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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by cerebus on April 11, 2007, at 16:10:37
I am currently taking Paxil and Lithium. Recently have noticed an increase in anxiety during the morning. I am going to stop taking both, and will probably try an MAOI. Which one would be better? I am very sensitive to medications. What does it mean to have generalized social anxiety. I am not sure which diagnosis I have. I have always been told by pdoc. to have GAD first then SAD, which I cannot find any relief. Any feedback would be appreciated.
Posted by UgottaHaveHope on April 12, 2007, at 5:06:10
In reply to Increased Anxiety: Possible Nardil or Parnate, posted by cerebus on April 11, 2007, at 16:10:37
Nardil is considered better for all forms of anxiety, while Parnate is said to have an energizing effect. Every med affects everyone differently.
Posted by FredPotter on April 13, 2007, at 5:47:32
In reply to I am taking Nardil for GAD » cerebus, posted by UgottaHaveHope on April 12, 2007, at 5:06:10
Michael I was wondering how you were getting on with Nardil. I've been on Nardil for 3 weeks 2 days and I'm noticing marked pro-social effects, but I can collapse into tears when I'm alone, although I've been in a hotel this last week. I also feel angry often and will stand up to people when I think they're talking rubbish. I gave a seminar and felt very relaxed however. It's been a rough ride, but I made a sudden transition from Effexor. I wake feelimg groggy but somehow don't want to take to the couch.
I find it difficult to pronounce words, but that may be anxiety while I wait for Nardil to do its stuff. And I gave my seminar and didn't care if my speech was slurred. You're 1 week behind me aren't You? I hope you're doing well on Nardil
Fred
Posted by UgottaHaveHope on April 14, 2007, at 0:27:14
In reply to Re: I am taking Nardil for GAD » UgottaHaveHope, posted by FredPotter on April 13, 2007, at 5:47:32
Fred: I feel you. Yes I am a week behind you and I am also feeling some nasty side effects from Nardil, But the good news is that everyone who has taken it and had the guts to stay on it says the side effects lessen or go away all together over time. And I still think you are two weeks to a month away from having it reach its full benefits. We can make it through this together. Dont waste these first three weeks. Hang on, and just know you are going to get better. Tell yourself that every day. No pain, no gain. Im always here for you dude, Michael
Posted by FredPotter on April 16, 2007, at 13:54:19
In reply to Re: Hang in there Fred » FredPotter, posted by UgottaHaveHope on April 14, 2007, at 0:27:14
Hey Michael thanks. I'm here for you too. Weight gain is a bugger, my poor legs can hardly stand the strain. And I have a tight chest. Do you have any of these things?
I still cry a lot, sometimes for no apparent reason, often without even feeling sad. I think this may be because Effexor dammed it up and now my feelings, good and bad are unblocked. My ability to talk in an authoritative tone amazes me, compared to the wimp I was. There is a lot of people, esp bureaucrats, out there who talk rubbish and carry out social experiments on us and I won't stand for it any more.If I tell people my honest opinion, they are perfectly free to argue back, so where's the problem? I also mentioned being pro-social didn't I?
One thing worries me. How can the body tell the difference between side effects and the intended AD effect? If the side effects fade with time, then so will the AD effect. I hope this isn't true.
I told you about the weight gain from Nardil. But did I say that my blood sugar has come down. This is great news for me, a diabetic. There are also stories of blood pressure lowering. So perhaps I can chuck out all my pills! uh apart from Nardil. However I read somewhere that Metformin, which my Dr was considering giving me for hyperglycaemia, is also said to eradicate Nardil weight gain. Now my blood sugar has returned to normal, it looks unlikely that my Dr will take this route.
So how about you? What effects/side effects are you having?
regards
Fred
Posted by missliz on April 18, 2007, at 1:37:48
In reply to Re: Hang in there Fred » UgottaHaveHope, posted by FredPotter on April 16, 2007, at 13:54:19
It takes eight weeks for an MAOI to really settle in. Right now it's probably rewiring your brain to normal and it's a rough ride on. You're crying because you can; After the strange things SSRIs do to you it's a shocking thing to be yourself again.
One day soon you will look up and around and think "my god, this is how the normal people live!"
It's not easy though. You have to do the cognitive work and learn how to be social. But you won't be afraid.Nardil is currently a genericized version of the original, just at patented prices, so if you get any disgusting looking pills take them back and whine and see if you can get some from a different manufacturing lot. The number is on the bottle and the pharmacist has it. Bioavailability can be a problem with old stock. Phizer would rather us take pricey patented drugs that don't work.
MAOIs are the only anti depressant drug that can cause complete remission.Lizzy
Many years of Nardil
Love the stuff
Posted by FredPotter on April 18, 2007, at 16:22:38
In reply to Re: Hang in there Fred, posted by missliz on April 18, 2007, at 1:37:48
Thanks missliz your encouraging post has come just at the right time as I'm crying all the time, thinking of suicide etc. My 13 yr old boy is staying with me. He's such a treasure and keeps me going, although it's a rotten thing to put on him. Added to which I'm in constant pain due to suspected gallstones. I think the tight chest and weakness comes from years of statins. I was reading some shocking stuff about CoA10 depletion.
Posted by missliz on April 18, 2007, at 19:41:10
In reply to Re: Hang in there Fred » missliz, posted by FredPotter on April 18, 2007, at 16:22:38
Statins are awful! Have you tied Omega threes in fish oil? I take like 5 caps a day. Fixes cholesterol for many people, and is an excellent adjunct for depression meds. In fact I consider them part of my treatment.
Omega 3s from fish oil-NOT Cod Liver Oil. That'll give you vitamin A poisoning.
The tight chest and weakness are classic anxiety symptoms; I had a complete shift in anxiety presentation on MAOIs and it's overwhelming. It can be a hard ride on to Nardil, and not every body sticks it out to the pay off. Not every body can deal with being much better, either.
If you're suicidal you need to call somebody there. Call your Doctor. A 13 year old can't take care of a depressive. It is a rotten thing to put on him. Get a grown up.
It's the nature of first time MAOI use to have to ride this monster. You are in the gap, so hang on.Lizzy
Posted by FredPotter on April 18, 2007, at 20:33:08
In reply to Re: Hang in there Fred, posted by missliz on April 18, 2007, at 19:41:10
Lizzy thanks once again. I take about 7 caps a day of Omega 3 and have been doing so for years. Also a handful of walnuts per day (my Dr said the person who suggested that to me was LOOPY! He's also the CEO of a top government research organisation). Yeah thanks I know I'm in the gap at 4 weeks. I think I'm also still suffering from suddenly coming off Effexor 5 weeks ago. Why are statins awful in your opinion? I think that anything that prevents the manufacture of anything as absolutely crucial as CoQ10 is going to produce very bad effects, like exhaustion, even depression, and muscle aches and degeneration, heart failure, wheezy chest.
Posted by missliz on April 19, 2007, at 1:40:52
In reply to Re: Hang in there Fred » missliz, posted by FredPotter on April 18, 2007, at 20:33:08
Yikes! No wonder you feel like garbage. Effexor is bizarre stuff, terrible withdrawal- meaning a big old brain insult- and you may have had a rather short washout for that particular c$***y SSRI. Although I don't remember the washouts, I refuse to ever take the junk again.
Statins are pretty toxic from what I hear, I've never taken them but have had friends have frightening side effects from them. I don't know what peice of biochemistry you refer to, but the word in taking care of yourself through common sense underground is that fish oil and eating green vegetables instead of Ho Ho's will do what an expensive toxic statin does for a great many people. My doctor backs this up.
A lot of commonly used wonder drugs have more to do with profit than best treatment, and statins are in that column. I truthfully don't remember the details- but a few people actually need them and the rest need a healthier diet. This does not pay for new Gulfstream jets, though, so statins are pushed hard.
I'd worry more about how you're going to deal with the misery while you wait. And the current Nardil is a reformulation of the original Warner Lambert wonder drug (gee, thanks, Phizer) so the dose can need more tweaking than you think. Bioavailability can be different than the books say, so if you aren't chilling soon talk to the psydoc about tweaking the dose up.
Famous Doc wrote that if an MAOI seems not to be working, it's the dose- because MAOIs ALWAYS work. You just have to ride that stumbling pony for two months. It's much worse on Parnate- the rebuild job it does on the functional matrix you live in can be quite a hive of busy worker bees, and it's a shocking thing to be recreated as not depressed in such a short period of time. Really good, but a shock.
So get a new hobby. Being a diagnosis won't work anymore. That's the biggest MAOI failure- people who are so bought into the mental illness machine they have nothing left and don't realize they need to go out and live. get a library card and crawl the stacks for something interesting. it'll take your mind off how crummy you feel.
Exhaustion, muscle aches, and tight chest are all anxiety and mood disorder symptoms. You need to put the depression into remission before you can parse symptoms of other diseases.
Go read Ken Gillman on this at Psychotropical.com. He knows MAOIs.
Posted by FredPotter on April 19, 2007, at 16:18:58
In reply to Re: Hang in there Fred, posted by missliz on April 19, 2007, at 1:40:52
Yes Ken Gilman's good. As I'm only on 45mg/day I need to rev Nardil up gradually to 90mg wouldn't you say? I really appreciate your help. Most people when they get better don't bother with psychobabble anymore I would guess. From what you say it hasn't pooped out either. And have side effects like weight gain gone too? They ALWAYS work - wow that's encouraging
re: statins I realise I've been on a huge dose (80mg/day). My wheezing and aching joints are over and above anxiety I think. And I walk like the tin man before Dorothy found the oil can. I've got loads of hobbies - they're just on hold for when I can stop crying
love
Fred
Posted by UgottaHaveHope on April 21, 2007, at 3:12:31
In reply to Re: Hang in there Fred, posted by FredPotter on April 19, 2007, at 16:18:58
Fred, unless you feel like Nardil is pooping out on you, I dont know why you would go up. But yes, many find success on 60. 90 is about as high as Drs will prescribe but some of this board cheat and take more and have for decades
Posted by gardenergirl on April 21, 2007, at 8:35:01
In reply to Re: 45mg or 90mg, posted by UgottaHaveHope on April 21, 2007, at 3:12:31
It's a pain, but I've at times taken 52.5 mg (3 and a half tablets) or 67.5 (4 and a half). Those half tablets do make a difference for me, and it gives me more options for dose without automatically going through another wave of side effects. Going from 45 to 60 always meant another wave of anorgasmia and urinary retention would show up as an SE. Both eventually go away, so 60 mg is very tolerable to me. Actually, 67.5 is also quite tolerable, but I just don't need it enough to warrant cutting tablets all the time right now. I know others have also done well at 75 and 90. I can't go that high, 75 was too much, but I'd give it a shot with raising your dose if you had a positive response. Just go slow with it.
Namaste
gg
Posted by missliz on April 21, 2007, at 8:39:59
In reply to Re: 45mg or 90mg, posted by UgottaHaveHope on April 21, 2007, at 3:12:31
I've been on 45 mg for years, but the Nardil is different now, Phizer got ahold of it and made the original recipe into a really cr*%%y generic. Bioavailability is a problem, especially from lot to lot. Some of it's fine, and some of it's garbage. There's a big patient political action organization on the FDA's back about this, but if you have a bad lot you may need a huge amount. This can be dicey, but worth knowing about.
Or you can compromise and go 60?
Mood stabilizers help for a lot of people; I know I've been on Tegretol then Trileptal for years and that takes up a lot of the slack, too. It's a thought.You know what may be up Fred? People just bawl at the gym, or at rehab, and it's because they hold emotional pain stored up in their bodies. You may have a huge amount of emotional stuff you need to just bawl over and get it out; Maybe you just couldn't before. It took my Pdocs ten years to get me to cry, and it was awful when they finally made me. But it was a therapuetic thing. Depression is horrendously painful. And certain kinds of tears clean bad chemicals out of your brain, emotional byproduct stuff. If you can't cry it gives you awful head aches.
Maybe you should just howl like a chic with hormones until it ends. Maybe you need to cry. Just do it.
Therapy is recommended when starting MAOIs because they're such an experience. Maybe you don't need to pay somebody- the crying is it. Or you should tell somebody (liscensed) what comes up and makes you cry. Your call, but I think you just need to bawl.Lizzy
Posted by FredPotter on April 21, 2007, at 19:58:55
In reply to Re: 45mg or 90mg, posted by gardenergirl on April 21, 2007, at 8:35:01
Thanks I just want to ramp up the dose as the present dose isn't working yet, after 4.5 weeks
Posted by FredPotter on April 21, 2007, at 20:03:02
In reply to Re: 45mg or 90mg, posted by missliz on April 21, 2007, at 8:39:59
Thanks Lizzie once again. I couldn't cry on Effexor. Now it's happening all the time on Nardil. It's quite a relief when you can cry at last Fred
Posted by missliz on April 21, 2007, at 22:50:49
In reply to Re: 45mg or 90mg » missliz, posted by FredPotter on April 21, 2007, at 20:03:02
Actually I just bumped my dose two days ago, and I am doing stuff instead of thinking it- so it may be the formulation change, or it may be that I whiegh a hundred pounds more than I used to...
Still Fred, doubling up at once may be strong! you can go 60, 75, 90 so feel it out. Do you want to be in hospital getting pulled off the drug by some ignorant resident and going back to square one?
Call me paranoid but drug induced mania and the following trip to lock up hell are soooo counterproductive. Crawl it up over some days or lweeks and see where you get. A 100% increase is a lot. A 33% increase and some thought about why you're crying is a healthy pause. It doesn't happen all at once. You don't get fixed in a day- it's a process. I hate that, but it's the truth.
If 60 doesn't lighten you up in a few days to a week, go to 75. But this drug does have high dose side effects and why invite trouble? I know how hard it is when you're sick and hurting, but be judicious. Even 45 to 67 to 90 will soften the shock at least and let you see where you really need to be. Top end increases can need to be subtle...
Posted by FredPotter on April 23, 2007, at 2:25:08
In reply to Re: 45mg or 90mg, posted by missliz on April 21, 2007, at 22:50:49
Thanks Lizzie I'm on 60mg now, but still hurting real bad. I drink a few beers of an evening to ease the pain. Will that completely screw up my progress? If alcohol messes with neurotransmitters, how does it do it? Thanks again - you're helping me a lot
Fred
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