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Dr. Bob is Robert Hsiung, MD,
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Posted by sfy on December 5, 2004, at 15:12:28
In reply to MAOI withdrawal, posted by ed_uk on December 5, 2004, at 4:43:11
I don't recall having any problems withdrawing from Nardil in a systematic, tapered manner.
Posted by gardenergirl on December 5, 2004, at 22:09:07
In reply to MAOI withdrawal, posted by ed_uk on December 5, 2004, at 4:43:11
Hi Ed,
Thanks for posting this. I recently went down from 60 mg to 45 mg of Nardil due to peripheral edema. I experienced the following from your list that might be considered withdrawal: > headache, irritability, anger, stiff neck (at least according to the massage therapist), hypersomnia, sensitivity to sound and light, lack of energy, abnormal movements in sleep eg. of legs.I never considered these (except for the myoclonic jerks) to be related to decreasing the dose. Thanks again for posting this.
gg
Posted by ace on December 5, 2004, at 23:44:42
In reply to MAOI withdrawal, posted by ed_uk on December 5, 2004, at 4:43:11
Personally, for me, Ace, the Nardil Champ!, Nardil withdrawal has been very benign in the past.
Vivid dreams and a bit of insomnia is all that it really has caused.
Just another great aspect to a great drug!
Ace
Nardil- 60mg
Zyprexa- 2.5mg
Xanax- 2-4mg
Lamictal- 50mg
Posted by SLS on December 6, 2004, at 0:36:16
In reply to Re: MAOI withdrawal » ed_uk, posted by gardenergirl on December 5, 2004, at 22:09:07
> Hi Ed,
> Thanks for posting this. I recently went down from 60 mg to 45 mg of Nardil due to peripheral edema. I experienced the following from your list that might be considered withdrawal: > headache, irritability, anger, stiff neck (at least according to the massage therapist), hypersomnia, sensitivity to sound and light, lack of energy, abnormal movements in sleep eg. of legs.
>
> I never considered these (except for the myoclonic jerks) to be related to decreasing the dose. Thanks again for posting this.
Some of these symptoms could also represent a return of depression. I would say that most people with severe depression don't do well at dosages below 60mg.
- Scott
Posted by gardenergirl on December 6, 2004, at 10:11:42
In reply to Re: MAOI withdrawal, posted by SLS on December 6, 2004, at 0:36:16
Very good point, Scott. I am trying to monitor this. It's so hard to piece out what's situational (like the inlaws and their incessant need for heat) and what's a return of depression. Ugh. But hopefully 45 mg will be okay, will help me with the weight, and will not cause edema.
Oh, and if it could wash my car on occasion, that would be cool, too! ;)
Thanks for you input.
gg
Posted by kellym on December 6, 2004, at 17:34:15
In reply to MAOI withdrawal, posted by ed_uk on December 5, 2004, at 4:43:11
When I first tried to get off Nardil, I went too fast. It was not pretty-I was up to 105 or 120mg (I only started to feel the positive effects at 90mg). I think I tried dropping a couple of tablets at first and I started crying like a baby a day or two later. When I went more slowly it was much better, although I still suffered some effects- "electrical zaps" and nightmares.
I understand the apathy with some drugs. Wellbutrin doesn't cause me any problems in that regard and neither did Nardil; it unfortunately stopped working. At that point there wasn't much point in continuing with the dietary restrictions and the insomnia it caused. However, I understand it works for some people- good for them.
Posted by cubbybear on December 7, 2004, at 0:45:40
In reply to Re: MAOI withdrawal, posted by kellym on December 6, 2004, at 17:34:15
In the old days when I used to try a "holiday" and survive without Parnate (before I discovered I need it daily and probably for the rest of my life), I followed the withdrawal schedule my pdoc gave me:
Going down from 40 mg maintenance dose:
30 mg. for one week,
20 mg. for one week,
10 mg. for one week,
then zero.NEVER had a problem. My only noticeable changes were an increase in the need to sleep (conversely, Parnate reduces my need for sleep) plus a change my dreams--seemingly, they became more vivid. But, as one poster said, withdrawing from Parnate has always been uneventful.
Posted by Dan Perkins on December 7, 2004, at 20:01:34
In reply to Re: MAOI withdrawal, posted by cubbybear on December 7, 2004, at 0:45:40
I had a very bad experience coming off of Parnate. I came off of it too quickly (from 70mg to zero in about two weeks) and it really screwed me up. I just remember walking down the street in absolute misery and having to stop at one point and just stand there paralyzed like a heroine addict. And when I went back on it I found that it was never again as effective as before I stopped taking it.
MAOIs are very good (at least Parnate was for me), but my advice would be to taper off of them as slowly as possible if you do have to stop.
Posted by cubbybear on December 8, 2004, at 5:54:12
In reply to Re: MAOI withdrawal, posted by Dan Perkins on December 7, 2004, at 20:01:34
> I had a very bad experience coming off of Parnate. I came off of it too quickly (from 70mg to zero in about two weeks) and it really screwed me up. I just remember walking down the street in absolute misery and having to stop at one point and just stand there paralyzed like a heroine addict. And when I went back on it I found that it was never again as effective as before I stopped taking it.
>
This is an unusual thread--we don't often see posts here about MAOI withdrawal. Just curious--why did you try coming off the med. so fast? Was it your decision or your doctor's?
Posted by Dan Perkins on December 8, 2004, at 13:05:42
In reply to Re: MAOI withdrawal » Dan Perkins, posted by cubbybear on December 8, 2004, at 5:54:12
> This is an unusual thread--we don't often see posts here about MAOI withdrawal. Just curious--why did you try coming off the med. so fast? Was it your decision or your doctor's?
I came off of Parnate b/c I was planning to have an elective surgery and Parnate and general anesthesia don't mix. I didn't tell my doctor that I was going to stop taking Parnate, so the decisions to stop and to stop so quickly were mine. I knew that the sensible thing would have been to taper more slowly, but I was feeling a bit reckless. So, in other words, there was no good reason to stop so quickly.
Posted by cubbybear on December 10, 2004, at 3:31:52
In reply to Re: MAOI withdrawal » Dan Perkins, posted by Dan Perkins on December 8, 2004, at 13:05:42
>
> I came off of Parnate b/c I was planning to have an elective surgery and Parnate and general anesthesia don't mix. I didn't tell my doctor that I was going to stop taking Parnate, so the decisions to stop and to stop so quickly were mine. I knew that the sensible thing would have been to taper more slowly, but I was feeling a bit reckless. So, in other words, there was no good reason to stop so quickly.Your problem is of much interest to me because I've been putting off an elective procedure (colonoscopy) myself since,among other things, I dread the whole issue of anaesthesia. I made a decision not to come off the Parnate for this procedure but rather to go through with it. If I can get up the guts to make an appointment with the gastroenterologist, I will discuss with her ahead of time, the various analgesics/sedatives that could be used safely. I'm pretty sure that in this case, general anaesthesia would be unnecessary.
Posted by Dan Perkins on December 10, 2004, at 13:55:53
In reply to Re: MAOI withdrawal » Dan Perkins, posted by cubbybear on December 10, 2004, at 3:31:52
If you don't absolutely have to come off of Parnate, then my advice would be to not come off of it. Aside from having a horrible time coming off of the drug, the Parnate never worked as well for me again after I stopped it that first time.
It seems to me that just about every warning that goes along with taking an MAOI is either exagerated or entirely unnecesary. I'm not sure if this is the case w/anesthesia, but I would try everything possible to avoid coming off of Parnate for your colonoscopy.
Your gastroenterologist may tell you that you have to stop the Parnate simply b/c he/she might not have any experience with MAOIs and might be being overly cautious. I think the best way to find out which anesthesia is OK to take w/Parnate would be by posting the question directly on this message board in a seperate topic and maybe in an MAOI discussion forum (I know that Yahoo has an active one) to hear from people who have direct experience with this topic.
Best of luck,
>
> Your problem is of much interest to me because I've been putting off an elective procedure (colonoscopy) myself since,among other things, I dread the whole issue of anaesthesia. I made a decision not to come off the Parnate for this procedure but rather to go through with it. If I can get up the guts to make an appointment with the gastroenterologist, I will discuss with her ahead of time, the various analgesics/sedatives that could be used safely. I'm pretty sure that in this case, general anaesthesia would be unnecessary.
Posted by cubbybear on December 11, 2004, at 6:14:38
In reply to Re: MAOI withdrawal » Dan Perkins, posted by Dan Perkins on December 10, 2004, at 13:55:53
. I think the best way to find out which anesthesia is OK to take w/Parnate would be by posting the question directly on this message board in a seperate topic and maybe in an MAOI discussion forum (I know that Yahoo has an active one) to hear from people who have direct experience with this topic.
>
> You're really on my wavelength, although I haven't experienced any loss of effectiveness in the (distant) past when I stopped the Parnate for a while and then went back on it.
More to the point, I've found that there's a lot of contradiction in warnings regarding what anaesthesia is safe with an MAOI and which isn't. I've already done a lot of research on this topic and think I know the way to go, especially which anaesthesia would NOT be safe.Just to illustrate what we're up against when we try to pose the MAOI vs. anaesthesia question to the doctors themselves, I sent an E-mail to this guy who actually performed the surgery on a Psychobabble poster who was taking an MAOI. The doctor never responded. I myself went to a local hospital to pose the question. The gastroenterologist told me that I should start with the anaesthesiologist. So I went to consult with him, and his department told me to start with the surgeon. Nobody in this rotten profession wants to take responsibility for a difficult decision and we all know why. Hence, we have to do our own homework and our own research and rely on message boards like Psychobabble
Posted by Dan Perkins on December 11, 2004, at 7:44:02
In reply to Re: MAOI and anaesthesia » Dan Perkins, posted by cubbybear on December 11, 2004, at 6:14:38
>Nobody in this rotten profession wants to take responsibility for a difficult decision and we all know why. Hence, we have to do our own homework and our own research and rely on message boards like Psychobabble
Totaly agree with you. I'm always a bit embarassed to tell people that I get medical information from the internet (or worse yet, internet message boards), but I tell you that there is no more reliable source for information than places like these. After a lifetime of dealing with ignorant doctors, I have come to realize that the combination of anecdotal experience (from websites like this one) and first hand research (actually going back and sorting through the studies to figure out which make sense (not many of them) is the only way to find reliable healthcare information. It certainly beats how the doctors themselves get their information, from the always attractive pharmaceutical sales reps who dish out free meds and biased advice.
Posted by KaraS on December 11, 2004, at 16:15:37
In reply to Re: MAOI withdrawal » Dan Perkins, posted by Dan Perkins on December 10, 2004, at 13:55:53
> If you don't absolutely have to come off of Parnate, then my advice would be to not come off of it. Aside from having a horrible time coming off of the drug, the Parnate never worked as well for me again after I stopped it that first time.
>
> It seems to me that just about every warning that goes along with taking an MAOI is either exagerated or entirely unnecesary. I'm not sure if this is the case w/anesthesia, but I would try everything possible to avoid coming off of Parnate for your colonoscopy.
>
> Your gastroenterologist may tell you that you have to stop the Parnate simply b/c he/she might not have any experience with MAOIs and might be being overly cautious. I think the best way to find out which anesthesia is OK to take w/Parnate would be by posting the question directly on this message board in a seperate topic and maybe in an MAOI discussion forum (I know that Yahoo has an active one) to hear from people who have direct experience with this topic.
>
> Best of luck,
>
>
> >
> > Your problem is of much interest to me because I've been putting off an elective procedure (colonoscopy) myself since,among other things, I dread the whole issue of anaesthesia. I made a decision not to come off the Parnate for this procedure but rather to go through with it. If I can get up the guts to make an appointment with the gastroenterologist, I will discuss with her ahead of time, the various analgesics/sedatives that could be used safely. I'm pretty sure that in this case, general anaesthesia would be unnecessary.
>
>Would you mind posting more information on how to get to that Yahoo chat group. I just went to check it out. I found live chat groups on depression but most of the talk was silliness - not about anything medical or even depression related. It was probably a group of teenagers. I must have gone to the wrong place.
Posted by Dan Perkins on December 12, 2004, at 2:40:12
In reply to Re: MAOI withdrawal » Dan Perkins, posted by KaraS on December 11, 2004, at 16:15:37
Here is the link to the an MAOI chat group on Yahoo. I used to post on here a lot and found the other posters to be extremely well informed about all aspects of Nardil/Parnate.
Posted by KaraS on December 12, 2004, at 14:23:58
In reply to Re: MAOI withdrawal, posted by Dan Perkins on December 12, 2004, at 2:40:12
Posted by Dan Perkins on December 12, 2004, at 15:00:42
In reply to Re: You forgot to add the link.... (nm) » Dan Perkins, posted by KaraS on December 12, 2004, at 14:23:58
Sorry, here it is:
Posted by KaraS on December 12, 2004, at 16:36:10
In reply to Re: You forgot to add the link...., posted by Dan Perkins on December 12, 2004, at 15:00:42
> Sorry, here it is:
>
> http://health.groups.yahoo.com/group/maois/I can see that there's a lot of good information there. I'm still trying to figure out how to navigate around. I've been so spoiled here where everything is so easy and visually available.
Posted by Dan Perkins on December 12, 2004, at 19:23:27
In reply to Re: Thanks so much » Dan Perkins, posted by KaraS on December 12, 2004, at 16:36:10
You're welcome. I just looked at that website again for the first time in months and had your same reaction that it could be laid out a lot more clearly. But there is no doubt that there is a ton of useful information about Nardil and Parnate available and a bunch of very knowledgable people who can answer questions about MAOIs.
> > Sorry, here it is:
> >
> > http://health.groups.yahoo.com/group/maois/
>
> I can see that there's a lot of good information there. I'm still trying to figure out how to navigate around. I've been so spoiled here where everything is so easy and visually available.
Posted by KaraS on December 12, 2004, at 20:58:43
In reply to Re: Thanks so much, posted by Dan Perkins on December 12, 2004, at 19:23:27
> You're welcome. I just looked at that website again for the first time in months and had your same reaction that it could be laid out a lot more clearly. But there is no doubt that there is a ton of useful information about Nardil and Parnate available and a bunch of very knowledgable people who can answer questions about MAOIs.
>Definitely. I wonder how you ever found it to begin with. If I go into the groups section and try to look for it, I can't. If I didn't have the link you provided, I'd never find it again.
> > > Sorry, here it is:
> > >
> > > http://health.groups.yahoo.com/group/maois/
> >
> > I can see that there's a lot of good information there. I'm still trying to figure out how to navigate around. I've been so spoiled here where everything is so easy and visually available.
>
>
Posted by tecknohed on December 12, 2005, at 21:28:56
In reply to MAOI withdrawal, posted by ed_uk on December 5, 2004, at 4:43:11
Thought I'd add my 2 cents, despite being sooo late!
I've only come off Nardil once, after 18 months use. It was planned (was switching meds) but i developed a virus at the same time. NASTY! Maybe not a direct cause, but I feel my immune system may have become over-burdoned. I rarely had as much as a sniffle on Nardil.
Other, more direct symptomes were: on/off depression, worsening of Social Phobia, SEVERE worsening of OCD, paranoia (scared of the dark!), and an unsteady physical/mental balance.This all got progressively worse until I got a med back inside me. One thing which was particularly strong was a kind of 'wake up' from Nardil, as if I could feel its psychotropic mechanism 'leave' me. Bear in mind that I'd never been on a med as long as Nardil, niether had anything 'changed' my personality so much.
And I just cann't forget to mention the nice part of it all - the full return of easy orgasm, AND THEN SOME!
Don't get me wrong - it's ALL worth it BELIEVE!
I'm back on Nardil now.
Posted by joemzak on January 12, 2006, at 10:38:34
In reply to MAOI withdrawal, posted by ed_uk on December 5, 2004, at 4:43:11
I just joined this board because it is so relevant to me.
I have been on Nardil for 18 years. From the very beginning, whenever I stopped taking it for one reason or another, I felt worse than I did before I started any medication.
Through the years I have had to get off Nardil 3 additional times for hip replacement surgery. It has gotten so bad- the psychic pain is so unbearable- that I once said: "It was like losing my soul."!
The only thing that stops this pain (along with every mentioned withdrawal symptom posted on this board) is taking opiates...in my case...percocet or just plain oxycodone. These were given to me by my doctor as he knew it to be the only way for me.
I just checked into (on Jan 9) NY Presbeterian Hospital (affiliated with Columbia U. Med School and Cornell Med. School) and they had no idea what to do for me...so I checked out the next day.
I want to get off Nardil, must get off Nardil, because:
I am now literally addicted to carbs (when I don't have them I got physically and mentally sick) and have gained 100 lbs since starting Nardil (60 of those pounds in 6 years)
Some drugs have NO EFFECT on me...like Halcion and Seconal (given to me to try to make me sllep)
Because, Nardil is now interferring with my sleep in a big way
Also, have had BIZARRE and FRIGHTENING side effects when given: Gabitrol, Depakote and Zyprexa (these given to me to "boost" the effects of Nardil-they did not)
I started this mess with only atypical depression and wish I had never taken anything for it. I now feel a good, no make that great psychoanalyst would have done the job 19 years ago. Oh, I have had therapists, but do you know how easy it is to hang a shingle out that says: "Therapist"? Anything from a lower degree in Social Work to a degree from an accredited School of Psychoanalysis!!!
I am LOST what to do and where to go now. I have been contemplating trips to: Mass. General (Harvard), Cleveland Clinic, Johns Hopkins or anywhere I can where I can find a doctor that can take me off this!
If anyone can help me, I would be eternally grateful!
Posted by 4WD on January 14, 2006, at 21:56:13
In reply to Re: MAOI withdrawal, posted by joemzak on January 12, 2006, at 10:38:34
> I just joined this board because it is so relevant to me.
> I have been on Nardil for 18 years. From the very beginning, whenever I stopped taking it for one reason or another, I felt worse than I did before I started any medication.
> Through the years I have had to get off Nardil 3 additional times for hip replacement surgery. It has gotten so bad- the psychic pain is so unbearable- that I once said: "It was like losing my soul."!
> The only thing that stops this pain (along with every mentioned withdrawal symptom posted on this board) is taking opiates...in my case...percocet or just plain oxycodone. These were given to me by my doctor as he knew it to be the only way for me.
> I just checked into (on Jan 9) NY Presbeterian Hospital (affiliated with Columbia U. Med School and Cornell Med. School) and they had no idea what to do for me...so I checked out the next day.
> I want to get off Nardil, must get off Nardil, because:
> I am now literally addicted to carbs (when I don't have them I got physically and mentally sick) and have gained 100 lbs since starting Nardil (60 of those pounds in 6 years)
> Some drugs have NO EFFECT on me...like Halcion and Seconal (given to me to try to make me sllep)
> Because, Nardil is now interferring with my sleep in a big way
> Also, have had BIZARRE and FRIGHTENING side effects when given: Gabitrol, Depakote and Zyprexa (these given to me to "boost" the effects of Nardil-they did not)
> I started this mess with only atypical depression and wish I had never taken anything for it. I now feel a good, no make that great psychoanalyst would have done the job 19 years ago. Oh, I have had therapists, but do you know how easy it is to hang a shingle out that says: "Therapist"? Anything from a lower degree in Social Work to a degree from an accredited School of Psychoanalysis!!!
> I am LOST what to do and where to go now. I have been contemplating trips to: Mass. General (Harvard), Cleveland Clinic, Johns Hopkins or anywhere I can where I can find a doctor that can take me off this!
> If anyone can help me, I would be eternally grateful!Have you tried switching to Parnate? Or to another class of AD?
I know what you mean about the psychic pain. It can be so bad it is physical pain. Writhing in the floor pain. Many of us here have experienced it so you are not alone.
What does your pdoc say?
Marsha
Posted by joemzak on January 15, 2006, at 7:25:34
In reply to Re: MAOI withdrawal » joemzak, posted by 4WD on January 14, 2006, at 21:56:13
> Have you tried switching to Parnate? Or to another class of AD?
>
> I know what you mean about the psychic pain. It can be so bad it is physical pain. Writhing in the floor pain. Many of us here have experienced it so you are not alone.
>
> What does your pdoc say?
>
> MarshaMy doc??? That's another story. (By the way, thanks for writing)
My doc of 10 years said to me that the effects I suffer when I come off Nardil could be either a rebound effect or it could be the state I would be in had I never started with Nardil. A LIE! This past week I found an article at: "http://www.psychiatriat.com/pcc/abstracts/pcc030404.htm" The article basically talks about withdrawal from anti-depressants, with a section on MAOI. Boy, was it an eye opener. He states that if the side effects occur within a few days after stopping your medication, it is NOT depression but withdrawal - which he calls discontinuation symptoms. He talks about all kinds of side effects - including one similiar to withdrawing from SPEED! The article also has recommendations for getting off meds. I now have a new doctor and started coming off Nardil today. I take 6 pills and will reduce by 1/4 pill every 2 weeks. It will take 48 weeks, but that doesn't concern me, as long as I get off these devils!
As far as Parnate, frankly, I need to see what my natural state of being is before I take anything else. I have been on Nardil for 18 years and maybe, just maybe, I am okay without them. 18 years ago, I started seeing a doc and was diagnosed with atypical depression. In retrospect, I believe it was and is more of a social phobic thing than depression. Anyway, the only way I will find out is to stop Nardil.
I have found this board so comforting that I will keep everyone posted how the long road off is progressing. Thank you all. Joe
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