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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by F00TBALL on May 30, 2007, at 0:56:58
Thank God. I see him monday. It's been a rough two weeks since I was forced to quit it cold turkey.
Anyone have any idea how he'll likely prescribe it to me? Meaning, will I start at a low dose and slowly increase it like my first time being on it, will he increase the dose rapidly, or will he put me right back to 75 MG?
Obviously each P-doc has his own method, but what do you think is most likely?
Posted by KayeBaby on May 30, 2007, at 1:40:00
In reply to Found a new p-doc who'll put me back on Nardil!, posted by F00TBALL on May 30, 2007, at 0:56:58
Football,
I'm so glad for you!I don't know jack about that drug but I hope you get right back where you were before lightening fast!
Kaye
Posted by Phillipa on May 30, 2007, at 11:20:51
In reply to Re: Found a new p-doc who'll put me back on Nardil!, posted by KayeBaby on May 30, 2007, at 1:40:00
Football I read from top to bottom and didn't see this so happy for you. Love Phillipa
Posted by Jedi on May 31, 2007, at 2:31:46
In reply to Found a new p-doc who'll put me back on Nardil!, posted by F00TBALL on May 30, 2007, at 0:56:58
> Thank God. I see him monday. It's been a rough two weeks since I was forced to quit it cold turkey.
>
> Anyone have any idea how he'll likely prescribe it to me? Meaning, will I start at a low dose and slowly increase it like my first time being on it, will he increase the dose rapidly, or will he put me right back to 75 MG?
> Obviously each P-doc has his own method, but what do you think is most likely?Football,
He won't start you right back at 75mg and you probably would not want him to. You still should be able to titrate up a lot faster than a 1st time user or someone that has been off for months.I've told this story before but I had a PDOC once for nine months, that would have let me die before putting me back on a MAOI. I'm from a small town and I could not find anyone who would go against what this guy said. Finally, in a life or death situation, I used my emergency stash of Nardil and reported on enough studies of Nardil's efficacy for atypical depression that I got a local MD to prescribe it. I do not recommend this route. Your supply can run out before you find the right doctor. And, doing good research is hard when you are in the "Pit"!
Good luck with your new Doc,
Jedi
Posted by UgottaHaveHope on June 1, 2007, at 2:40:55
In reply to Re: Found a new p-doc who'll put me back on Nardil! » F00TBALL, posted by Jedi on May 31, 2007, at 2:31:46
15mg for two days, 30mg for three, and then 45 from there out.
Ive been gone for a month. Why did you go off Nardil? Michael
Posted by Jedi on June 4, 2007, at 14:44:26
In reply to Re: Im thinking the pdoc will do this ..., posted by UgottaHaveHope on June 1, 2007, at 2:40:55
> 15mg for two days, 30mg for three, and then 45 from there out.
>
> Ive been gone for a month. Why did you go off Nardil? MichaelHi Michael,
I've been gone for a time also. I decided to try Parnate because of the sweet carbohydrate cravings and associated weight gain from Nardil.I'm afraid I may have to return to Nardil because of some spontaneous blood pressure increases on Parnate. This happens with some people. I've woken in the middle of the night with just a splitting headache, and I'm the person that does not get headaches. I thought it might have been a sinus infection, but I don't even get bad headaches from these. I went to the clinic to get some antibiotics for the sinus infection and they measured my BP at 160/100. So I've cut my Parnate in half, down to 40mg and haven't had any more headaches, and the BP is averaging about 130/75. But I don't know if 40mg of Parnate will hold off the major depression. I've reconciled myself to dysthymia, I can at least function with this. I have to E-Mail my MD and get permission for all of this. Then I have an appointment with him in a couple of weeks and we will decide which way to go. It would be great just to be off everything except for some clonazepam for a while. But, if the major depression strikes again, it can take weeks for Nardil or Parnate to kick back in. Just my latest story.
Take care you guys,
JediResearch:
Biol Psychiatry. 1993 Aug 1;34(3):146-51.
Spontaneous hypertensive reactions with monoamine oxidase inhibitors.
Lavin MR, Mendelowitz A, Kronig MH.
Department of Psychiatry, Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY.Despite long-standing concerns over hypertensive reactions, monoamine oxidase inhibitors (MAOIs) have grown in popularity and are now used in a variety of psychiatric disorders. The risk of hypertensive episodes is less than 1%. This is most likely the result of careful dietary instructions and prudent prescribing of concomitant medications. The possibility exists of spontaneous or unprovoked hypertensive crises in patients receiving MAOIs. In this report, we review the literature on spontaneous hypertensive episodes and present a case report. There has been a total of 11 cases described in six separate reports. We discuss the possible mechanism, risk factors, treatment, and safety of rechallenging the patients with the MAOI. Further research is needed to clarify this reaction. For now, it remains a rare but worrisome phenomenon. It should stand as an additional source of concern for clinicians who are already well aware of the risk of hypertensive episodes in patients receiving MAOIs.
J Clin Psychopharmacol. 1989 Feb;9(1):48-51. Links
Comment in:
J Clin Psychopharmacol. 1990 Jun;10(3):232.
Autoinduction of hypertensive reactions by tranylcypromine?
Keck PE Jr, Pope HG Jr, Nierenberg AA.
Laboratories for Psychiatric Research, Mailman Research Center, Belmont, Massachusetts.Although rarely described in the psychiatric literature, patients treated with monoamine oxidase inhibitors may experience acute hypertensive reactions that are not readily attributable to dietary indiscretion or use of concomitant medications. Four cases of apparent autoinduction of hypertensive reactions in patients receiving tranylcypromine are presented. The mechanism of this reaction is unknown, but may involve conversion of tranylcypromine to metabolites with pressor activity.
Posted by UgottaHaveHope on June 5, 2007, at 4:24:16
In reply to Off Nardil - On Parnate » UgottaHaveHope, posted by Jedi on June 4, 2007, at 14:44:26
That is very interesting what you have to say. I dont know what to say bec I have never taken Parnate. Please keep us updated, interested to see how you do. Prayers, Michael
Posted by Jedi on June 7, 2007, at 1:40:44
In reply to Re: Keep us posted » Jedi, posted by UgottaHaveHope on June 5, 2007, at 4:24:16
> That is very interesting what you have to say. I dont know what to say bec I have never taken Parnate. Please keep us updated, interested to see how you do. Prayers, Michael
Michael,
Still no more headaches or high BP at 40mg Parnate. I've been kind of spacey lately, but that may be from the sudden 40mg drop in dosage. I'm going to stay at this dosage for now and cross my fingers that the major depression does not return. Who knows, I may just go off it all for a couple of months to see what happens. But I'm going to make sure my MD will prescribe Nardil again for me if things start heading for the "Black Hole" again.
Be Well,
Jedi
Posted by F00TBALL on June 8, 2007, at 0:13:18
In reply to Re: Im thinking the pdoc will do this ..., posted by UgottaHaveHope on June 1, 2007, at 2:40:55
Pretty good guess!
15 mg for two days, 30 mg for two days, 45 mg for three days, then 60 mg.
"Ive been gone for a month. Why did you go off Nardil? Michael"Very bad Serotonin syndrome from accidentally taking 1 Zoloft.
http://www.dr-bob.org/babble/20070524/msgs/759593.html
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