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Dr. Bob is Robert Hsiung, MD,
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Posted by dreamboat_annie on January 7, 2007, at 11:59:04
In reply to Re: Nardil + nortriptyline is working - AGAIN! » Phillipa, posted by SLS on January 7, 2007, at 11:09:44
Woohoo is right!!! I will keep my fingers crossed for you, Scott, that it continues to work even better as the days go by.
Take care.
> Woohoo!
>
> I discontinued Nardil for a few days and restarted it at 45mg and moved up to 60mg. It's starting to work again.
>
> I know, I know. I shouldn't get my hopes up too high given my history, but what the hell. I think this might really be it.
>
> Woohoo!
>
>
> - Scott
Posted by dreamboat_annie on January 7, 2007, at 12:01:12
In reply to Re: Nardil + nortriptyline is working - AGAIN! » Phillipa, posted by SLS on January 7, 2007, at 11:09:44
> I know, I know. I shouldn't get my hopes up too high given my history, but what the hell. I think this might really be it.-- Yes, but sometimes hope is what sustains us through the trying and difficult times. Without it, we would be lost. So, hang on to that hope. My hope is that is translates into success!!
Posted by ed_uk on January 7, 2007, at 13:34:44
In reply to Re: Nardil + nortriptyline is working - AGAIN! » Phillipa, posted by SLS on January 7, 2007, at 11:09:44
That's fantastic Scott :) I hope the effect builds up over the next few days/weeks. Keep us updated!
Ed
Posted by Phillipa on January 7, 2007, at 18:48:12
In reply to Re: Nardil + nortriptyline is working - AGAIN! » Phillipa, posted by SLS on January 7, 2007, at 11:09:44
Yeah!!!!!!!Oh Scott so happy for you. You deserve it and more now will you be my pdoc? I think you have time to go to school and even if you don't I trust you the most. Love Jan
Posted by stargazer on January 7, 2007, at 22:53:10
In reply to Re: Nardil + nortriptyline is working - AGAIN! » SLS, posted by Phillipa on January 7, 2007, at 18:48:12
Scott,
Happy to hear the Nardil is working so well. I may have to try Nardil again if Emsam doesn't start to work soon. I'm only at 6 mg but usually meds will work for me at the lower end of things if they are going to work.
I believe I have alot of he same type of depressive symptoms you have...I have TRD with alot of anergia, some social anxiety, although I havent't been putting myself out there lately so I'm rusty with that... and ADD symptoms, lack of motivation, focus, attention span, distractibility, etc.
My choice was to try Nardil again, but my pdoc wanted me to try EMsam first so thats what I'm doing. Initially I had alot of energy on Emsam but not feeling like I did when Nardil and Marplan worked in the mid to late 80's. That was a normal person type of feeling, where I would never think about what I was doing and wouldjust be living anormal, productive life. All the years on the other meds (SSRI's, etc.) I may have not been depressed but I was still thinking about how I was doing and how I really wasn't comfortable in my life and my relationships with others. It's hard to explain the difference but I'm sure anyone who has TRD knows the difference.
I'm glad it is working for you but I don't understand how the combination works. I have had problems with Lamictal, only took Nortrip, briefly, on it's own...think I took Abilify once, no recollection of effect...and is Trileptal an antiseizure/mood stabalizer? Can you say what each one adds to the formula in terms of symptom control?
God bless whoever is handling your psychopharm management. It is an unusual mix but very customized so hope it keeps you out of trouble, I'm keeping my fingers crossed...SG
Posted by SLS on January 8, 2007, at 7:58:10
In reply to Re: Nardil + nortriptyline is working - AGAIN!, posted by stargazer on January 7, 2007, at 22:53:10
Hi.
> Happy to hear the Nardil is working so well.
Thanks. The improvement is mild at this point, but I expect it to grow gradually over the course of months, not weeks.
> My choice was to try Nardil again, but my pdoc wanted me to try EMsam first so thats what I'm doing. Initially I had alot of energy on Emsam but not feeling like I did when Nardil and Marplan worked in the mid to late 80's.
This is exactly what I have observed with others who have tried Emsam.
> That was a normal person type of feeling, where I would never think about what I was doing and wouldjust be living anormal, productive life.
Yes!
> All the years on the other meds (SSRI's, etc.) I may have not been depressed
How do you know that you weren't still somewhat depressed? Often, there is some residual depression after medication that just doesn't feel as bad as before medication. This is often confused for a lack of interest, laziness, lack of desire to socialize, etc.
> but I was still thinking about how I was doing and how I really wasn't comfortable in my life and my relationships with others. It's hard to explain the difference but I'm sure anyone who has TRD knows the difference.
Yes. Responses to medication can be very incomplete.
> I'm glad it is working for you but I don't understand how the combination works.
That's ok. I'm sure very few people would. I don't. Discovering the drugs that work is partly deductive, but mostly empirical.
> and is Trileptal an antiseizure/mood stabalizer?
Yes. I think it's a good drug. It is almost free of cognitive side effects compared to its sister drug, Tegretol. I found that it had a mild antidepressant effect.
> Can you say what each one adds to the formula in terms of symptom control?
Not really.
:-)
All of the drugs possess mild antidepressant effects for me. However, I think the real magic lies in the combination of Nardil + nortriptyline. However, that magic might not exist at all without some or all of the others.
nortriptyline
Nardil
Lamictal
Topamax
AbilifyNortriptyline + Lamictal provides a stable, mild improvement where each alone does little or nothing. Adding Abilify gave me a mild improvement in mental energy and motivation. Adding Topamax provided some further improvements, although mild. However, it gave me hints of something special that I can't put into words. Adding Nardil has produced a more social demeanor, more mental and physical energy, an improvement in anhedonia, interest, motivation, cognition, and memory. Food tastes better. Music sounds better. Stuff like that.
> God bless whoever is handling your psychopharm management.
It has been a combined effort. I am happy that I have a doctor who has been willing to work with me and act on the ideas that I present to him. I am especially grateful that he encouraged me to restart the Nardil. I had been undecided about it.
> It is an unusual mix but very customized so hope it keeps you out of trouble, I'm keeping my fingers crossed...SG
Toes and eyes too?
Thanks.
:-)
- Scott
Posted by stargazer on January 8, 2007, at 10:13:08
In reply to Re: Nardil + nortriptyline is working - AGAIN! » stargazer, posted by SLS on January 8, 2007, at 7:58:10
Toes and eyes remain crossed at all times for extra luck...I'm a site to behold....
Nardil can be the bomb, those MAO's really are the key that I'm still pursuing...hope i can find the answer soon.
I'm 50 this year and haven't really had more than a few years out of the past 20 that have been good, sad but true. But that has only happened on Nardil and Marplan(before they discontinued it) and that was my only real "normal" period although I have been functional, but still depressed, but I can hideit very well.
I haven't given up on Emsam yet though so we may be tweaking it before changing to another med, but if that fails I will insist on Nardil.
Wouldn't it be interesting, if those of you like myself and others that respond so well to the MAO's could be tested chemically and determine what is the biochemical similarities that exist in our blood/ brain, etc. There may be a connection that could really be beneficial to others and a breakthrough in the quantification of certain types of depression.
Thanks for your response. I am only able to read the ones lately that give me some hope and don't confuse an already confusing and long process. I have given up hope on most of the new AD's and find reading about them too frustrating and it justs makes me relive all the drug trials I have been through over the past 20 years. Not fun!
SG
Posted by corafree on January 24, 2007, at 16:10:48
In reply to Re: Scott how did you come up with this combo? » UGottaHaveHope, posted by SLS on December 18, 2006, at 6:21:01
Scott I can't find the last discussion I had with you. I think you asked me if I had ever tried Nardil. Can you jog my memory?
tks, cf
Posted by SLS on January 25, 2007, at 5:26:49
In reply to Re: Scott how did you come up with this combo?, posted by corafree on January 24, 2007, at 16:10:48
> Scott I can't find the last discussion I had with you. I think you asked me if I had ever tried Nardil. Can you jog my memory?
>
> tks, cf
Several years of trial and error. I chose to remain on the drugs that gave me a steady partial response. Of course, being on Nardil, that excludes any of the serotonin reuptake inhibitors. Topamax produces positive effect, which might be indicative of the bipolar nature of my illness. Lamictal helps, but only when combined with nortriptyline, and at a dosage of 150mg. The most positive effect of Nardil occurs when the dosage of nortriptyline is brought up to 100mg. I might not need Abilify, but I prefer to attempt its discontinuation when I get stabilized and progress substantially more in my recovery. It initially helped with mental energy and motivation, but I cannot tell if these benefits have persisted. One thing that probably has persisted is an anti-suicide effect. It may not be as potent as Zyprexa in this regard, but I feel Abilify is a cleaner drug with respect to side effects.I recently ran into complications. I developed hypotension which causes me to fall to the floor and the inability to urinate, which sometimes requires bethanecol to correct so that I can avoid going to the hospital for a catheterization. I have been playing with dosages, but so far have not been able to obviate the problems without reducing the dosages to the point where I lose the antidepressant effect. I'll get it.
- Scott
Posted by corafree on January 26, 2007, at 17:55:30
In reply to Re: Scott how did you come up with this combo? » corafree, posted by SLS on January 25, 2007, at 5:26:49
X
(That silly X means, "Yeah, I got ya', and tks!"', for further reference.)
I'm so piss*d! I just 'lost' a long response to your much appreciated post 'accidentally' .. becuz' my fingers are so freakin' tired I hit the wrong key.
I'm callin' P b4 he heads up to slopes for weekend!
CF is pissed enuf' to stand up for self!
I'll re-respond Scott.
cf
Posted by corafree on January 26, 2007, at 21:19:45
In reply to Re: Scott how did you come up with this combo? » corafree, posted by SLS on January 25, 2007, at 5:26:49
Oh Scott, I'm sorry. I give up! I did it three times, and now, well I'm dazed and confused.
U'd asked me if I'd tried Nardil some time back.
I asked my P about it. He said, "Oh, that's an MAOI. They've come out w/ it in a patch form called Ensam, which bypasses your gut so as not to tie you to dietary restrictions."
That's incorrect, isn't it?
Anyway, just now (Or, has it been hours now?), excited @ your news, feeling strong, I felt pro-active and quickly called my P.
I've had awful anxiety. Two wks off Eff-XR. "No" to prn lorazepam. P thinks starting Lexapro next week will help.
I've had a NB. I now have ongoing anxiety probs' w/ panic attacks. Man ... I'm suffering.
This is just too long of a story for me to not accidentally delete and wipe out this entire post again!
At a point a few yrs back, I too became anti-suicide. I thought it was a blessing/miracle.
Thought of Enablex for inability to urinate. Dunno. I've had it and it's awful! Otherwise, pray u stay the course.
cf
ps Control copy that!
Posted by TehDizzyBroad on January 30, 2007, at 14:49:51
In reply to Re: Scott how did you come up with this combo? » corafree, posted by SLS on January 25, 2007, at 5:26:49
Scott,
Thank you so much for being so lucid and forthcoming in everything you write here. I am a newcomer, but have found your post among most others as being the most informative and hope-inspiring. Not so much because you've found success in better living through modern chemistry - this most recent thread showing the pains you're going through to find the perfect blend - but that you're so well informed and patient!
Too often I've found that people, both here and at other boards, are too quick to lambast this or that medication because of what it did for them after only a day or three. You are patient and thorough and hopeful throughout all of it. It's refreshing, and hope-inspiring to someone who is desperately looking for an objective view and experience while on their first real venture into Pharmaceutical-Land!
Thanks, and thanks again.
Posted by SLS on January 30, 2007, at 15:06:10
In reply to Re: Scott how did you come up with this combo?, posted by TehDizzyBroad on January 30, 2007, at 14:49:51
:-)
- Scott
Posted by corafree on January 31, 2007, at 6:38:47
In reply to Re: Scott how did you come up with this combo?, posted by TehDizzyBroad on January 30, 2007, at 14:49:51
Yep UR definitely 'patient' Scott. Next time somebody calls me a patient, I'll say no, I'm not Scott.
I'm supposing it is in your character.
Fire is in my character ... a lot of fire/passion. I could never do what you do w/o someone to hold me.
cf
Posted by Jedi on February 4, 2007, at 2:44:49
In reply to Nardil + nortriptyline is working., posted by SLS on December 16, 2006, at 6:36:52
Hi Scott,
I've mixed 100mg nortriptyline with 90mg Nardil with no problems. It worked for me, but after a while it seemed like the nortriptyline was not adding anything over and above the Nardil. It was a good combo for me though with absolutely no sign of serotonin syndrome. However, I wasn't taking all of the other augmentors that you take. The only thing I was adding to the mix was 1mg of clonazepam for the social anxiety.My depression is treatment resistant atypical with social and generalized anxiety. I also have a bipolar component as several medications have put me in a hypomanic state, almost manic. In fact, when I first used Nardil in 1997, when it kicked in, it put me in an almost manic state. It sure felt good at the time, but I'm really careful to watch for it now. Nardil + Geodon did the same thing for a while.
How does your system handle the Topamax? I would like to add something to the Nardil to counteract the severe carbohydrate cravings and associated weight gain. I can't handle any more lowering of my mental capabilities, though. I'm stupid enough already.
Good Luck,
Jedi
> Hi all.
>
> I increased my dose of Nardil from 60mg to 75mg a few days ago.
>
> I am beginning to respond. The antidepressant effect is unmistakable.
>
> Yay!
>
> I am afraid, of course, that I will stop responding. It is so early. I'm already preparing my doctor to let me go up to 90mg when I see him next in a few weeks. His only trepidation is that combining Nardil with nortriptyline might produce serotonin syndrome. It is a valid concern, but I doubt it will occur. I am very impatient.
>
>
> Currently:
>
> Nardil 75mg
> nortriptyline 100mg
> Lamictal 150mg
> Topamax 100mg
> Abilify 10mg
>
>
> - Scott
Posted by SLS on February 4, 2007, at 11:16:48
In reply to Re: Nardil + nortriptyline is working. » SLS, posted by Jedi on February 4, 2007, at 2:44:49
> I've mixed 100mg nortriptyline with 90mg Nardil with no problems.I've had to increase the dosage of nortriptyline to 200mg. Interestingly, the side effects have mitigated at this higher dosage.
> It worked for me, but after a while it seemed like the nortriptyline was not adding anything over and above the Nardil.
Maybe you needed a higher dosage of nortriptyline.
> It was a good combo for me though with absolutely no sign of serotonin syndrome. However, I wasn't taking all of the other augmentors that you take. The only thing I was adding to the mix was 1mg of clonazepam for the social anxiety.
> How does your system handle the Topamax?It has not affected me negatively cognitively at all. I started low and increased the dosage very slowly to 150mg. I then backed off to 100mg. I find that Topamax has a mild energizing effect for me and actually improves me cognitively at 100mg.
> I would like to add something to the Nardil to counteract the severe carbohydrate cravings and associated weight gain. I can't handle any more lowering of my mental capabilities, though. I'm stupid enough already.
Perhaps you can try a stimulant like Ritalin or Adderall first. What was your appetite like when you were taking Nardil + nortriptyline?
> Good Luck,
Thanks.
You too.
Currently:Nardil 75mg
nortriptyline 200mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
- Scott
Posted by Michael on July 25, 2007, at 18:19:03
In reply to Nardil + nortriptyline is working., posted by SLS on December 16, 2006, at 6:36:52
> Hi all.
>
> I increased my dose of Nardil from 60mg to 75mg a few days ago.
>
> I am beginning to respond. The antidepressant effect is unmistakable.
>
> Yay!
>
> I am afraid, of course, that I will stop responding. It is so early. I'm already preparing my doctor to let me go up to 90mg when I see him next in a few weeks. His only trepidation is that combining Nardil with nortriptyline might produce serotonin syndrome. It is a valid concern, but I doubt it will occur. I am very impatient.
>
>
> Currently:
>
> Nardil 75mg
> nortriptyline 100mg
> Lamictal 150mg
> Topamax 100mg
> Abilify 10mg
>
>
> - Scott
Hey Scott,Just wondering how the combo is working for you now...? (just came across this thread)
Still well, I hope!
Btw, I'd be interested in any thoughts/insights you might have (if any, & if you're up to it) regarding abilify, as it relates to the questions in the following post:
http://www.dr-bob.org/babble/20070719/msgs/771945.html
Thanks for all your feedback & help in the past, & hope your good news is persisting!
michael
Posted by Phillipa on July 25, 2007, at 20:18:04
In reply to Re: Nardil + nortriptyline is working. » SLS, posted by Michael on July 25, 2007, at 18:19:03
Michael sorry I forgot a few of his meds but so glad you found the thread. Love Phillipa
Posted by Fivefires on August 1, 2007, at 13:10:10
In reply to Re: Nardil + nortriptyline is working. » SLS, posted by Michael on July 25, 2007, at 18:19:03
Don't stop believing Scott!
Gosh it's good to hear good.
sending miracle vibes, 5f
Posted by Fivefires on August 5, 2007, at 3:58:44
In reply to Re: Nardil + nortriptyline is working. » Michael, posted by Phillipa on July 25, 2007, at 20:18:04
In Feb Scott posted and in July Michael posted.
What's going on here? I am totally confused!
I found my response above this one, also down below somewhere by itself.
Michael, did you reach Scott, as I don't see him responding?
Anyway, I'm glad you Michael, not Scott, are doing well on your regimen.
I sat down here in the middle to find your post and copy and (w/o name of course) as like to keep successful regimens for reference.
Scott, are you out there? Where is Scott?
I'm sooooooo confused, I really need Admin to explain this to me.
This thread disconnects somehow and my post, which was incorrect re: which person I was responding to, is here, and it is also down there somewhere.
Who knows where this one will end up!
5f
Posted by Fivefires on August 5, 2007, at 4:32:36
In reply to Nardil + nortriptyline is working., posted by SLS on December 16, 2006, at 6:36:52
Hi Scott, wherever you are. It's nearly fall. Where ya' been?
(Not that it's my business in particular, but I'm so freakin' confused, and hope someone can explain the incontinuity of this thread.)
I got totally confused down at the bottom of the thread where M is sharing his success w/ U and I think asking how U are doing. But, in looking back, I can see why I was confused, because it's as if some information is missing causing incontinuity of the thread.
Can u share pls Scott. RU still on same combo as in 2/07, and successfully?
Pls forgive the three posts every1 but I'm ready to bang my head against the wall repeatedly! (Just kidding.)
And, my followups that are here, are also down below, sporadically, alone.(?) o_o
so confused, 5f
Posted by stargazer2 on September 8, 2007, at 13:49:00
In reply to Re: Nardil + nortriptyline is working., posted by Fivefires on August 5, 2007, at 4:32:36
I just started on this combination. Nardil 45 mg and Notriptyline 50 mg. Was at Nortrip 75 with side effects (dry mouth, lethargy, no motivation) that were bothersome and just reduced to 50 so we'll see what happens. I also was recently started on Synthroid, 25 mcg up to 50 mcg, just reduced to 25 mcg yesterday with SE's of sweating and heat intolerance, which I think are related to Synthroid not Nortriptyline.
My situation is complicated by recent onset of menapause.
Of interest is a renewed focus on working again. I hope this is not a placebo effect or transitory response. I am reaching the end of my rope with finding something to get me out of a two year slump and this has been the longest bout with no response. In th past I functioned with dysthymia and depression better and could fool myslef into thinking I was OK. Now it's impossible to do this, probably from years of pretending I was OK...
Wish me luck with this combination for the long haul.
Stargazer
Posted by Phillipa on September 8, 2007, at 20:43:07
In reply to Re: Nardil + nortriptyline is working., posted by stargazer2 on September 8, 2007, at 13:49:00
Stargazer that's great . I'd say you are correct about the snythroid causing the sweating as if you start to get hyperthroid that causes it. So you're thinking about working again? Any idea what type of work? Phillipa
Posted by stargazer2 on September 10, 2007, at 8:58:37
In reply to Re: Nardil + nortriptyline is working. » stargazer2, posted by Phillipa on September 8, 2007, at 20:43:07
P, whatever job pays decently and that provides me benefits is better than where I'm at now.
At least from the number of people on PB that still work with their depression, even if my depression flares up again, I won't be alone.
I must be doing better since I haven't felt I could work in the past year, nor have I thought about working without feeling extremely anxious. Not working has really hurt my self-esteem and
it's time to regain some confidence before it gets to the point that I can never work again.The longer you are out of work makes it almost impossible to go back to work and I have another 10-15 years to go before I can think of retiring. Of course all of this is dependent on my depression staying under control but since so many here have proven they can keep working with depression, I have more faith in being able to persevere through a relapse, that has proven will inevitably occur again. It's the nature of the beast.
Stargazer
Posted by Phillipa on September 10, 2007, at 20:00:47
In reply to Re: Nardil + nortriptyline is working/Phillipa., posted by stargazer2 on September 10, 2007, at 8:58:37
Stargazer maybe you won't relapse. I know the feeling of being out of work for many years as I wasn't depressed when quit only anxious. Don't think I'd be depressed if kept working. Love Phillipa
This is the end of the thread.
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