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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 zeus751 on February 11, 2008, at 0:37:37
Hi, Ive been on Nardil 60mg a day for a week now and havent noticed much improvement in my SA or depression. But, I have been experiencing something close to daytime narcolepsy that is very disturing to me. My eyelids just get so heavy and I fall into a half-sleep. This happens when Im writing, eating, talking to people, reading. Is this normal? And how can I avoid this very embarrassing side effect? Should I be taking some kind of medication for this? Also, is it ok to take a tricyclic AD like elavil at night to help with staying asleep? I always seem to wake up after only 2 or 3 hours of sleep at night. Thanks!
Posted by squatlover on February 11, 2008, at 2:53:06
In reply to Nardil...Some newbie questions!!, posted by zeus751 on February 11, 2008, at 0:37:37
I don't get it that bad, but I do get drowsy. Honestly if its that sleep provoking you might think about taking some coffee or red bull to keep you awake - its actually really good. I have been on 60mg for 2.5 weeks, (tapering up for 2.5 weeks) and I haven't noticed any change in SA either. I am going to keep on going at this dose for 1.5 weeks, and up it to 75mg (1mg/kg) if i don't have any joy. And red bull on standby.
Posted by Justherself54 on February 11, 2008, at 8:04:04
In reply to Nardil...Some newbie questions!!, posted by zeus751 on February 11, 2008, at 0:37:37
Maybe drop down to 45 for a while..I know some people can ramp up quickly but maybe you've started on too high a dose..I had the opposite effect..Nardil gave me energy..and severe insomnia too..you should talk to your pdoc about sleep meds. I have to take 2 different ones for sleep..
It also takes 3-4 weeks before it kicks in and does it kick in!
Posted by Phoenix1 on February 11, 2008, at 11:18:22
In reply to Nardil...Some newbie questions!!, posted by zeus751 on February 11, 2008, at 0:37:37
> Hi, Ive been on Nardil 60mg a day for a week now and havent noticed much improvement in my SA or depression. But, I have been experiencing something close to daytime narcolepsy that is very disturing to me. My eyelids just get so heavy and I fall into a half-sleep. This happens when Im writing, eating, talking to people, reading. Is this normal? And how can I avoid this very embarrassing side effect? Should I be taking some kind of medication for this? Also, is it ok to take a tricyclic AD like elavil at night to help with staying asleep? I always seem to wake up after only 2 or 3 hours of sleep at night. Thanks!
Hi Zeus,
First of all, 1 week isn't long enough to assess how affective Nardil is. You need to give it at least 2-3 months to see the full effect. And during this period, many of your side effects will fade and/or disappear. I am not sleepy during the day, but I do drink 3-4 coffees throughout the day which may be helping. As for the sleeping, Nardil does cause pretty bad insomnia in many people. You can try a tricyclic but be VERY careful as if you use the wrong one or wrong dosage you could get serotonin overload. Why not try something like zolpidem or eszopiclone instead? There aren't any potential interactions at all. For my insomnia from Nardil, I take zopiclone 7.5mg and seroquel 50mg. The seroquel really helps, but I'm trying to quit it as I worry about long term effects.
You could try reducing your dosage to 45 and then 30mg, and then SLOWLY working your way back up again as the side effects fade. But don't give up on Nardil so soon. You really do have to give it some time to let it do it's thing, and for your body to get used to it.
Good Luck,
Phoenix1
Posted by Phillipa on February 11, 2008, at 11:26:37
In reply to Nardil...Some newbie questions!!, posted by zeus751 on February 11, 2008, at 0:37:37
Just wanted to welcome you to babble as I see you are new also see that you've received some excellent advise from others so welcome again. Phillipa
Posted by tecknohed on February 11, 2008, at 17:56:16
In reply to Nardil...Some newbie questions!!, posted by zeus751 on February 11, 2008, at 0:37:37
Hi zeus751!
I had the same thing with Nardil, though maybe not quite as bad. I would fall asleep on trains, buses, when reading, TV, boring meetings, etc. But I slept fine.
The fact that you are only getting a few hours sleep a night, its no wander these sleep attacks are so severe. I agree with above poster - add a sleep med, at least temporarily. Zopiclone (already mentioned) & trazodone are effective sleeping aids you can take with Nardil. OR, you could take diphenhydramine (eg. Nytol) for the short term insomnia just whilst you give Nardil a chance to settle. You can buy it over the counter in pharmacies.
I also agree that it might be worth cutting back to 45mg for a while. 60mg strait off is pretty high. I started with 15mg & added 15mg per week & it kicked in as soon as I reached 60mg during week 4. I still think I was too impatient as 45mg may have been enough had I waited.Good luck!
teck
Posted by tecknohed on February 11, 2008, at 18:01:25
In reply to Nardil...Some newbie questions!!, posted by zeus751 on February 11, 2008, at 0:37:37
By the way, I do not agree with caffein use to sort this Nardil problem out. Nardil will sort itself out with time. Caffein ruined Nardil for me.
teck
Posted by Justherself54 on February 11, 2008, at 18:16:05
In reply to Re: Nardil...Some newbie questions!! » zeus751, posted by tecknohed on February 11, 2008, at 18:01:25
> By the way, I do not agree with caffein use to sort this Nardil problem out. Nardil will sort itself out with time. Caffein ruined Nardil for me.
>
> teckWhat happened with the caffeine?
Posted by tapiocamonk on February 11, 2008, at 19:00:23
In reply to Re: Nardil...Some newbie questions!! » zeus751, posted by tecknohed on February 11, 2008, at 18:01:25
> By the way, I do not agree with caffein use to sort this Nardil problem out. Nardil will sort itself out with time. Caffein ruined Nardil for me.
>
> teckPlease do tell what the caffeine problem was. I'm relying on caffeine now to get me through some of the daytime drowsiness w/Nardil, so I'd hate to hear of any problem here.
(ATTN NARDIL USERS: Please leave reviews of your experience with Nardil BOTH here: http://www.askapatient.com/viewrating.asp?drug=11909&name=NARDIL and here: http://www.revolutionhealth.com/drugs-treatments/rating/nardil?sort=recent ............ the more people who contribute, the more useful these resources will be. Thanks!)
Posted by tecknohed on February 11, 2008, at 19:08:50
In reply to Re: Nardil...Some newbie questions!!/tech, posted by Justherself54 on February 11, 2008, at 18:16:05
> What happened with the caffeine?
Felt like it desensitized dopamine response for me. Whether through some receptor downregulation or maybe just lowered DA turnover. Not exactly sure. What I AM sure of is that Nardil relies on its DA raising capabilities for its full PUNCH! Not something you want to play around with IMO. GABA, NE, SE & DA - what else could you ask for from a SINGLE med, especially for social anxiety. I just feel that Nardil is such a delicate & temperamental med that toying whith its effects will lead to the inevitable- poopout. Thats when you reach for the DRIs & DA agonists, etc to try & augment. I believe low DA is responsible for most Nardil poopouts.
Nobody is the same. Its just a word of caution.
teck
Posted by tecknohed on February 11, 2008, at 19:16:19
In reply to Nardil...Some newbie questions!!, posted by zeus751 on February 11, 2008, at 0:37:37
As a side note, I had the best months on Nardil when I stayed clear of caffein. I would often go clubbing till 8am on just Nardil & water!
I'm also doing very well on Marplan at the moment - again with no caffein on board. Marplan does make me tired hence why I am also taking nootropics & wellbutrin too. These are better solutions than caffein as thier effects are sustained.teck
Posted by zeus751 on February 11, 2008, at 19:35:45
In reply to Re: Nardil...Some newbie questions!! » zeus751, posted by tecknohed on February 11, 2008, at 17:56:16
> Hi zeus751!
>
> I had the same thing with Nardil, though maybe not quite as bad. I would fall asleep on trains, buses, when reading, TV, boring meetings, etc. But I slept fine.
> The fact that you are only getting a few hours sleep a night, its no wander these sleep attacks are so severe. I agree with above poster - add a sleep med, at least temporarily. Zopiclone (already mentioned) & trazodone are effective sleeping aids you can take with Nardil. OR, you could take diphenhydramine (eg. Nytol) for the short term insomnia just whilst you give Nardil a chance to settle. You can buy it over the counter in pharmacies.
> I also agree that it might be worth cutting back to 45mg for a while. 60mg strait off is pretty high. I started with 15mg & added 15mg per week & it kicked in as soon as I reached 60mg during week 4. I still think I was too impatient as 45mg may have been enough had I waited.
>
> Good luck!
> teckHi, I am seeing my pdoc tomorrow and was thinking of asking for some Zopiclone or Ambien CR for the nighttime insomnia. I think my sudden sleepiness during the day could be due to me not getting my Zzzzz's at night. :) I have been staying away from the Diphenhydramine cause I thought it was a big no-no as far as dangerous side effects go. Thanks
for the quick response guys. You all seem to know
your stuff, hehe. Hope this Nardil works as well as everybody says. Ive tried just about everything
else, as this is my last resort.
Posted by tecknohed on February 11, 2008, at 21:20:19
In reply to Re: Nardil...Some newbie questions!!, posted by zeus751 on February 11, 2008, at 19:35:45
Hope all goes well mate! And you CAN safely take diphenhydramine with Nardil, no problem. You wont find it on any no-no list.
Best wishes,
teck
Posted by tapmonk on February 12, 2008, at 12:00:48
In reply to Re: Nardil...Some newbie questions!!/tech » Justherself54, posted by tecknohed on February 11, 2008, at 19:08:50
> > What happened with the caffeine?
>
> Felt like it desensitized dopamine response for me. Whether through some receptor downregulation or maybe just lowered DA turnover. Not exactly sure. What I AM sure of is that Nardil relies on its DA raising capabilities for its full PUNCH! Not something you want to play around with IMO. GABA, NE, SE & DA - what else could you ask for from a SINGLE med, especially for social anxiety. I just feel that Nardil is such a delicate & temperamental med that toying whith its effects will lead to the inevitable- poopout. Thats when you reach for the DRIs & DA agonists, etc to try & augment. I believe low DA is responsible for most Nardil poopouts.
>
> Nobody is the same. Its just a word of caution.
>
> teckVery interesting; I'm certainly thinking twice about caffeine consumption now. Are there any energizing things that don't contain caffeine that would be OK?
Posted by tecknohed on February 12, 2008, at 16:20:24
In reply to Re: Nardil...Some newbie questions!!/tech, posted by tapmonk on February 12, 2008, at 12:00:48
> > > What happened with the caffeine?
> >
> > Felt like it desensitized dopamine response for me. Whether through some receptor downregulation or maybe just lowered DA turnover. Not exactly sure. What I AM sure of is that Nardil relies on its DA raising capabilities for its full PUNCH! Not something you want to play around with IMO. GABA, NE, SE & DA - what else could you ask for from a SINGLE med, especially for social anxiety. I just feel that Nardil is such a delicate & temperamental med that toying whith its effects will lead to the inevitable- poopout. Thats when you reach for the DRIs & DA agonists, etc to try & augment. I believe low DA is responsible for most Nardil poopouts.
> >
> > Nobody is the same. Its just a word of caution.
> >
> > teck
>
> Very interesting; I'm certainly thinking twice about caffeine consumption now. Are there any energizing things that don't contain caffeine that would be OK?Yes there are. Meds - Wellbutrin (my fave), Reboxetine, tricyclic ADs of the NRI type like desipramine (must be done carefully) and Provigil, though I personally wouldn't favour the latter.
Alternatives: There are MANY. Heres a few I KNOW work (for me) - Ginseng (all over fatigue lifter), vinpocetine (for mind sluggishness) & acetyl-L-carnitine (for physical fatigue - my fave). There are lots of others that I haven't tried but you'll need to be carefull & go slow when combining ANYTHING with an MAOI.
teck
Posted by Dr. Bob on February 13, 2008, at 0:58:31
In reply to Re: Nardil...Some newbie questions!!/tech, posted by tapmonk on February 12, 2008, at 12:00:48
> Very interesting
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