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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by UGottaHaveHope on July 18, 2008, at 2:06:20
I've been on Nardil (switching btw 30-45mg) for 16 months, along with 2mg Klonopin and 50mg of Seroquel.
Im kinda struggling now w/anxiety (Generalized Anxiety Disorder) w/symptoms of depression, therefore that's now why I am back on here searching for ... well, some hope myself.
I will say the last 16 months have been the best out of the past 11 years of dealing with GAD. I've had some solid periods and once went several months without hanging out at my parents, which is my "comfort zone" when I am struggling. I have my own place, but forget about that when I am struggling.
I am struggling now. And when I am struggling, I forget that I ever forget that I felt good? Does that make sense? Other Nardil users, is it like this with you, too? Are there period when the Nardil doesn't work as well? Maybe when you are under stressful times?
I had all the brutal Nardil side effects during the startup, but all have disappeared but daytime sedation. I am just always tired. But I guess I think of that as one of the "trade-offs" for taking the medication. For the most part, I have been better, but Nardil is not a complete cure, which makes me think now about trying another MAOI, perhaps Parnate or ... any suggestions?
Thanks for your input, Michael :)
Posted by SLS on July 18, 2008, at 5:44:48
In reply to 16 months on Nardil, posted by UGottaHaveHope on July 18, 2008, at 2:06:20
I would continue to increase the dosage of Nardil as tolerated until you reach 75mg, and combine it with Deplin. Deplin might take up to 3 months to produce a robust response, but it can make a huge difference. In the meantime, the increased dosage of Nardil might help improve your current state while the Deplin is doing its thing. At least two people in this forum have responded to adding Deplin to Nardil.
My current diagnosis: bipolar disorder, depressive type.
My current treatment:Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg
Deplin 7.5mg
- Scott
Posted by Phillipa on July 18, 2008, at 10:59:03
In reply to 16 months on Nardil, posted by UGottaHaveHope on July 18, 2008, at 2:06:20
I was thinking of you the other day and wondering how you were doing. I'm sorry to hear it's not that good. So anxiety comes back and you're tired at the same time? I'd say listen to Scott. Love Phillipa
Posted by blueboy on July 18, 2008, at 11:21:16
In reply to 16 months on Nardil, posted by UGottaHaveHope on July 18, 2008, at 2:06:20
> I've been on Nardil (switching btw 30-45mg) for 16 months, along with 2mg Klonopin and 50mg of Seroquel.
>Why do you go to the lower dosage? You don't have to answer, but I'm thinking you might want to explore this.
In my experience, the correlation between taking Nardil and its effects are so long (I calculated ten days for myself) that it's entirely possible to fine-tune your blood level by varying the dose daily. For example, you could take 30mg and 45mg on alternate days.
I haven't seen anything in the literature to support this, it's purely my own idea.
Another thought is that you might be having a "poop-out" and need to try a higher dose for a few weeks.
I'm actually a bit skeptical about your lack of side effects. Nardil is such a dirty drug. I hate to say it, but it is at least possible that the lack of side effects indicates that you aren't taking enough to get the full therapeutic effects.
> Im kinda struggling now w/anxiety (Generalized Anxiety Disorder) w/symptoms of depression, therefore that's now why I am back on here searching for ... well, some hope myself.
>Sorry to hear it. One thought is whether you have been dealing with a higher level of overall stress.
> I will say the last 16 months have been the best out of the past 11 years of dealing with GAD. I've had some solid periods and once went several months without hanging out at my parents, which is my "comfort zone" when I am struggling. I have my own place, but forget about that when I am struggling.
>
> I am struggling now. And when I am struggling, I forget that I ever forget that I felt good? Does that make sense?It's not just Nardil users. It's pretty much anyone who suffers from anxiety and depression. The lower brain is a lot more powerful than the cerebral cortext.
Nevertheless, you can get some relief in this regard from Cognitive Behavioral Therapy. Basically, it teaches you to fight back against unrealistic feelings of permanent despair with conscious realization that the condition could improve -- and even, the near-certainty that it will improve.
[...]
> I had all the brutal Nardil side effects during the startup, but all have disappeared but daytime sedation.Your problems and/or experience are very different from mine. I would get extremely energized in the morning and stuporous in the late afternoon.
One thought is to discontinue the Seroquel or benzo, or lower the dosage. Although, in this regard, most people get a temporary unpleasant reaction (i.e. a withdrawal period) from lowering/discontinuing a benzo, because of its habituating nature.
>I am just always tired. But I guess I think of that as one of the "trade-offs" for taking the medication. For the most part, I have been better, but Nardil is not a complete cure, which makes me think now about trying another MAOI, perhaps Parnate or ... any suggestions?
>My guess would be no. Nardil is supposed to be the most "activating" of the MAOI's.
> Thanks for your input, Michael :)I hope you get back on track soon.
I was recently diagnoses as bipolar, after decades of treatment for unipolar depression. Make sure and check out that possibility. However, it might not be right, since I experienced such a rush of energy (hypomania) from Nardil.
Posted by cumulative on July 18, 2008, at 12:32:13
In reply to 16 months on Nardil, posted by UGottaHaveHope on July 18, 2008, at 2:06:20
That is a lower dose of Nardil. Many try up to 1mg/kg.
Posted by UGottaHaveHope on July 18, 2008, at 18:12:23
In reply to Re: 16 months on Nardil, posted by blueboy on July 18, 2008, at 11:21:16
Blueboy:
Along with all the others, thanks so much for the feedback.
I'm very interested to hear, and perhaps you have a link to where you may have already told it on here, on how the pdocs decided you were bipolar after years of being classified as depressed. That's very interesting, how long it took, and how they arrived at a such a drastic change, then what medicinal changes were made.
Thanks, Michael
Posted by UGottaHaveHope on July 18, 2008, at 18:16:23
In reply to Re: 16 months on Nardil, posted by blueboy on July 18, 2008, at 11:21:16
That is very, very intriguing what you said, about Nardil being a "dirty drug" and how if I was not feeling some of those nasty side effect that it might not be helping me out as it should.
I realize it's justa a theory, but I believe it to be TRUE. I've never heard it described that way, but now that I have, it makes perfect sense.
Does anything understand, or feel the same way?
+ + +
>
> I'm actually a bit skeptical about your lack of side effects. Nardil is such a dirty drug. I hate to say it, but it is at least possible that the lack of side effects indicates that you aren't taking enough to get the full therapeutic effects.
>
Posted by UGottaHaveHope on July 18, 2008, at 18:16:29
In reply to Re: 16 months on Nardil, posted by blueboy on July 18, 2008, at 11:21:16
That is very, very intriguing what you said, about Nardil being a "dirty drug" and how if I was not feeling some of those nasty side effect that it might not be helping me out as it should.
I realize it's justa a theory, but I believe it to be TRUE. I've never heard it described that way, but now that I have, it makes perfect sense.
Does anything understand, or feel the same way?
+ + +
>
> I'm actually a bit skeptical about your lack of side effects. Nardil is such a dirty drug. I hate to say it, but it is at least possible that the lack of side effects indicates that you aren't taking enough to get the full therapeutic effects.
>
Posted by UGottaHaveHope on July 18, 2008, at 18:16:34
In reply to Re: 16 months on Nardil, posted by blueboy on July 18, 2008, at 11:21:16
That is very, very intriguing what you said, about Nardil being a "dirty drug" and how if I was not feeling some of those nasty side effect that it might not be helping me out as it should.
I realize it's justa a theory, but I believe it to be TRUE. I've never heard it described that way, but now that I have, it makes perfect sense.
Does anything understand, or feel the same way?
+ + +
>
> I'm actually a bit skeptical about your lack of side effects. Nardil is such a dirty drug. I hate to say it, but it is at least possible that the lack of side effects indicates that you aren't taking enough to get the full therapeutic effects.
>
Posted by UGottaHaveHope on July 18, 2008, at 18:18:19
In reply to Re: Nardil 'the dirty drug' in a good way » blueboy, posted by UGottaHaveHope on July 18, 2008, at 18:16:23
I only meant to post that once, not three times. Sorry
Posted by blueboy on July 19, 2008, at 9:06:57
In reply to Re: QQQssss » blueboy, posted by UGottaHaveHope on July 18, 2008, at 18:12:23
> Blueboy:
>
> Along with all the others, thanks so much for the feedback.
>
> I'm very interested to hear, and perhaps you have a link to where you may have already told it on here, on how the pdocs decided you were bipolar after years of being classified as depressed. That's very interesting, how long it took, and how they arrived at a such a drastic change, then what medicinal changes were made.
>I took about 20 or 30 different drugs over the course of decades (starting with a tricyclic in 1977), including tricyclics, SSRI's, SNRI's, antipsychotics, neurontin, and stuff I don't even know what it was. None of them seemed to help me, with the exception of Nardil, which I now believe put me into a state of continuous hypomania. I was much improved and could work, but my judgment was impaired and I lost a LARGE amount of money.
Some SSRI-type drugs really screwed me up (Wellbutrin, Effexor, Prozac), including seizures and catatonia.
My latest pdoc, who is pretty decent, was about to give up and was strongly recommending ECT. However, he also urged me to get a second opinion from a very prominent researcher associated with Emory University. This guy does not take patients but will see a few patients per week, for a 2+ hour appointment, to take a history and make a diagnosis. It was this doctor who diagnosed me as "definitely bipolar".
Prior to that, I had been diagnosed with "recurrent major depressive episodes" because my primary complaints were depressive in nature. This isn't unusual, by the way, because bipolar II patients frequently don't complain about their hypomanic episodes -- they feel "better than normal" and can work hard, etc.
The recommended treatment for Bipolar disorders and unipolar depression are very different. For BP, the starting point is "mood stabilizers" such as Lamictal (which I am now trying), depakote, lithium, etc. Apparently, BP patients often have bad experiences with SSRI's. I don't know whether or not to say SSRI's generally don't help BP patients. I have seen this said, but I have also seen a lot of Lamictal/SSRI cocktails talked about.
I really don't think anyone actually knows. Primary diagnoses seem to be a starting point. Then they just try different drugs/therapies to see if something works!
I also have "concurrent" OCD and anxiety (especially agoraphobia and social anxiety). Again, I think the system of diagnosis and treatment (e.g., DSM IV) is fairly rudimentary at this point, but it appears to be making progress.
Posted by UGottaHaveHope on July 19, 2008, at 17:27:34
In reply to Re: QQQssss, posted by blueboy on July 19, 2008, at 9:06:57
Blueboy:
For starters, that is very interesting, since the pdoc I see also is at Emory.
Were you diagnosed with Bipolar? Or BPII?
I was diagnosed with Generalized Anxiety Disorder (GAD) and atypical depression, along with some components of BPII.
Your story interests me, not only because we both went to the same place, but also because SSRIs have never really helped me.
If you get a chance, and feel comfortable, please shoot me an email at sportscarvell@yahoo.com
Thanks.
This is the end of the thread.
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