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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by amdew717 on May 27, 2004, at 11:17:47
Ace,
I'm a 50 year old guy, and I have also been helped by Nardil more than any other AD I've taken...and I've taken quite a few, but I recently tried to go back on it and even after ONE day at 15 mg, I had the same side effects that caused me to go off of it 6 mos ago:1) Waking up after 5 hours and not being able to return to sleep
2) Inability to have an orgasm.I've read some of your posts and don't recall if you mentioned having these problems. But if you have, how do you deal with them? I've been taking 1600 mg Neurontin for about 3 years and even that doesn't seem to allow me to sleep all the way through. I've asked him to put me on Klonopin (which I've taken in the past from another doc without any problem) but he refuses, claiming it's addictive. I never felt the need to increase my dosage of Klonopin the whole time I was on it, but I guess that doesn't mean anything to him. Also tried Trazadone but the priapism was too much for me. Regarding the sexual problems...I have no clue as to what to do other than give it up. It seems the older I get, the less patience I have with the side effects.
It was not my intention to exclude other members here, and I welcome anyone else's input but I just wanted to make sure I also heard from Ace, since "you ARE the Champion of Nardil," and I'd like to be one too!
Thanks, Jim
Posted by flipsactown on May 27, 2004, at 22:56:15
In reply to Attn ACE: Nardil S/E, posted by amdew717 on May 27, 2004, at 11:17:47
Jim,
Although Nardil for the most part had been effective in lifting my unipolar depression, I
stopped taking it, yesterday, after 6 weeks because of severe insomnia. I was able to tolerate the insomnia the first 3 weeks and as a result of the insomnia, I had so much time on my hands, that I was able to do many of my home chores which was actually a pleasant surprise. However, doing this much extra work caused me to take more pain med and wreaked havoc with my ongoing home Oxy detox. Consequently, I decided to quit Nardil not just for this reason but for the continuous severe insomnia during the following next 3 weeks. The sleep deprivation took its toll on me after 6 weeks and could no longer continue taking Nardil, even when I took Ambien, Benadryl or Remeron. The most I slept, even after taking multiple sleeping meds, was about 3 to 4 interrupted hours which made me very irritable and actually even more depressed. Libido wise, I was fine which was one positive, along with the excellent AD effect. I hope you have better luck.FST
> Ace,
> I'm a 50 year old guy, and I have also been helped by Nardil more than any other AD I've taken...and I've taken quite a few, but I recently tried to go back on it and even after ONE day at 15 mg, I had the same side effects that caused me to go off of it 6 mos ago:
>
> 1) Waking up after 5 hours and not being able to return to sleep
> 2) Inability to have an orgasm.
>
> I've read some of your posts and don't recall if you mentioned having these problems. But if you have, how do you deal with them? I've been taking 1600 mg Neurontin for about 3 years and even that doesn't seem to allow me to sleep all the way through. I've asked him to put me on Klonopin (which I've taken in the past from another doc without any problem) but he refuses, claiming it's addictive. I never felt the need to increase my dosage of Klonopin the whole time I was on it, but I guess that doesn't mean anything to him. Also tried Trazadone but the priapism was too much for me. Regarding the sexual problems...I have no clue as to what to do other than give it up. It seems the older I get, the less patience I have with the side effects.
>
> It was not my intention to exclude other members here, and I welcome anyone else's input but I just wanted to make sure I also heard from Ace, since "you ARE the Champion of Nardil," and I'd like to be one too!
>
> Thanks, Jim
Posted by ace on May 27, 2004, at 23:03:30
In reply to Attn ACE: Nardil S/E, posted by amdew717 on May 27, 2004, at 11:17:47
> Ace,
> I'm a 50 year old guy, and I have also been helped by Nardil more than any other AD I've taken...Nardil is great isn't it?!!
and I've taken quite a few, but I recently tried to go back on it and even after ONE day at 15 mg, I had the same side effects that caused me to go off of it 6 mos ago:
This can be a GOOD sign....You have developed immunity to the side effects, and, therefore, the AD quality you experienced before will come back!!
I have seen the reverse happen- some people go back on Nardil experience no s/effects and then have to double the dose to regain their previous AD effect. I am speculating a bit here but!
>
> 1) Waking up after 5 hours and not being able to return to sleepOK. Lets sort this out. This can be very easily treated with safe effective medication. My suggestions...
1. Before bed add 15mg Remeron
2. Before bed take Melatonin
3. Before bed add 1-2gram L-Tryptophan
4. Before bed add 5-10mg Nitrazepam
5. Before bed add 5-10 mg Valium
6. Before bed add 25-50mg Seroquel (this is an antipsychotic, but at that dose, which is EXTREMELY SMALL, you will have sedation, but probably no other s/effects.
7. Before bed, add 2.5-5mg Zyprexa (see above about Seroquel)> 2) Inability to have an orgasm.
Try the following
1. Bethenachol
2. Cyproheptadine
3. Remeron may help with both probsI know there is many more, but all my research is at home and im at university! sorry!
> I've read some of your posts and don't recall if you mentioned having these problems.I had orgasmic problems BIG TIME for a long time. Bethenachol and Lithium helped. But eventually the ability to orgasm came back. Now im on 105mg Nardil and can orgasm easily.
But if you have, how do you deal with them? I've been taking 1600 mg Neurontin for about 3 years and even that doesn't seem to allow me to sleep all the way through.I tried Neurontin- it didn't have much of a sedative effect for me.
I've asked him to put me on Klonopin (which I've taken in the past from another doc without any problem) but he refuses, claiming it's addictive.Find a new doctor. Im sick to death of hearing people speak only of the negatives of Benzo's and ignore the positives. And it IS NOT ADDICTIVE FOR THE VAST MAJORITY OF USERS. When you finish it, you taper off it slow and their is usually no problems. People can become medically dependant on it, but this is not congruent with the term 'addiction'.
I never felt the need to increase my dosage of Klonopin the whole time I was on it, but I guess that doesn't mean anything to him.That's a sure sign youre NOT addicted!!! Loose this guy in my opinion. Find another MD!
Also tried Trazadone but the priapism was too much for me.You had a sustained erection (Thats priapism isn't it?)? Did it help you orgasm?
Regarding the sexual problems...I have no clue as to what to do other than give it up. It seems the older I get, the less patience I have with the side effects.
Don't!! I will get some more references and try to find an antidote. Please be patient. You deserve to enjoy life, just as we all do.
>
> It was not my intention to exclude other members here, and I welcome anyone else's input but I just wanted to make sure I also heard from Ace, since "you ARE the Champion of Nardil," and I'd like to be one too!
>
> Thanks, JimI am forever the Nardil champion!!! Nardil has saved my life from being a life of misery...
Take Care Jim!Ace.
Posted by Chairman_MAO on May 28, 2004, at 5:24:01
In reply to Re: Attn ACE: Nardil S/E » amdew717, posted by ace on May 27, 2004, at 23:03:30
Man, all this talk of Nardil makes me jealous. I have few resources and am stuck with a public doctor who does 10-minute med consults, refusing me everything except the big 10 antidepressants. I'm on Effexor now, which is better than nothing, but does little for social phobia. I know what MAOIs are capable of, and I deserve it. Someday ...
The best treatments for orgasm problems are dopaminergic. Try amantadine, cabergoline, bromocriptine, pramipexole, ropinirole, etc. Cabergoline can give many men not on meds multiple orgasms; thus I would expect it has potential as an antidote. It is also $$$$.
Posted by amdew717 on May 28, 2004, at 11:55:04
In reply to Re: Attn ACE: Nardil S/E » amdew717, posted by ace on May 27, 2004, at 23:03:30
> 1) Waking up after 5 hours and not being able to return to sleep
>
> OK. Lets sort this out. This can be very easily treated with safe effective medication. My suggestions...
>
> 1. Before bed add 15mg Remeron
> 2. Before bed take Melatonin
> 3. Before bed add 1-2gram L-Tryptophan
> 4. Before bed add 5-10mg Nitrazepam
> 5. Before bed add 5-10 mg Valium
> 6. Before bed add 25-50mg Seroquel (this is an antipsychotic, but at that dose, which is EXTREMELY SMALL, you will have sedation, but probably no other s/effects.
> 7. Before bed, add 2.5-5mg Zyprexa (see above about Seroquel)> > 2) Inability to have an orgasm.
>
> Try the following
>
> 1. Bethenachol
> 2. Cyproheptadine
> 3. Remeron may help with both probs
>
> I know there is many more, but all my research is at home and im at university! sorry!
>
> I had orgasmic problems BIG TIME for a long time. Bethenachol and Lithium helped. But eventually the ability to orgasm came back. Now im on 105mg Nardil and can orgasm easily.I will see if he's willing to try any of the above meds, although I expect him to shoot most of them down. I have a history of urninay retention problems, so he claims many of the other medicines have anti-cholinergic properties that I should avoid.
> I tried Neurontin- it didn't have much of a sedative effect for me.
I find that my system gets used to the sedating qualities of Neurontin very quickly, and with Nardil it just doesn't keep me asleep long enough.
> Find a new doctor. Im sick to death of hearing people speak only of the negatives of Benzo's and ignore the positives. And it IS NOT ADDICTIVE FOR THE VAST MAJORITY OF USERS. When you finish it, you taper off it slow and their is usually no problems. People can become medically dependant on it, but this is not congruent with the term 'addiction'.
> That's a sure sign youre NOT addicted!!! Loose this guy in my opinion. Find another MD!
Looks like I'll be moving in that direction. I see this guy every week, so he's also my full-time therapist for the past 6 years, but I feel we have too many critical differences of opinion for this to truly work.
> You had a sustained erection (Thats priapism isn't it?)? Did it help you orgasm?
Yep, most persistent ones I've ever had, but they didn't feel good, in fact they were downright painful, so I would just have to wait for them to go away on their own so I could pee. Plus I've heard that they can cause permanent damage, so I stay away from the trazadone.
> Regarding the sexual problems...I have no clue as to what to do other than give it up. It seems the older I get, the less patience I have with the side effects.
>
> Don't!! I will get some more references and try to find an antidote. Please be patient. You deserve to enjoy life, just as we all do.I very much appreciate your help ACE.
Thanks so much for the input,
Jim
Posted by amdew717 on May 28, 2004, at 11:57:48
In reply to Re: Attn ACE: Nardil S/E, posted by Chairman_MAO on May 28, 2004, at 5:24:01
> The best treatments for orgasm problems are dopaminergic. Try amantadine, cabergoline, bromocriptine, pramipexole, ropinirole, etc. Cabergoline can give many men not on meds multiple orgasms; thus I would expect it has potential as an antidote. It is also $$$$.
Thanks for the suggestions MAO, I will definitely do some research on these and keep them in mind.
Good Luck to you,
Jim
Posted by Questionmark on May 29, 2004, at 3:25:00
In reply to Re: Attn ACE: Nardil S/E, posted by amdew717 on May 28, 2004, at 11:55:04
> > 1) Waking up after 5 hours and not being able to return to sleep
> >
> > OK. Lets sort this out. This can be very easily treated with safe effective medication. My suggestions...
> >
> > 1. Before bed add 15mg Remeron
> > 2. Before bed take Melatonin
> > 3. Before bed add 1-2gram L-Tryptophan
> > 4. Before bed add 5-10mg Nitrazepam
> > 5. Before bed add 5-10 mg Valium
> > 6. Before bed add 25-50mg Seroquel (this is an antipsychotic, but at that dose, which is EXTREMELY SMALL, you will have sedation, but probably no other s/effects.
> > 7. Before bed, add 2.5-5mg Zyprexa (see above about Seroquel)
>
> > > 2) Inability to have an orgasm.
> >
> > Try the following
> >
> > 1. Bethenachol
> > 2. Cyproheptadine
> > 3. Remeron may help with both probs
> >
> > I know there is many more, but all my research is at home and im at university! sorry!
> >
> > I had orgasmic problems BIG TIME for a long time. Bethenachol and Lithium helped. But eventually the ability to orgasm came back. Now im on 105mg Nardil and can orgasm easily.
>
> I will see if he's willing to try any of the above meds, although I expect him to shoot most of them down. I have a history of urninay retention problems, so he claims many of the other medicines have anti-cholinergic properties that I should avoid.
>
> > I tried Neurontin- it didn't have much of a sedative effect for me.
>
> I find that my system gets used to the sedating qualities of Neurontin very quickly, and with Nardil it just doesn't keep me asleep long enough.
>
> > Find a new doctor. Im sick to death of hearing people speak only of the negatives of Benzo's and ignore the positives. And it IS NOT ADDICTIVE FOR THE VAST MAJORITY OF USERS. When you finish it, you taper off it slow and their is usually no problems. People can become medically dependant on it, but this is not congruent with the term 'addiction'.
>
> > That's a sure sign youre NOT addicted!!! Loose this guy in my opinion. Find another MD!
>
> Looks like I'll be moving in that direction. I see this guy every week, so he's also my full-time therapist for the past 6 years, but I feel we have too many critical differences of opinion for this to truly work.
>
> > You had a sustained erection (Thats priapism isn't it?)? Did it help you orgasm?
>
> Yep, most persistent ones I've ever had, but they didn't feel good, in fact they were downright painful, so I would just have to wait for them to go away on their own so I could pee. Plus I've heard that they can cause permanent damage, so I stay away from the trazadone.
>
> > Regarding the sexual problems...I have no clue as to what to do other than give it up. It seems the older I get, the less patience I have with the side effects.
> >
> > Don't!! I will get some more references and try to find an antidote. Please be patient. You deserve to enjoy life, just as we all do.
>
> I very much appreciate your help ACE.
> Thanks so much for the input,
> Jim
All three of Ace's suggestions for anorgasmia might be really good for you to try. Cyproheptadine should be helpful for both the insomnia AND the anorgasmia-- hopefully you'd just need a higher dose for the insomnia than the anorgasmia. But definitely try to have a trial with this (plus it's super cheap).
Also, if you have a history of urinary retention problems and thus need to avoid excessive anticholinergic action, then bethanacol might be a great option for your anorgasmia (it is a cholinergic drug). The one downside that i wouldn't like is that it only lasts for like an hour or so, i believe, so you'd have to plan every time you wanted to ... have an orgasm.
Thirdly, Remeron is supposed to be quite effective at alleviating excess-serotonin-induced anorgasmia. And if Remeron doesn't relieve your insomnia then i don't know what the heck will (okay maybe not exactly true but you get the idea). i would personally go with the the cyproheptadine (Periactin) before the Remeron since the latter's antihistamine effects are so freaking potent that i've never been able to bare a high enough dose to experience any of its other effects, and the cyproheptadine seems to me to be significantly more effective at alleviating anorgasmia. Of course, i don't really have insomnia (any worse) on Nardil, and i DO suffer from the other problem pretty stinking badly. So maybe the cypro. wouldn't be better for you than Remeron. Anyway, definitely check one of those two out, and bethanacol as well if you can. Actually, i wonder if nightly doses of Remeron or cyproheptadine would help the insomnia more or less fully and the anorgasmia at least enough to make orgasm reasonably possible at any time-- and then reasonably EASY if you also took a dose of bethanachol shortly beFORE the "activity."
Posted by Carlos C on May 30, 2004, at 3:05:56
In reply to Re: Attn ACE: Nardil S/E, posted by Chairman_MAO on May 28, 2004, at 5:24:01
Hi Chairman,
I think it's outrageous that your doc will not prescribe an MAOI. Do you suspect he suggest the "big 10" for personal financial reasons or lack of knowledge or experience with MAOIs? These meds carry a horrible stigma and prejudice. They do wonders for those who can put up with so unwanted side-effects.
I experienced orthostatic hypostension and fainting for a few weeks. They, with others subsided. Then came some GI problems and eventually substantial weight gain. Just to name a few. The last two componded my problem considering my obsessive body-image issue. Then after all that it eventually "pooped out".
Sorry I'm such a downer. I guess misery really does love company? lol. No, but seriously Ace is a wonderful example MAOI potential. I truely wish you the best!
> Man, all this talk of Nardil makes me jealous. I have few resources and am stuck with a public doctor who does 10-minute med consults, refusing me everything except the big 10 antidepressants. I'm on Effexor now, which is better than nothing, but does little for social phobia. I know what MAOIs are capable of, and I deserve it. Someday ...
>
> The best treatments for orgasm problems are dopaminergic. Try amantadine, cabergoline, bromocriptine, pramipexole, ropinirole, etc. Cabergoline can give many men not on meds multiple orgasms; thus I would expect it has potential as an antidote. It is also $$$$.
Posted by don_bristol on June 1, 2004, at 3:49:40
In reply to Re: Attn ACE: Nardil S/E, posted by Chairman_MAO on May 28, 2004, at 5:24:01
> Man, all this talk of Nardil makes me jealous. I have few resources and am stuck
> with a public doctor who does 10-minute med consults, refusing me everything
> except the big 10 antidepressants. I'm on Effexor now, which is better than
> nothing, but does little for social phobia. I know what MAOIs are capable of,
> and I deserve it. Someday ...Chairman_MAO
After what seems like a personal odyssey through various mood medications I finally got to take Nardil. Hmmm .. it was a bit of a disappointment to me. It was "fair" in how much it helped aalthough two other mood meds helped me just as much util they stopped working: moclobemide and rexoetine). But the side effects of Nardil were so detrimental that I had to stop taking it. Sadly, one day you may find you fare no better with nardil.
> The best treatments for orgasm problems are dopaminergic. Try amantadine, cabergoline, bromocriptine, pramipexole, ropinirole, etc. Cabergoline can give many men not on meds multiple orgasms; thus I would expect it has potential as an antidote. It is also $$$$.
Carbelogine is a new one to me. Here sin the UK I have come across the dopaminergic apomorphine hydrochloride which is taken subligually (UK name = Uprima) but i don't think it is available in the US.
http://www.netdoctor.co.uk/medicines/showpreparation.asp?id=4580Do you know how this sublingual apomorphine hydrochloride compares to Cabergoline as a treatment ?
Don
Posted by don_bristol on June 1, 2004, at 4:01:02
In reply to Re: Attn ACE: Nardil S/E » amdew717, posted by ace on May 27, 2004, at 23:03:30
Hi Ace, good to see you are living proof of the effectiveness of Nardil. For me the side effects were all too much and I had to give it up. One of the side effects I had was when Ii went (carefull and slowly with lots of accomodation time) from 45mg to 60mg and I would talk and move slowly. It was quite a pronoumced effect and I have not found anything about it. This effect was not a co-incidence but quite repeatable whenever I pushed the Nardil up.
There was also the common Nardil fuzzy headed fog and so in the end I gave it up.
-- snip --
Amdew717 wrote:
>>
>> 1) Waking up after 5 hours and not being able >> to return to sleep
>>Ace wrote:
>
> OK. Lets sort this out. This can be very easily treated with
> safe effective medication. My suggestions...
>
> 1. Before bed add 15mg Remeron
> 2. Before bed take Melatonin
> 3. Before bed add 1-2gram L-Tryptophan
> 4. Before bed add 5-10mg Nitrazepam
> 5. Before bed add 5-10 mg Valium
> 6. Before bed add 25-50mg Seroquel (this is an antipsychotic, but
> at that dose, which is EXTREMELY SMALL, you will have sedation,
> but probably no other s/effects.
> 7. Before bed, add 2.5-5mg Zyprexa (see above about Seroquel)
>
Am interested to see you list Nitrazepam. Is it available in the US? I am in the UK and I used to take it. I have never heard Americans refere to it. Can you or someone else say a bit more about Nitrazepam's availability in the US?
Posted by Chairman_MAO on June 2, 2004, at 12:15:19
In reply to Re: Attn ACE: Nardil S/E » Chairman_MAO, posted by don_bristol on June 1, 2004, at 3:49:40
I think apomorphine is similar in overall effectiveness; how exactly they differ is well beyond the scope of my knowledge. Cabergoline probably has fewer side effects (especially nausea) and a more potent effect, though. This is mostly speculation on my part. Anyone care to add to this discussion?
This is the end of the thread.
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