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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Justherself54 on January 9, 2008, at 22:30:15
I think I'm just a tad paranoid! I have an upper respiratory infection (no fever) and am on a steroid inhaler and antibiotics, but I feel depression creeping back..just laid on the couch all day which is unusual for me since nardil..I've been sick for 8 days but for the last couple of days I've felt very depressed..can physical illness cause a MAOI to poop out? You have no idea how the thought of that scares the you know what out of me..
Posted by Phillipa on January 10, 2008, at 0:04:07
In reply to Nardil pooping out?, posted by Justherself54 on January 9, 2008, at 22:30:15
I do know that I was just sick too and felt like all I could do was lie on the sofa let your body heal and I bet the good feelings you've had on nardil come back. Being sick is no fun. Good luck Phillipa don't think but don't know if it could cause a med to poop out.
Posted by bleauberry on January 10, 2008, at 21:16:32
In reply to Nardil pooping out?, posted by Justherself54 on January 9, 2008, at 22:30:15
These four things can make you depressed enough to over-ride your good med:
1. Illness
2. Antibiotics (some yes, some no, mileage varies)
3. The toxins circulating within you of the dead microbials the antibiotics killed.
4. Steroids.I hope you get well fast! That would be awesome. Don't forget, anytime one takes antibiotics, always follow it up with high doses of high quality refrigerated probiotics as soon as treatment is over. Replenish the good flora in your gut before armies of bad guys hog all the space, creating more problems for you down the road.
Posted by Phoenix1 on January 10, 2008, at 21:52:05
In reply to Nardil pooping out?, posted by Justherself54 on January 9, 2008, at 22:30:15
> I think I'm just a tad paranoid! I have an upper respiratory infection (no fever) and am on a steroid inhaler and antibiotics, but I feel depression creeping back..just laid on the couch all day which is unusual for me since nardil..I've been sick for 8 days but for the last couple of days I've felt very depressed..can physical illness cause a MAOI to poop out? You have no idea how the thought of that scares the you know what out of me..
I've also just noticed that some days I can really FEEL the Nardil working and other days I can't. And on the days I can't. I feel the depression creeping back. It reminds me where I was a month or two ago. Not fun. Maybe you and/or I need a higher dose?
Phoenix1
Posted by Justherself54 on January 10, 2008, at 22:36:05
In reply to Re: Nardil pooping out?, posted by Phoenix1 on January 10, 2008, at 21:52:05
> > I think I'm just a tad paranoid! I have an upper respiratory infection (no fever) and am on a steroid inhaler and antibiotics, but I feel depression creeping back..just laid on the couch all day which is unusual for me since nardil..I've been sick for 8 days but for the last couple of days I've felt very depressed..can physical illness cause a MAOI to poop out? You have no idea how the thought of that scares the you know what out of me..
>
> I've also just noticed that some days I can really FEEL the Nardil working and other days I can't. And on the days I can't. I feel the depression creeping back. It reminds me where I was a month or two ago. Not fun. Maybe you and/or I need a higher dose?
>
> Phoenix1I was thinking the same thing that I may need an increase..but pharmacist said hold off until this supply thing is fixed which really irritates me..I've had a pretty bad day with a lot of racing thoughts and almost felt teary (which is always not a good sign)..I see pdoc next week..I probably do need an increase as I'm only at 45 mg..
Even though I've been sick I still had energy to get things done..the last couple of days I want to be a couch potato and try to handle racing thoughts and that niggling feeling of depression showing it's face again..
Are you going to do an increase Phoenix..if you do, keep posting how it's going and I'll do that same, that it when my pharmacist can get enough of the drug in to do an increase..akkkk
Posted by Justherself54 on January 10, 2008, at 22:38:34
In reply to Re: Nardil pooping out?, posted by bleauberry on January 10, 2008, at 21:16:32
> These four things can make you depressed enough to over-ride your good med:
>
> 1. Illness
> 2. Antibiotics (some yes, some no, mileage varies)
> 3. The toxins circulating within you of the dead microbials the antibiotics killed.
> 4. Steroids.
>
> I hope you get well fast! That would be awesome. Don't forget, anytime one takes antibiotics, always follow it up with high doses of high quality refrigerated probiotics as soon as treatment is over. Replenish the good flora in your gut before armies of bad guys hog all the space, creating more problems for you down the road.By probiotics, do you mean in yogurt..I eat a lot of yogurt
Posted by Phoenix1 on January 11, 2008, at 8:48:14
In reply to Re: Nardil pooping out?, posted by Justherself54 on January 10, 2008, at 22:36:05
> > > I think I'm just a tad paranoid! I have an upper respiratory infection (no fever) and am on a steroid inhaler and antibiotics, but I feel depression creeping back..just laid on the couch all day which is unusual for me since nardil..I've been sick for 8 days but for the last couple of days I've felt very depressed..can physical illness cause a MAOI to poop out? You have no idea how the thought of that scares the you know what out of me..
> >
> > I've also just noticed that some days I can really FEEL the Nardil working and other days I can't. And on the days I can't. I feel the depression creeping back. It reminds me where I was a month or two ago. Not fun. Maybe you and/or I need a higher dose?
> >
> > Phoenix1
>
> I was thinking the same thing that I may need an increase..but pharmacist said hold off until this supply thing is fixed which really irritates me..I've had a pretty bad day with a lot of racing thoughts and almost felt teary (which is always not a good sign)..I see pdoc next week..I probably do need an increase as I'm only at 45 mg..
>
> Even though I've been sick I still had energy to get things done..the last couple of days I want to be a couch potato and try to handle racing thoughts and that niggling feeling of depression showing it's face again..
>
> Are you going to do an increase Phoenix..if you do, keep posting how it's going and I'll do that same, that it when my pharmacist can get enough of the drug in to do an increase..akkkk
>
>Hi Justherself. Sorry you aren't feeling well. I am definitely going to increase my dose. I showed some literature to my doc that suggested that 1mg/kg is a safe and effective dose of Nardil. So based on my (excessive) weight, I am aiming for 90mg as a peak dose. I will start on 75mg next Wednesday. Yesterday was a high-anxiety day for me for some random reason. I'm working on eliminating the clonazepam, but I don't think that's what did it. I never know what to expect from my Nardil days. One day is great, and the next may be not so great. (I don't expect to feel on top of the world everyday; "not so great" = depression creeping back, anxiety bad, irritability, focus, motivation bad.) I'm hoping a higher dosage will smooth these things over...
Phoenix1
Posted by Justherself54 on January 11, 2008, at 9:32:05
In reply to Re: Nardil pooping out? » Justherself54, posted by Phoenix1 on January 11, 2008, at 8:48:14
It's sure frustrating and frightening when you feel the anxiety and depression creep back..Can you let me know how your increase goes as I see my pdoc on the 16..hopefully my pharmacy has gotten in enough by then so I can do it!
I was hoping Nardil would be the magic bullet..I'm crossing my fingers an increase will do the trick ..cause for me there aren't any options left..I've been on them all (except for remeron)
I'm got my fingers and toes crossed for you that the increase brings back the initial benefit of when you first started..good luck and I'll be thinking of you..
Posted by Phoenix1 on January 11, 2008, at 10:02:38
In reply to Re: Nardil pooping out? Phoenix1, posted by Justherself54 on January 11, 2008, at 9:32:05
> It's sure frustrating and frightening when you feel the anxiety and depression creep back..Can you let me know how your increase goes as I see my pdoc on the 16..hopefully my pharmacy has gotten in enough by then so I can do it!
>
> I was hoping Nardil would be the magic bullet..I'm crossing my fingers an increase will do the trick ..cause for me there aren't any options left..I've been on them all (except for remeron)
>
> I'm got my fingers and toes crossed for you that the increase brings back the initial benefit of when you first started..good luck and I'll be thinking of you..I agree, it's frustrating to have a promising start, and then see some regression. I also have no or few options left. I guess I could try Parnate. at my last pdoc appointment, my doc casually said "And don't worry too much, if Nardil doesn't work we can talk about ECT". He threw ECT in the conversation like it was some sort of gentle massage therapy. Great, just what I need, ECT... But Nardil SEEMS to be working, it's certainly better than any of the numerous other drugs I've tried, and I still have lots of room to increase the dose. So for know, it is still my salvation.
You shouldn't delay the dose increase because of the supply issue. ERFA will help you out here. Please ask your pharmacist to call them and explain the situation. They will come through for you. There CS # is listed here: http://www.erfa-sa.com/Nardil/english/contact_en.html
I will certainly keep you updated on my progress, and I hope you do the same. You're my Nardil buddy from now on!Phoenix1
Posted by Phoenix1 on January 11, 2008, at 10:15:00
In reply to Re: Nardil pooping out? Phoenix1, posted by Justherself54 on January 11, 2008, at 9:32:05
> It's sure frustrating and frightening when you feel the anxiety and depression creep back..Can you let me know how your increase goes as I see my pdoc on the 16..hopefully my pharmacy has gotten in enough by then so I can do it!
>
> I was hoping Nardil would be the magic bullet..I'm crossing my fingers an increase will do the trick ..cause for me there aren't any options left..I've been on them all (except for remeron)
>
> I'm got my fingers and toes crossed for you that the increase brings back the initial benefit of when you first started..good luck and I'll be thinking of you..One other thing that I wanted to mention that I think is sort of humorous but I HATE at the same time is this: Every time I have to mention to a doctor or pharmacist (GP, etc.) that I am on Nardil they tell me one of the following GURANTEED:
1.)Nardil? That's not even available anymore!
2.)Nardil? Thats an OLD one!
3.)Nardil? We don't prescribe/dispense that anymore!
4.)Why on earth are you on Nardil?My G*D, am I a freaking leper to be on this stuff? I don't understand it. It's a current drug in the CPS formulary. I'ts not like it's LSD or something. I get tired of it... I keep telling these docs/pharmacists that it's actually a miracle drug, and it's a true shame that it isn't used more.
That rant was just sponsored by my morning 30mgs of Nardil and 2 strong coffees. Hypomanic? Nope, just animated today. Tomorrow? Who knows.
Phoenix1
Posted by Justherself54 on January 11, 2008, at 12:40:14
In reply to Re: Nardil pooping out? Phoenix1 » Justherself54, posted by Phoenix1 on January 11, 2008, at 10:15:00
Yeah..one of my pharmacists asked if I was going to be staying on it cause it wasn't something that was normally carried..I said how the heck do I know..hopefully I will be able to..since then no more problems and they are working to scoop up a supply when it comes available..but I know the feeling..
My own GP who's treating me for the respiratory infection said if I needed ventolin treatments I just have to stop the Nardil...ummm..are we forgetting the 14 day washout period..seems like you have to educate the people you least expect you need to..
It's nice to have a Nardil buddy!
Posted by mav27 on January 11, 2008, at 13:11:51
In reply to Re: Nardil pooping out? Phoenix1, posted by Justherself54 on January 11, 2008, at 12:40:14
I wouldn't have thought the washout period would be needed just to start using ventolin. The washout period is just to allow the maoi to regenerate so that if you take another AD you don't get the seratonin syndrome. I can't see ventolin for a respirotory infection increasing seratonin. You would just have to allow a day for the nardil to get out of your body.
>
> My own GP who's treating me for the respiratory infection said if I needed ventolin treatments I just have to stop the Nardil...ummm..are we forgetting the 14 day washout period..seems like you have to educate the people you least expect you need to..
>
> It's nice to have a Nardil buddy!
Posted by Phoenix1 on January 11, 2008, at 13:25:09
In reply to Re: Nardil pooping out? Phoenix1 » Justherself54, posted by mav27 on January 11, 2008, at 13:11:51
> I wouldn't have thought the washout period would be needed just to start using ventolin. The washout period is just to allow the maoi to regenerate so that if you take another AD you don't get the seratonin syndrome. I can't see ventolin for a respirotory infection increasing seratonin. You would just have to allow a day for the nardil to get out of your body.
>
> >
> > My own GP who's treating me for the respiratory infection said if I needed ventolin treatments I just have to stop the Nardil...ummm..are we forgetting the 14 day washout period..seems like you have to educate the people you least expect you need to..
> >
> > It's nice to have a Nardil buddy!
>
>Hypersertonemia from another AD is not the only risk and not the only reason for the washout. If your going to be strict about the rules (which is safe IMO), you need a 14 day washout to go to Ventolin. It is a sympathomimetic, and you risk a hypertensive crisis. It's a small risk, but I know I'm sure scared about having one. Not pleasant according to those who have experienced them.
Phoenix1
Posted by FrequentFryer on January 15, 2008, at 22:47:57
In reply to Nardil pooping out?, posted by Justherself54 on January 9, 2008, at 22:30:15
> I think I'm just a tad paranoid! I have an upper respiratory infection (no fever) and am on a steroid inhaler and antibiotics, but I feel depression creeping back..just laid on the couch all day which is unusual for me since nardil..I've been sick for 8 days but for the last couple of days I've felt very depressed..can physical illness cause a MAOI to poop out? You have no idea how the thought of that scares the you know what out of me..
Im pretty sure the respitory infection won't make the Nardil poop out, the inhaler and antibiodics might though, not sure, Pheonix1 could probably tell you.
Posted by FrequentFryer on January 15, 2008, at 23:07:03
In reply to Re: Nardil pooping out? Phoenix1 » Justherself54, posted by Phoenix1 on January 11, 2008, at 10:02:38
> > It's sure frustrating and frightening when you feel the anxiety and depression creep back..Can you let me know how your increase goes as I see my pdoc on the 16..hopefully my pharmacy has gotten in enough by then so I can do it!
> >
> > I was hoping Nardil would be the magic bullet..I'm crossing my fingers an increase will do the trick ..cause for me there aren't any options left..I've been on them all (except for remeron)
> >
> > I'm got my fingers and toes crossed for you that the increase brings back the initial benefit of when you first started..good luck and I'll be thinking of you..
>
> I agree, it's frustrating to have a promising start, and then see some regression. I also have no or few options left. I guess I could try Parnate. at my last pdoc appointment, my doc casually said "And don't worry too much, if Nardil doesn't work we can talk about ECT". He threw ECT in the conversation like it was some sort of gentle massage therapy. Great, just what I need, ECT... But Nardil SEEMS to be working, it's certainly better than any of the numerous other drugs I've tried, and I still have lots of room to increase the dose. So for know, it is still my salvation.
>
> You shouldn't delay the dose increase because of the supply issue. ERFA will help you out here. Please ask your pharmacist to call them and explain the situation. They will come through for you. There CS # is listed here: http://www.erfa-sa.com/Nardil/english/contact_en.html
>
> I will certainly keep you updated on my progress, and I hope you do the same. You're my Nardil buddy from now on!
>
> Phoenix1hahaah "He threw ECT in the conversation like it was some sort of gentle massage therapy."
Can I be in the Nardil Buddy group two?
I would be interested to know if a dose increase helps, (if your talking over 1mg per 1kg)
I dont reckon you should try ECT, the success rate of it dosn't come close to outweighing the side effects.
Nardil is a healthy walk in the park compared to getting ya brain zapped.
If it badly poops out on me I will try augmenting
with Bupropion or a primary NA tricyclic.
Tried those?
Posted by SLS on January 17, 2008, at 6:15:20
In reply to Nardil pooping out?, posted by Justherself54 on January 9, 2008, at 22:30:15
> I think I'm just a tad paranoid! I have an upper respiratory infection (no fever) and am on a steroid inhaler and antibiotics, but I feel depression creeping back..just laid on the couch all day which is unusual for me since nardil..I've been sick for 8 days but for the last couple of days I've felt very depressed..can physical illness cause a MAOI to poop out? You have no idea how the thought of that scares the you know what out of me..
Episodes of physical illness can indeed produce medication "breakthrough"*, and even trigger a full relapse. My guess upon witnessing this phenomenon in a friend of mine is that you should eventually rebound and again respond robustly to treatment.* "breakthrough" is not a good thing. In this case, it means to relapse, partially or wholly, after establishing a stable antidepressant response.
It will pass. Let's just watch and see what happens. If you don't rebound quickly - within 3 weeks from the end of the physical illness - you might try adding Deplin before using anything that would have a smaller therapeutic window (efficacy + side effects).
Good luck.
- Scott
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