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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by UGottaHaveHope on April 2, 2007, at 17:30:10
I am on my seventh day of Nardil 45mg. I also take 150 of Seroquel and 2mg of Klonopin. The biggest side effects are: 1) Really tired during the day and 2) have trouble falling asleep at night.
Does anyone know if this will go away? Only been on it a week. What is the best way of taking pills? Without or with food? At all at once or spready evenly throughout day?
Thanks, Michael
Posted by football on April 2, 2007, at 19:40:05
In reply to Does Nardil fatigue go away?, posted by UGottaHaveHope on April 2, 2007, at 17:30:10
It supposedly does with time.
I know exactly what you're going through side-effect wise, because I feel the same way. :)My doc claims the best way to take the pills is to spread it out, so I'm currently taking 30 MG when I wake up, 15 MG 2-3 hours later, and 30 MG in the afternoon as he directed me to do. He also said it doesn't matter if I take it with or without food.
3 questions for you:
1. Is dizziness a major problem with you? Because that's the most significant side-effect I'm currently experiencing.
2. Have you considered Provigil for the fatigue? It's done wonders for my fatigue and I honestly can not recommend it enough. Only negative is the price.
3. Why don't you just add something like Ambien for your insomnia? It does the trick for me!
Posted by FredPotter on April 2, 2007, at 20:49:52
In reply to Does Nardil fatigue go away?, posted by UGottaHaveHope on April 2, 2007, at 17:30:10
Michael all I can say is I find the drowsiness a nuisance too. I think it goes away and I think certain augmentations can make it go away (eg Provigil of course). Incidentally it's not nearly as unmanageable as Effexor was. I've been on 45mg for nearly 2 weeks. Lets' stick together
Fred
Posted by FredPotter on April 2, 2007, at 20:51:40
In reply to Re: Does Nardil fatigue go away?, posted by football on April 2, 2007, at 19:40:05
YES clumsiness, lack of balance, loss of temper when I inevitably knock things over
Posted by greywolf on April 2, 2007, at 21:41:24
In reply to Does Nardil fatigue go away?, posted by UGottaHaveHope on April 2, 2007, at 17:30:10
Have you narrowed the fatigue specifically to Nardil? I am extremely susceptible to the fatigue element, and Nardil was one of the few meds that I had no problem with in that regard. Of course, everyone's different.
Now, Seroquel was an entirely different story for me. It knocked me out like a bomb at even a low dose, and it's often prescribed to people who have difficulty getting a good night's sleep. If you're still ramping up the Seroquel dosage, the fatigue may not be caused by the Nardil.
Greywolf
Posted by Phillipa on April 2, 2007, at 21:45:59
In reply to Re: Does Nardil fatigue go away?, posted by greywolf on April 2, 2007, at 21:41:24
Michael I didn't know you had started the nardil. But maybe less seroquel now? Love Phillipa
Posted by gardenergirl on April 2, 2007, at 23:06:30
In reply to Re: Does Nardil fatigue go away?, posted by football on April 2, 2007, at 19:40:05
I'm right there with football: I use Provigil to deal with fatigue and ambien to sleep. I also take my 60 mg spread out, though I do morning, mid afternoon, and evening. I usually but not always take it with food, though I've not noticed any difference whether I do or not.
Namaste
gg
Posted by UgottaHaveHope on April 3, 2007, at 0:03:38
In reply to Re: Does Nardil fatigue go away?, posted by football on April 2, 2007, at 19:40:05
Football: Now you know why I constantly ask you questions. You are about two weeks ahead of me and I am monitoring everything you go through. Thanks for being so open on the board and feel free to e me directly anytime at sportscarvell@yahoo.com
I will answer below in ALL CAPS
>
> 3 questions for you:
>
> 1. Is dizziness a major problem with you? Because that's the most significant side-effect I'm currently experiencing. NONE. I HAVE SEVERE FATIGUE, CANT SLEEP AT NIGHT AND SOMETIMES LOSE MY BALANCE WHEN FIRST STANDING UP.
>
> 2. Have you considered Provigil for the fatigue? It's done wonders for my fatigue and I honestly can not recommend it enough. Only negative is the price. NO, BECAUSE IM AFRAID PROVIGIL WOULD GIVE ME MORE ANXIETY, WHICH IS THE ONLY REASON I AM TRYING NARDIL.
>
> 3. Why don't you just add something like Ambien for your insomnia? It does the trick for me! SEROQUEL IS THE BEST MED I HAVE EVER TAKEN FOR INSOMNIA. UNFORTUNATELY, IT IS MAKING ME MORE TIRED IN COMBINATION WITH NARDIL, BUT HOPEFULLY THAT WILL GO AWAY IN TIME.
Posted by UgottaHaveHope on April 3, 2007, at 0:06:06
In reply to Re: Does Nardil fatigue go away?, posted by greywolf on April 2, 2007, at 21:41:24
Thanks for sharing that experience. I emailed my pdoc today and he told me to make sure to spread out the 15mg doses of Nardil. He said this side effect of fatigue could go away and if not we will reduce Seroquel first, and then look at Klonopin, which I dont really think makes me fatigued.
Thanks for your input greywolf.
Posted by UgottaHaveHope on April 3, 2007, at 0:13:15
In reply to Re: Does Nardil fatigue go away?, posted by Phillipa on April 2, 2007, at 21:45:59
Jan, I was a 6 most of the time and sometimes a 7 on scale 1-10 on Emsam. It was a good trial, and something I will go back to if Nardil does not work.
However, reading about people's experiences with Nardil made me absolutely obsess about it. I was never going to be satisfied on Emsam or anything until I tried Nardil. My pdoc understood, saying he would "be obsessed too" if he had anxiety for 10 years. He said I had nothing to lose by trying Nardil, and the good news that there was no washout period (although did take 15 or 30 first six days to slowly build up).
I try to base my whole life on taking chances. Sometimes it works out, sometimes it fails. But I would never know if Nardil is my miracle unless I try it. The diet seems simple and there are no side effects, other than what I mentioned above, and hopefully they will go away in time.
Jan, I dont know. We'll see what happens. Believe me, I will keep you posted on everything because I know you and many others are interested in a real MAOI trial too. Thanks for caring, Michael
Posted by UgottaHaveHope on April 3, 2007, at 0:14:33
In reply to Re: Does Nardil fatigue go away?, posted by gardenergirl on April 2, 2007, at 23:06:30
GG: If I am taking Nardil for generalied anxiety, wouldn't you think that Provigil would add to the GAD?
> I'm right there with football: I use Provigil to deal with fatigue and ambien to sleep. I also take my 60 mg spread out, though I do morning, mid afternoon, and evening. I usually but not always take it with food, though I've not noticed any difference whether I do or not.
>
> Namaste
>
> gg
Posted by gardenergirl on April 3, 2007, at 0:43:21
In reply to Re: Provigil + Nardil in theory ... » gardenergirl, posted by UgottaHaveHope on April 3, 2007, at 0:14:33
I'm not sure. I don't feel at all "ramped up", jittery, or anxious on Provigil. Heck, a lot of the time I don't feel anything at all, except I can get up in the a.m., feel alert, not be hugely grumpy (which my husband really really appreciates), and not need a nap. I currently take 200 mg. I accidentally took 400 mg the other day when I mistook my Provigil for my vitamin. I didn't notice any difference and didn't feel any more ramped up.
I'm not an overtly anxious person. My anxiety gets covered up really well by depression and if not depressed, by avoidance, repression, and distraction. So I don't really know how it might affect someone who's primarily anxious. If your insurance will cover it and pdoc agrees, I'd say it's worth a try though. It's got a pretty short half-life, so if it makes you more anxious you can stop it and have it out of your system pretty quick.
namaste
gg
Posted by gardenergirl on April 3, 2007, at 0:47:56
In reply to Re: Does Nardil fatigue go away? » football, posted by UgottaHaveHope on April 3, 2007, at 0:03:38
> I HAVE SEVERE FATIGUE, CANT SLEEP AT NIGHT AND SOMETIMES LOSE MY BALANCE WHEN FIRST STANDING UP.
That sounds like orthostatic hypotension. It's when you go from lying down to sitting and/or sitting to standing, and your blood takes too long to get back up to your brain. It's sort of pooled in your lower body, and your blood pressure is too low to get it back up, so you feel dizzy. Does it pass pretty quickly?
I'm not sure if this is one of the side effects that goes away in a few months or sticks around. If it sticks around, it can be dealt with. You just have to go slow when getting up, and maybe hold onto something til your BP normalizes. Some folks have it for no particular reason, and they just sort of adapt. In some cases, though, it can get more severe, leading the person to actually fall and risk injury. Then it might be decision time. I believe there might be a med to counter-act it...Florinef comes to mind but it's too late at night for me to actually look it up. Sorry.
Anyway, I hope it passes, and in the meantime, don't go bounding out of your chair. ;)
namaste
gg
> >
> > 2. Have you considered Provigil for the fatigue? It's done wonders for my fatigue and I honestly can not recommend it enough. Only negative is the price. NO, BECAUSE IM AFRAID PROVIGIL WOULD GIVE ME MORE ANXIETY, WHICH IS THE ONLY REASON I AM TRYING NARDIL.
> >
> > 3. Why don't you just add something like Ambien for your insomnia? It does the trick for me! SEROQUEL IS THE BEST MED I HAVE EVER TAKEN FOR INSOMNIA. UNFORTUNATELY, IT IS MAKING ME MORE TIRED IN COMBINATION WITH NARDIL, BUT HOPEFULLY THAT WILL GO AWAY IN TIME.
>
>
Posted by football on April 3, 2007, at 2:22:48
In reply to Re: Does Nardil fatigue go away? » football, posted by UgottaHaveHope on April 3, 2007, at 0:03:38
> Football: Now you know why I constantly ask you questions. You are about two weeks ahead of me and I am monitoring everything you go through. Thanks for being so open on the board and feel free to e me directly anytime at sportscarvell@yahoo.com
>
> I will answer below in ALL CAPS
>
>
>
> >
> > 3 questions for you:
> >
> > 1. Is dizziness a major problem with you? Because that's the most significant side-effect I'm currently experiencing. NONE. I HAVE SEVERE FATIGUE, CANT SLEEP AT NIGHT AND SOMETIMES LOSE MY BALANCE WHEN FIRST STANDING UP.
> >
> > 2. Have you considered Provigil for the fatigue? It's done wonders for my fatigue and I honestly can not recommend it enough. Only negative is the price. NO, BECAUSE IM AFRAID PROVIGIL WOULD GIVE ME MORE ANXIETY, WHICH IS THE ONLY REASON I AM TRYING NARDIL.
> >
> > 3. Why don't you just add something like Ambien for your insomnia? It does the trick for me! SEROQUEL IS THE BEST MED I HAVE EVER TAKEN FOR INSOMNIA. UNFORTUNATELY, IT IS MAKING ME MORE TIRED IN COMBINATION WITH NARDIL, BUT HOPEFULLY THAT WILL GO AWAY IN TIME.
>
>interesting that you report no dizziness. I'm trying to remember if I experienced it at the dose you're taking, or if it only got significant when I increased to 70 MG day... I think, but I'm not certain that it started to appear at 70 MG, so just a warning for you to be prepared when you increase your dose.
In regards to Provigil and anxiety, while it has been proven to occasionally increase anxiety, this is quite rare and occurs is only 5% of users.
http://www.rxlist.com/cgi/generic/modafinil_ad.htm
If you're one of the unlucky ones who does experience anxiety, then just quit the drug. But if your fatigue is significant, it's seems worth the small risk.
"SEROQUEL IS THE BEST MED I HAVE EVER TAKEN FOR INSOMNIA. UNFORTUNATELY, IT IS MAKING ME MORE TIRED IN COMBINATION WITH NARDIL, BUT HOPEFULLY THAT WILL GO AWAY IN TIME."
I'm confused. I've never been on Seroquel, so would you mind telling me a little about it?
Oh, and feel free to ask me questions whenever you want!
Posted by greywolf on April 3, 2007, at 3:41:12
In reply to Re: Does Nardil fatigue go away?, posted by football on April 3, 2007, at 2:22:48
Seroquel is an atypical antipsychotic that is sometimes used in treatment of bipolar. I was taking it for BP and to help with my OCD. I complained of long periods of insomnia, so my doctor felt Seroquel would be just perfect.If I recall correctly, I started the Seroquel out at 100mg/day with a plan to gradually work up to 300mg/day at my discretion. After having some serious insomnia problems for a few weeks, at first it was a huge relief to get some real sleep with Seroquel. But then came Monday and I actually had to be able to function at work--wishful thinking at anything more than 100mg.
By taking the low dose as early as reasonably possible in the evening, I experienced only a little grogginess in the morning. But when I was at 200mg and above, you could have mistaken me for one of those tranquilized elephants on the Discovery Channel. I just could not shake the fatigue.
Curiously, I also experienced restless legs syndrome on Seroquel. I've never had it in the past, and it is a known but rare SE of Seroquel. I mentioned it to my psychiatrist, and he had just come back from a seminar a few days before where the restless legs problem caused by Seroquel was discussed. It apparently dissipates after a few weeks, but I never got far enough to confirm that.
Because I research and write for a living, being awake helps a lot. I've experienced fatigue with many medications, but rarely to the degree I did with Seroquel.
Greywolf
Posted by UGottaHaveHope on April 3, 2007, at 9:30:17
In reply to Re: Does Nardil fatigue go away?, posted by football on April 3, 2007, at 2:22:48
Dizziness: No I dont have that at 45mg, but I have read as you go up in the drug, so do the number of side effects, many of which eventually disappear or become less prominent over time. Thanks for the warning about 75, hopefully as high as I get is 45 or maybe 60.
Provigil: Thats a great chart on Provigil and one I will keep to show my pdoc if I continue to sleep walk during the day. Spreading the 15mg tablets throughout the day has helped a lot, but it hasn't totally gone away. Maybe it will in another week or so. If not, then I will need to do something, either add Provigil or decrease Seroquel.
Seroquel: It is like being shot with an elephant dart. Ive taken anywhere from 25 to 400 mg, with no side effects, other than dry mouth at start. If there is someone out there who is not taking any other drugs, and they take Seroquel, I cant imagine them not sleeping like a log. Of course, we take Nardil, and any drug interaction could cause the opposite effect (unlikely, but everybody is different). It seems to work the same with me on Nardil. I am taking 150mg now, and hope to eventually go down to 25-50mg. They have sample packets in your pdoc's office. Well there is another side effect, at higher doses it can make you groggy as heck the next day. But that helped me with anxiety. And I just drank some caffeine for that to go away. Actually, when my body becomes used to meds (and it's going to take 3-4 more weeks with Nardil), it seems like the lower dose of Seroquel 25mg was just as effective as higher dose. And you will know the first day you take this med whether or not it works..
Q's for you:
1. How long have you been taking Nardil now? Three weeks? Is it doing anything for you?
2. At what dosage did you finally feel some positive effects?
Posted by UGottaHaveHope on April 3, 2007, at 9:36:28
In reply to Re: Provigil + Nardil in theory ... » UgottaHaveHope, posted by gardenergirl on April 3, 2007, at 0:43:21
GG: Thanks for your insight. Yeah, I guess I will wait another week or two, and see if this tiredness goes away. I have a pdoc appt on April 17. And if I need something earlier I can just email him. I hope football's chart is correct, saying Provigil causes anxiety in only 5-percent of users. To me, though, it just doesnt make sense that something that jacks you up wouldnt cause anxiety. I dont understand that concept.
Losing balance: Yes, it's nothing major at this point.
Posted by UGottaHaveHope on April 3, 2007, at 9:38:57
In reply to Re; Trying to understand Provigil » gardenergirl, posted by UGottaHaveHope on April 3, 2007, at 9:36:28
Before I began taking Nardil, my pdoc took a blood test. He said something to the effect that it would give him a baseline, therefore when I begin taking Nardil he could give me another blood test to see how much was making it into my blood system. He said this one of the few drugs you could do this with.
Anyone heard of this?
Posted by greywolf on April 3, 2007, at 11:10:39
In reply to Re: Blood test on Nardil????, posted by UGottaHaveHope on April 3, 2007, at 9:38:57
Yes. Had it done myself when I was first on Nardil. Also had testing when I was on Depakote. It's the best way for your doctor to determine whether you've actually reached a therapeutic level of the med in your bloodstream. If you have reached the desired level, but you are not experiencing expected benefits, then you can decide not to waste any further time on the experiment.
Posted by UGottaHaveHope on April 3, 2007, at 14:31:14
In reply to Re: Blood test on Nardil???? » UGottaHaveHope, posted by greywolf on April 3, 2007, at 11:10:39
Thats cool they can do blood tests for these specific drugs, and shame cant or dont do for others.
Posted by Phillipa on April 3, 2007, at 18:56:48
In reply to Re; Trying to understand Provigil » gardenergirl, posted by UGottaHaveHope on April 3, 2007, at 9:36:28
Michael I don't get it either. And if you are dizzy how will you drive or does it go away? And you're very young and indestructable so you have a lot of time for med trials. Unfortunately I don't. One of my problems not is dealing with aging. And seeing no future and there is no way you will understand it till you're my age. Seriously. Love Phillipa ps Michael you know I want it to work for you. Funny I tried seroquel once in the hospital I didn't sleep through the night even with benzos and in the morning I had to be put back to bed by staff the feeling was I could think but couldn't form words came out as gibberish. The doc dc'd it that day.
Posted by football on April 4, 2007, at 1:03:13
In reply to Re; Trying to understand Provigil » gardenergirl, posted by UGottaHaveHope on April 3, 2007, at 9:36:28
> GG: Thanks for your insight. Yeah, I guess I will wait another week or two, and see if this tiredness goes away. I have a pdoc appt on April 17. And if I need something earlier I can just email him. I hope football's chart is correct, saying Provigil causes anxiety in only 5-percent of users. To me, though, it just doesnt make sense that something that jacks you up wouldnt cause anxiety. I dont understand that concept.
>
> Losing balance: Yes, it's nothing major at this point.
ilProvigil's hard to describe unless you've tried it.
It doesn't "jack you up" and give you lots energy like an amphetamine would.Here's a good description of it, that I found...
"Modafinil has changed the rules of the game. The drug is what's known as a eugeroic, meaning "good arousal" in Greek. It delivers natural-feeling alertness and wakefulness without the powerful physical and mental jolt that earlier stimulants delivered. "There are no amphetamine-like feelings," says Yves. And as Yves' way of taking it shows, being on modafinil doesn't stop you from falling asleep if you want to."
Posted by FredPotter on April 4, 2007, at 21:00:27
In reply to Re: Re; Trying to understand Provigil, posted by football on April 4, 2007, at 1:03:13
I understand the difference and I've been trying to convince my Drs of it. There's the jitters, which most doctors understand by abxiety. My type of anxiety starts in the earth's core rises up through my legs and ends up in my brain and in my lower abdomen. I imagine Provigil would help with that. I've always felt that anxiety is something I need to be lifted out of. So a stimulant for anxiety makes perfect sense to me. A sedative is definitely not what I need
This grogginess with Nardil (just over two weeks now) is bad in the morning and eases later although I spread my dose of 45mg throughout the day. It also makes me impatient, angry. I sure hope something good comes out of this
Fred
Posted by bengi68 on April 5, 2007, at 9:24:20
In reply to Re: Re; Trying to understand Provigil, posted by football on April 4, 2007, at 1:03:13
in high doses it makes you speed . i have a problem with addiction and i know. if you take alot it gives you anxiety really bad . i had valium and proviigl and i ate like 20 at a time and took valium for anxiety and its like being high. i guess if you do not have an issue try a few and see .
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