agree your assessment of the last election. Pfizer broke no laws. She changed her drug because MAO Inhibitors are no longer being prescribed as much as they used to be, and so they just sit around and go flat. Well, guess what happens when some pharmacist sells "flat" Nardil to customers? The people who take it relapse, and then Pfizer and that pharmacist and perhaps even the chain they are working for are in trouble, which is real the reason why Pfizer changed this medication in the first place.

"I'm just not so sure what they have done is by accident."

Of course it wasn't. Pfizer found out she could be hurt by selling Phenelzine in the older formulation. She had to change it and when she did, she made something that is metabolized differently -- which would have to be the case. Still, it was not done out of malice, Brain, even though I once though this myself.

"They are greedy and want to make more money, but if something doesn't work how can they do that?"

It does work in most people, Brian, and that is precisely the problem. And they have to take a bit higher dosage -- which is my real problem, because my therapeutic window is smaller that most other people who only have to take Nardil.
Pfizer will continue to make money and, in fact, she is doing exactly that.

"Something is in the wind, I just can't put the pieces together,"

Re-read everything I said above, and if you still have any questions, please do not hesitate to ask them, all right?

Brain, I still believe that one of us or all of us are going to have to make our own "old" Nardil ourselves. The problem with this idea is twofold, but here they are:

1. We must gain access to the manufacturing specifications of the "old" Nardil, which might only exist inside Parke-Davis - a division of Pfizer. I am not certain of that. They might also exist elsewhere, but so far I have not been able to find them and I have been looking a bit, but not enough.

2. We will probably have to spend quite a bit of money to do this.

Still, it's very probably your only chance of saving yourself. So why don't we figure this together and do it?

You see Pfizer is NEVER going to make the "old" Nardil again. I urge you to get cracking in this direction, if you can, that is.

 

Re: Hey there Luther........ (nm) Spotcheck

Posted by luther on February 1, 2004, at 0:44:12

In reply to Hey there Luther........ luther, posted by Spotcheck on January 31, 2004, at 11:51:09

 

Re: Nardil from Australia = 1950's version.

Posted by SuzyQ1 on April 9, 2004, at 18:34:46

In reply to Re: Nardil from Australia = 1950's version., posted by luther on December 15, 2003, at 12:08:49

I've been on Nardil since 1979, which would make it 25 years this July 2004. It literally saved my life. For the past few months, I've been on the new formula, and it seems that little by little, it's losing its effectiveness. I thought it was in my mind, til I read all these posts. I've been under some extra stress lately, so I'm not sure if it's psychological, or actually that the drug is not working as well as the earlier version. I take 30 mg. daily (2 pills), and have been fine on that dose for half of the time I've been on Nardil. For the first 12 years or so, I was on 60 mg. daily. I was able to slowly reduce the dose to 30mg. I'm not sure what's going on, but I sure hope that it's not the new formula, and is just a phase I'm going through. But I'm seriously considering increasing my dose to 45 mg. for the first time in a long time, as I'm feeling very anxious as well as shaky, even when I try to talk. I wonder if anyone else has had these symptoms? If anyone can get proof that the formula has indeed been changed to make it less effective (even if it's something in the inactive ingredients), then I think that we should file a class action suit against Pfizer. My life could literally depend on it. Also, has anyone heard of the new Selegiline Patch called EMSAM, By Somerset Pharmaceuticals, which is supposed to be approved by the FDA sometime this year? It's supposed to work similarly to Nardil, as it increases the levels of serotonin, norepinephrine, and dopamine in the brain, the same as Nardil, but with no food or drug interaction, since it bypasses the stomach.

 

Re: Nardil from Australia = 1950's version.

Posted by King Vultan on April 9, 2004, at 19:55:14

In reply to Re: Nardil from Australia = 1950's version., posted by SuzyQ1 on April 9, 2004, at 18:34:46

Well, the formula has definitely been changed, and the changes are all in the so-called inactive ingredients. The drug itself, phenelzine sulfate, is still the same. However, the inactive ingredients can have an effect on the absorption rate, which is apparently why some people are having difficulties.

From what my doctor said, it sounds like there were similar problems back when Tofranil (imipramine) went generic years and years ago. People would all of a sudden start having problems and complaining of reduced effectiveness. He would ask if the pill was the same, and they would reply no, it was different. With imipramine, it was a simple matter to run a blood plasma level and determine that the level of the drug in the blood had dropped. The reason was that the contents of the pill were passing through the system in a different manner, resulting in less ultimately getting absorbed into the blood.

From what you're saying about your experience since the new formulation came out, yes, it does sound like it would probably be a good thing to try going up by one pill, but I'm always in favor of including your doctor in this decision. I'm a newcomer to this drug and have only been on it for a month and half, so I do not know how the old formulation compared. I will say that for me, 45 mg/day had no effect at all, 60 mg/day started producing adverse effects (insomnia), as well as some slight therapeutic effects, and 75 mg/day is producing enough improvement in my mood that I want to hold it here for a while and see what the ultimate effect of the dosage will be. There is a school of thought that an effective Nardil dosage is related to one's weight, with a person needing to take at least 1 mg/kg/day, at least at the beginning of treatment (I am about 65 kg); however, this number is based on the old formulation. I have read that, yes, lowered maintenance dosages for Nardil are sometimes used.

As for Pfizer's responsibility in all this, I don't know what the root cause of their changing the formulation was. I've heard stuff about increasing shelf life, but you have to wonder why this would be necessary when the drug appears to have been working fine for decades. I tend to be cynical about what large companies say, but as someone who also works in the formulation industry, I can tell you that there are often legitimate reasons for changing a formulation. In any case, if a person happens to be one of the individuals who is sensitive to the formulation change but can restore the original effects just by taking an extra pill or two, that doesn't sound that horrible. Considering the fairly miniscule number of people taking Nardil, I think it's fortunate that it's still being produced.

Todd

 

Re: Nardil from Australia = 1950's version.

Posted by Spotcheck on April 9, 2004, at 22:49:56

In reply to Re: Nardil from Australia = 1950's version., posted by SuzyQ1 on April 9, 2004, at 18:34:46

We've been on Nardil for almost exactly the same number of years since I first found it for my Psychiatrist in 1978. He was raw one might say. I had to break him in some. It was rough on both of us, but worth it of course.

"For the past few months, I've been on the new formula, and it seems that little by little, it's losing its effectiveness. I thought it was in my mind, til I read all these posts. I've been under some extra stress lately, so I'm not sure if it's psychological, or actually that the drug is not working as well as the earlier version. I take 30 mg. daily (2 pills), and have been fine on that dose for half of the time I've been on Nardil."

That's a low dosage relatively speaking. I now take 45 mg of the new, whereas I only had to take 37.5 mg of the old. I had to kick it up a bit because it's not as effective, which did not please me, although I had no choice.

"For the first 12 years or so, I was on 60 mg. daily. I was able to slowly reduce the dose to 30mg. I'm not sure what's going on, but I sure hope that it's not the new formula, and is just a phase I'm going through. But I'm seriously considering increasing my dose to 45 mg."

If you have to, go ahead and increase the dosage.
There will be an increase in side-effects, but if this is the only medication you take that should no problem at all.

"for the first time in a long time, as I'm feeling very anxious as well as shaky, even when I try to talk. I wonder if anyone else has had these symptoms?"

Yes, allot of people have, Sue, but so far not me, thank God although it took me two or three trials to get the dosage right, because I take another antidepressant as well. Some people do not respond to it at all, and you well know, that is personally disastrous to them! I've seen careers wrecked over this change in Nardil and people's lives dramatically altered one might say.

"If anyone can get proof that the formula has indeed been changed to make it less effective (even if it's something in the inactive ingredients), then I think that we should file a class action suit against Pfizer. My life could
literally depend on it."

I know your life depends upon this medication. Here's the story: of the 15 original excipients in the good "old" Nardil, only 3 remain unchanged and the number of excipients has been reduced to 9 in the "new" Nardil. What Pfizer did is to use the FDA to legally turn Nardil into a generic drug. There is no more "old" Nardil being made in the world to the best of my knowledge, and only Link UK makes another generic version. Link Australia, which will cannot important their Nardil into America uses Link UK's formula, but then actually go to the effort and expense, I might say of adding the old sucrose M and M orange sucrose coating to their Nardil for some reason.

"Also, has anyone heard of the new Selegiline Patch called EMSAM, By Somerset Pharmaceuticals, which is supposed to be approved by the FDA sometime this year?"

I have heard a patch was coming out, but I never knew the manufacturer before. Thank you. That might prove useful indeed.

"It's supposed to work similarly to Nardil, as it increases the levels of serotonin, norepinephrine, and dopamine in the brain, the same as Nardil, but with no food or drug interaction, since it bypasses the stomach."

Yes, but it also increase the concentration of Gamma Amino Butyric Acid (GABA) as Phenelzine Sulfate does? Because if it does not, then I do not see how it can possibly be as effective in treating anxiety disorders as Phenelzine Sulfate is with the proper excipients.. Thank you for this information though, Sue.

 

Re: Nardil from Australia = 1950's version.

Posted by gardenergirl on April 10, 2004, at 11:12:41

In reply to Re: Nardil from Australia = 1950's version., posted by King Vultan on April 9, 2004, at 19:55:14

>Considering the fairly miniscule number of people taking Nardil, I think it's fortunate that it's still being produced.

Bite your tongue! :) Acutally I have had the same thought, but I hate to voice it. It would be devastating to lose Nardil.

gg

 

Above for KV, oops (nm)

Posted by gardenergirl on April 10, 2004, at 11:13:24

In reply to Re: Nardil from Australia = 1950's version., posted by gardenergirl on April 10, 2004, at 11:12:41

 

Re: Nardil from Australia = 1950's version.KV

Posted by Spotcheck on April 10, 2004, at 20:25:24

In reply to Re: Nardil from Australia = 1950's version., posted by King Vultan on April 9, 2004, at 19:55:14

Hello Todd,

As for Pfizer's reason for changing Nardil formulation, that truth is most probably disputable by us. On one hand, I have some old Nardil dispensed to me in the calendar year 2000 which is potent to this day. Hence, using this information, it's rather difficult for me to believe the change was necessary. You have never used this formulation before, and so you cannot know that it is indisputable a better formulation than the one that exists today and what you are taking right now. There is nobody would not go back to the old Nardil ASAP -- if they could -- that is at least among the 50 people or so that I have talked to in the last year. You would too!

On the other hand, Pfizer's Subsidiary Parke-Davis, apparently had some potency problems with Nardil and had to recall several lots. Some people were dispensed a medication which did not work, thus causing their symptoms to reappear. I honestly do not know that the problem here was, but if an excipient suddenly was no longer available, it could indeed force a change to a different formula. Since you know more about this than I do, I will leave up to your imagination as to what actually caused Pfizer to change, but her
statement is generally both shelf-life and dissolution rate.

Here's is what I would very much like to address with you, however, especially since you brought it up:

"In any case, if a person happens to be one of the individuals who is sensitive to the formulation change but can restore the original effects just by taking an extra pill or two, that doesn't sound that horrible."

Agreed, but what happens to the individuals who do not respond well or at all the new formulation? Would you care to hazard a guess as to what happens to them? That is what I honestly want to know. Excuse me very much if this appears belligerent. I just happen to know several people who are in exactly this position. I could sure use any ideas that might assist them.

David

 

Nardil and Selegline

Posted by Strat on April 10, 2004, at 21:47:24

In reply to Re: Nardil from Australia = 1950's version., posted by Spotcheck on April 9, 2004, at 22:49:56

Hello, all! I do wish some of you would come over and post on the other anxiety board; Spotcheck, you sound very knowledgeable, we could all use your input. We've all filed MedWatch forms, called Pfizer and done what we can to get attention. Won't you please stop by there, as well?

http://www.anxietyhelp.org/treatment/medication/nardil.html

Thanks!
Strat

 

Re: Nardil from Australia = 1950's version.KV Spotcheck

Posted by King Vultan on April 11, 2004, at 10:58:01

In reply to Re: Nardil from Australia = 1950's version.KV, posted by Spotcheck on April 10, 2004, at 20:25:24

Sorry if I came across as unsympathetic, as I think it's extremely unfortunate that so many people have suffered as a result of the Nardil formulation change. However, it is true that the number of people taking Nardil is tiny compared to the number taking Zoloft, for example. Having some experience with the way high and low volume compounds are differentiated and also some familiarity with the way big companies think, I think it's likely that the reformulation was done with less care than it should have been.

For the people who have been negatively affected by the formulation change, all I can suggest is to increase dosage and attempt to find a level, which hopefully actually exists, that will provide the same efficacy as did the former dosage of the old formulation. Everyone is agreed that the active ingredient, phenelzine sulfate, is unchanged and still in the pills, and my conclusion is that it's a very similar issue as the imipramine matter I referred to in my other post--the absorption rate has changed for those negatively affected by this, and not as much Nardil is actually making it into people's systems. I don't know if the old maximum dosage of 90 mg/day still holds true, but if I were someone who had successfully been on this drug for years, I think the reasonable and prudent thing to do would be to start increasing dosage and communicate with other affected users as to the results.

I do think Pfizer should be taking the complaints into account and informing doctors and pharmacies about the formulation change and its potential ramifications. I guess that's too much to expect from a big corporation, though.

Todd

 

Re: Nardil from Australia = 1950's version.KV King Vultan

Posted by Spotcheck on April 11, 2004, at 13:50:59

In reply to Re: Nardil from Australia = 1950's version.KV Spotcheck, posted by King Vultan on April 11, 2004, at 10:58:01

That's just the problem though Todd. These people do not respond to the new Nardil no matter what dosage level the choose. They can push the dosage as high as 120 mg and still not get enough Phenelzine Sulfate dissolved in the fats of their nervous system to help them at all.

Furthermore, it is quite true that Pfizer began having potency problems with the old Nardil. If you run a search on this problem you will find the exact dates and lots that she had to pull. So what began happening is that people would be dispensed Nardil, but their symptoms would return because the Nardil that they were taking was no longer potent enough to do them any good. In the end, I suspect the decision was made to continue producing Nardil, but to change the excipients from 15 in the old to 9 in the new only 3 of which remained the same. Hence, the new Nardil never was going to be metabolized by as many people due to the number of changes made here. That still might well have been the best Pfizer could do -- if they could not straighten out their manufacturing problem.

They will happily take your complaints, but they cannot do a bloody thing about them, so to complain is virtually worthless.

My recommendation would be then to prescribe either Parnate or Venlafaxine (EffexorRX) since Venlafaxine is the most balanced of the SNRIs out there and is a potent reuptake blocker of BOTH 5HT and NE that has a long half-life. Then, I would recommend people hang on using one of these two medications, and any other adjunct medications that worked well with them, until the FDA finally passes the Selegiline Patch called EMSAM which is manufactured by Somerset Pharmaceuticals that SuzyQ1 mentioned above. That rascal will increase brain concentrations of 5HT, NE and DA -- which is almost exactly what Nardil does, although not quite. Phenelzine Sulfate with the proper excipients or when it is also properly metabolized also increases the brain concentrations Gamma Amino Butyric Acid (GABA) which I have long suspects helps people cope with anxiety disorders.

Todd, I never did mean for you to think that I thought you were insensitive to this issue at all. I just think your explanation about this entire Nardil mess is incorrect as to why Pfizer actually did change Nardil. I think she pretty much had no other choice except to stop producing it entirely.

And of course I have gotten together was a flock of Nardil uses who are having problems with the new Nardil, and we attempt to keep each other going and figure out solutions to this problem in particular. Come visit us at the Anxiety board since this is pretty much all we do talk about.

You can find the link in Strat's post, in fact, if you wish to visit. If you can think of any thing else that can be done though kindly post something about it, will you please?

Thank you very much for replying to this post.

Dave

 

Re: Nardil from Australia = 1950's version.KV Spotcheck

Posted by King Vultan on April 11, 2004, at 17:04:57

In reply to Re: Nardil from Australia = 1950's version.KV King Vultan, posted by Spotcheck on April 11, 2004, at 13:50:59

I quite agree that either Parnate or Effexor would be the drugs to go to for those for whom the Nardil is unfortunately no longer effective. I'm curious as to whether you have an estimation as to what percent of Nardil users have been negatively affected by the formulation change. Are there some people who have not noticed a difference?

Thanks,
Todd

 

Re: Nardil from Australia = 1950's version.JV King Vultan

Posted by Spotcheck on April 11, 2004, at 18:45:38

In reply to Re: Nardil from Australia = 1950's version.KV Spotcheck, posted by King Vultan on April 11, 2004, at 17:04:57

I do not have any statistic -- yet -- that would tell me what percentage of Nardil users fail to respond to the new Nardil. Pfizer might have some of course, but I don't. I have run across about 10 people, but I suspect there are more. One has been able to move to Lamictal -- an atypical antidepressant. For some Parnate does not work on them at all, while in others it helps them only somewhat. However, it definitely does not work as well as the old Nardil did by anyone's standards.

When the new Nardil does not work or begins to fade and actually fails, it's a tragic event to witness, let me tell you. My heart drops whenever I read someone's post to that effect. In SuzieQ1's post, I suspect that all she really has to do is increase the dosage and she will be just fine. She is expecting the new Nardil to work as well as the old Nardil did which is a common mistake.

"Are there some people who have not noticed a difference?"

Everyone has noticed a difference Todd, and everyone would much rather be taking the old Nardil rather the the new. Only those who have never taken the old before cannot know the difference. For the most part we have all had to increase the dosage we take of the old to achieve a similar effect.

 

Re: Nardil from Australia = 1950's version.JV

Posted by djmmm on April 13, 2004, at 12:52:20

In reply to Re: Nardil from Australia = 1950's version.JV King Vultan, posted by Spotcheck on April 11, 2004, at 18:45:38

> I do not have any statistic -- yet -- that would tell me what percentage of Nardil users fail to respond to the new Nardil. Pfizer might have some of course, but I don't. I have run across about 10 people, but I suspect there are more. One has been able to move to Lamictal -- an atypical antidepressant. For some Parnate does not work on them at all, while in others it helps them only somewhat. However, it definitely does not work as well as the old Nardil did by anyone's standards.
>
> When the new Nardil does not work or begins to fade and actually fails, it's a tragic event to witness, let me tell you. My heart drops whenever I read someone's post to that effect. In SuzieQ1's post, I suspect that all she really has to do is increase the dosage and she will be just fine. She is expecting the new Nardil to work as well as the old Nardil did which is a common mistake.
>
> "Are there some people who have not noticed a difference?"
>
> Everyone has noticed a difference Todd, and everyone would much rather be taking the old Nardil rather the the new. Only those who have never taken the old before cannot know the difference. For the most part we have all had to increase the dosage we take of the old to achieve a similar effect.

that's not true...I took Nardil (the "older" version) for a few years..was off it, and have been back on the "new" Nardil for a few months. Other than the HORRIBLE "plastic/glue" taste, my dosage of 60mg has been fine....so count me as, apparently, the only one that DOESN'T notice an efficacy difference....

I think that a select few people have created this non-effective Nardil "hysteria" and it has spread like wildfire (through that OTHER med forum) I do miss that orange candy coating...my GOD does the newer Nardil taste bad.

 

Re: Nardil from Australia = 1950's version.JV

Posted by Spotcheck on April 13, 2004, at 16:14:50

In reply to Re: Nardil from Australia = 1950's version.JV, posted by djmmm on April 13, 2004, at 12:52:20

"that's not true...I took Nardil (the "older" version) for a few years..was off it, and have been back on the "new" Nardil for a few months. Other than the HORRIBLE "plastic/glue" taste, my dosage of 60mg has been fine....so count me as, apparently, the only one that DOESN'T notice an efficacy difference...."

All right, but you are still an exception, not the rule so far that is. I have no statistics on how many old Nardil customers respond to the new Nardil. Only that would really tell us the story. Nevertheless, I will not retract my statement that everyone would prefer the old Nardil even in you case since you find the tastes to be an irritant. I have heard if from others but it doesn't bother me at all. Nevertheless, I agree, that this can happen. I have just found it be rare.

"I think that a select few people have created this non-effective Nardil "hysteria" and it has spread like wildfire (through that OTHER med forum) I do miss that orange candy coating...my
GOD does the newer Nardil taste bad."

If this is what you think, then in my estimation alone, you know relatively little about medication pharmacology especially in tablet form. You see what really determines how any active ingredient, like phenelzine sulfate, is metabolized is not the phenelzine sulfate, djimm. The excipients or inactive ingredients that accompany the active ingredient do that. Otherwise, I should be to take straight Phenelzine Sulfate, put it in a glass of water (guess what? It will not even dissolve uniformly in H20 in my experiments) and you could drink that down, and it work just like the old Nardil. Well, sadly that is not the case my friend.
Consider this well: of the 15 original excipients in old Nardil, which I can and will enumerate if necessary, only 3 remain the same in the new Nardil, and the number of excipients dropped to 9 in the new Nardil as well. When a generic drug is made, there is no telling how well it will be metabolized. Did you not read KV's post to SuzyQ1 about the same problems in Tofranil, I believe, he said? Therefore, when Pfizer made this change, she was virtually guaranteeing that some small percentage of customers would not metabolize it well -- if at all and that is indeed the reality of this situation.

If I had a laboratory that was well equipped, I could make a generic Phenelzine that was in vitro bioequvalent to the old Nardil and so would pass the FDA under the ANDA = Abbreviated New Drug Application, which requires no animal or human trials, that your body would not metabolize. I actually already did with my H2O example. Then, we would see for yourself if your hypothesis of hysteria above is correct or incorrect. Yes, would be in rough shape exactly as these people are. So please do not make such rash assumptions henceforth, all right?

Dr. Bob, I apologize in advance if you think the tone of this post is too antagonistic. It is my intention to explain something important to this individual in particular and also to drive home with an example that would create this effect him him/her. Chastise me if you must.

 

Re: please be civil Spotcheck

Posted by Dr. Bob on April 13, 2004, at 20:41:15

In reply to Re: Nardil from Australia = 1950's version.JV, posted by Spotcheck on April 13, 2004, at 16:14:50

> If this is what you think, then in my estimation alone, you know relatively little about medication pharmacology

> Dr. Bob, I apologize in advance if you think the tone of this post is too antagonistic. It is my intention to explain something important to this individual in particular and also to drive home with an example that would create this effect him him/her. Chastise me if you must.

Please don't post anything that could lead others to feel accused or put down. It's possible to explain things without doing that.

If you have any questions or comments about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:

http://www.dr-bob.org/babble/faq.html#civil

or redirect a follow-up to Psycho-Babble Administration.

Thanks,

Bob

 

Re: Nardil from Australia = 1950's version.JV

Posted by djmmm on April 13, 2004, at 20:56:59

In reply to Re: Nardil from Australia = 1950's version.JV, posted by Spotcheck on April 13, 2004, at 16:14:50

> "that's not true...I took Nardil (the "older" version) for a few years..was off it, and have been back on the "new" Nardil for a few months. Other than the HORRIBLE "plastic/glue" taste, my dosage of 60mg has been fine....so count me as, apparently, the only one that DOESN'T notice an efficacy difference...."
>
> All right, but you are still an exception, not the rule so far that is. I have no statistics on how many old Nardil customers respond to the new Nardil. Only that would really tell us the story. Nevertheless, I will not retract my statement that everyone would prefer the old Nardil even in you case since you find the tastes to be an irritant. I have heard if from others but it doesn't bother me at all. Nevertheless, I agree, that this can happen. I have just found it be rare.
>
> "I think that a select few people have created this non-effective Nardil "hysteria" and it has spread like wildfire (through that OTHER med forum) I do miss that orange candy coating...my
> GOD does the newer Nardil taste bad."
>
> If this is what you think, then in my estimation alone, you know relatively little about medication pharmacology especially in tablet form. You see what really determines how any active ingredient, like phenelzine sulfate, is metabolized is not the phenelzine sulfate, djimm. The excipients or inactive ingredients that accompany the active ingredient do that.

Im not an idiot. I am aware of the role of inactive ingredients.

Otherwise, I should be to take straight Phenelzine Sulfate, put it in a glass of water (guess what? It will not even dissolve uniformly in H20 in my experiments) and you could drink that down, and it work just like the old Nardil. Well, sadly that is not the case my friend.

--Then you are a poor chemist..phenelzine sulfate dissolves readily in water (Evidence for carcinogenicity to animals)IARC Monographs, 24, 175-184, 1980

> Consider this well: of the 15 original excipients in old Nardil, which I can and will enumerate if necessary, only 3 remain the same in the new Nardil, and the number of excipients dropped to 9 in the new Nardil as well. When a generic drug is made, there is no telling how well it will be metabolized.

--You may not have an accurate grasp of the role of inactive ingredients, or the role of the FDA (when a drug formulation has changed)

Did you not read KV's post to SuzyQ1 about the same problems in Tofranil, I believe, he said? Therefore, when Pfizer made this change, she was virtually guaranteeing that some small percentage of customers would not metabolize it well -- if at all and that is indeed the reality of this situation.

--I just don't believe that...It doesn't make sense..for a company to change inactive ingredients, then inform the consumer that in some people the medication will not work at all... does this make sense to you??


>
> If I had a laboratory that was well equipped, I could make a generic Phenelzine that was in vitro bioequvalent to the old Nardil and so would pass the FDA under the ANDA = Abbreviated New Drug Application, which requires no animal or human trials, that your body would not metabolize.

--That just isn't the entire truth...true with an ANDA, you must demonstrate bioequivalence. The easiest and most common way to do this is with a specified number of HUMAN volunteers. The FDA requires that even ANDA generic meds must deliver the same amount of active ingredients into a patient's bloodstream in the same amount of time as the original patent drug(Waxman-Hatch Act)...regardless of the inactive ingredients. The "new" Nardil was subject to the same strict guidelines as any other drug.


I actually already did with my H2O example. Then, we would see for yourself if your hypothesis of hysteria above is correct or incorrect.

--well since you failed to dissolve phenelzine sulfate in water...

Yes, would be in rough shape exactly as these people are. So please do not make such rash assumptions henceforth, all right?


--I have read the original threads (on a different site) and I can also recall several completely ridiculous statements, one of which claimed that the "new" nardil was Phenelzine HCL, not sulfate...and this ridiculous fallacy was repeated several times in various threads, and believed to be the truth by many.

--FWIW, it is hysteria...drug companies change inative ingredients all the time. What manufacturer would mass produce a medication that is inferior to an older version? What manufaturer would waste millions of $$ in research/development and RISK not only their reputation, but the mental health of ten's of thousands of it's consumers?

--There is NO Nardil conspiracy, and no amount of bombastic, pseudo-scientific jargon will ever convince me otherwise.

>
> Dr. Bob, I apologize in advance if you think the tone of this post is too antagonistic. It is my intention to explain something important to this individual in particular and also to drive home with an example that would create this effect him him/her. Chastise me if you must.

--LOL..don't worry, no offense taken here..and that's what matters, right?

 

Re: Nardil from Australia = 1950's version.JV djmmm

Posted by Spotcheck on April 13, 2004, at 22:48:10

In reply to Re: Nardil from Australia = 1950's version.JV, posted by djmmm on April 13, 2004, at 20:56:59

djimm:

I think that a select few people have created this non-effective Nardil "hysteria" and it has spread like wildfire (through that OTHER med forum) I do miss that orange candy coating...my
GOD does the newer Nardil taste bad.

Spotcheck:

If this is what you think, then in my estimation alone, you know relatively little about medication pharmacology especially in tablet form. You see what really determines how any active ingredient, like phenelzine sulfate, is metabolized is not the phenelzine sulfate, djimm. The excipients or inactive ingredients that accompany the active ingredient do that.

djimm:

"Im not an idiot. I am aware of the role of inactive ingredients."

I never called you an idiot djimm, because I simply would not do that.

Spotcheck:

Otherwise, I should be to take straight Phenelzine Sulfate, put it in a glass of water (guess what? It will not even dissolve uniformly in H20 in my experiments) and you could drink that down, and it work just like the old Nardil.
Well, sadly that is not the case my friend.

djimm:

"Then you are a poor chemist..phenelzine sulfate dissolves readily in water (Evidence for carcinogenicity to animals)IARC Monographs, 24, 175-184, 1980"

Well done, and I stand corrected. It does dissolve much faster in ethyl alcohol though even though this does not erase my error.

Spotcheck:

Consider this well: of the 15 original excipients in old Nardil, which I can and will enumerate if necessary, only 3 remain the same in the new Nardil, and the number of excipients dropped to 9 in the new Nardil as well. When a generic drug is made, there is no telling how well it will be metabolized.

djmmm:

"You may not have an accurate grasp of the role of inactive ingredients, or the role of the FDA (when a drug formulation has changed)"

That's entirely possible, I must confess. However, I would like to know more since I might well need the information. Can you direct me to a source that would better inform me?

Spotcheck:

"Did you not read KV's post to SuzyQ1 about the same problems in Tofranil, I believe, he said? Therefore, when Pfizer made this change, she was virtually guaranteeing that some small percentage of customers would not metabolize it well -- if at all and that is indeed the reality of this situation."

djimm:

"I just don't believe that...It doesn't make sense..for a company to change inactive ingredients, then inform the consumer that in some people the medication will not work at all... does this make sense to you??"

djimm, they really don't inform anyone. The results I am talking about are empirical and based on people's experiences. In this particular case, I have allot of experience. What makes you think that any drug company announces it is changing to a generic drug? All they do is provide a package insert. That's all they have to do, in fact. In the case of new Nardil, they did not inform anyone -- not pharmacists and not doctors, and that's why this row began in fact.

Spotcheck:

If I had a laboratory that was well equipped, I could make a generic Phenelzine that was in vitro bioequvalent to the old Nardil and so would pass the FDA under the ANDA = Abbreviated New Drug Application, which requires no animal or human trials, that your body would not metabolize.

djimm:

"That just isn't the entire truth...true with an ANDA, you must demonstrate bioequivalence."

Exactly! That's precisely why it so easy to create generic using an ANDA. No animal or human trials are required. I can take you to the FDA and demonstrate this, if you would like.

"The easiest and most common way to do this is with a specified number of HUMAN volunteers. The FDA requires that even ANDA generic meds must deliver the same amount of active ingredients into a patient's bloodstream in the same amount of time as the original patent drug(Waxman-Hatch Act)...regardless of the inactive ingredients.
The "new" Nardil was subject to the same strict guidelines as any other drug."

First, I simply disagree with you about what is required to get a drug passed the FDA using an ANDA. That much I have researched, unless Waxman is more recent, and has not yet been posted to the FDA's website. Then, I would be in error.

However, that was never my argument with respect to Nardil, djimm, because Pfizer used what is called an SNDA -- Supplemental New Drug Approval, not an NDA nor an ANDA. It only requires limited human trials.

Spotty:

I actually already did with my H2O example. Then, we would see for yourself if your hypothesis of hysteria above is correct or incorrect.

djimm:

"--well since you failed to dissolve phenelzine sulfate in water..."

It works much better in 200 proof ethyl alcohol. However, even if I was mistaken about the water, that does not rebut what I said here, and I suspect you know it too.

Spotcheck:

Yes, would be in rough shape exactly as these people are. So please do not make such rash assumptions henceforth, all right?

djimm:

--I have read the original threads (on a different site) and I can also recall several completely ridiculous statements, one of which claimed that the "new" nardil was Phenelzine HCL, not sulfate...and this ridiculous fallacy was repeated several times in various threads, and believed to be the truth by many.

Well, if you are referring to a site both of have read then I agree, but the truth is that in tablet form, Phenelzine Sulfate is always used. So, I have no problem with you statement, since I agree.

djimm:

--FWIW, it is hysteria...

Spotcheck:

I wish that was true, djimm. I really do wish that was the God's honest truth, because nothing would please me more. Unfortunately, it is not the truth and I need to prove this then let us agree right here and now to get in touch via e-mail and I will prove it to you. You can reach me at Twinoppose@hotmail.com - if you wish.

djimm continued....

"drug companies change inative ingredients all the time. What manufacturer would mass produce a medication that is inferior to an older version?"

Whew, I can see that we really do need to talk somewhere else. However, at the risk of losing my neck here, they do not mean it to happen this way, djimm. It just does happen, because of the very role that excipients play in the metabolism of any complicated medication. I thought that I had made this abundantly clear in my first post in fact. If not, I am genuinely sorry that I did not better communicate my message.

djimm:

"What manufaturer would waste millions of $$ in research/development and RISK not only their reputation, but the mental health of ten's of thousands of it's consumers?"

Any company that faced this choice: either discontinue making a very old MAOI, that is rarely ever prescribed by a psychiatrist and almost never as the first medication, or produce a drug that was essentially a generic drug, which have been know to cause some people problems. Shoot it happened to me with one of the first generic Amitriptyline. I was taking Elavil, and I unknowing was prescribed a generic, and it simply did not work as well. I confirmed in myself a couple of times.

djimm:

"--There is NO Nardil conspiracy, and no amount of bombastic, pseudo-scientific jargon will ever convince me otherwise."

Of course there is no conspiracy djimm, nor did I ever say there was about Nardil. I have never considered it a Conspiracy at all. What I did, say however, is that whenever you change the excipients of any medication, you very likely Will get some people who do not metabolize it. And that spells trouble.

Now, if you are genuinely interested in engaging ina more in depth look into this subject where we could both learn something then please e-mail me and we will discuss privately so that Dr, Bob does not have to be the Matador. Agreed?

Spotcheck:

Dr. Bob, I apologize in advance if you think the tone of this post is too antagonistic. It is my intention to explain something important to this individual in particular and also to drive home with an example that would create this effect him him/her. Chastise me if you must.

djmmm:

-LOL..don't worry, no offense taken here..and that's what matters, right?

Absolutely! All I wish to do is better explain myself to you. Kindly contact me and we can do exactly that!

 

Redirect: questions and comments

Posted by Dr. Bob on April 14, 2004, at 1:12:31

In reply to Re: please be civil Spotcheck, posted by Dr. Bob on April 13, 2004, at 20:41:15

> If you have any questions or comments about this or about posting policies in general ... redirect a follow-up to Psycho-Babble Administration.

Here's a link:

http://www.dr-bob.org/babble/admin/20040307/msgs/336193.html

Thanks,

Bob

 

Re: please be civil djmmm

Posted by Dr. Bob on April 14, 2004, at 1:25:16

In reply to Re: Nardil from Australia = 1950's version.JV, posted by djmmm on April 13, 2004, at 20:56:59

> Then you are a poor chemist..

Please don't post anything that could lead others to feel accused or put down.

If you have any questions or comments about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:

http://www.dr-bob.org/babble/faq.html#civil

or redirect a follow-up to Psycho-Babble Administration.

Thanks,

Bob


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