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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 Four Feathers on August 19, 2008, at 17:47:12
I have been reading this board for years and occassionally thrown out a post when I have had questions and have always been thankful for the information all on this board share. As we often hear of negative experiences with medications, which it seems almost all of us have had at some point, I wanted to share my positive experience so far with Nardil.
After about 10 years on the med merry go round with limited success, and plenty of poor side effects, I began seeing a new pdoc last fall. His first recommendation to me was Nardil. At the time I had read so much negativity about the MAOIs that I was frankly afraid to go this route, especially the possibility of HT crisis. Insted I continued with the SSRIs and threw in Strattera for some of the concentratoin problems I was experiencing. Needless to say, these did nothing more for me than the others in the past. After much research, reassurance from my pdoc, and consideration I decided to start Nardil a little over three weeks ago.
BTW...the main symptoms I was looking to treat were dysthymia, physical anxious feelings (including high BP), decreased concentration, hypersomnia, decreased sex drive, apathy, and a touch of minor social phobia.
I am happy to say that the Nardil has been AMAZING! While the first week was tough, and I was very tempted to give up at times, I cannot express how thankful I am that I finally began this med. I now feel a sense of calmness within my body that I have not felt since I was a child, I care about things again and have motivation to do them, can concentrate, regained my self-confidence, feel completely comfortable in public, and actually have seen an increse in my libido since starting this. There have been no negative sexual side effects for me on this med which I cannot say about many of the others in teh past. I have achieved all of this at 30mg of Nardil daily (15 morning/15 evening). BTW...I began conservatively at 7.5mg morning and evening for the first 4 days before going to my current. The big effects were recognized about 10 days in at 30mg daily.
A quick recap of positive and negative effects to date: the first week I went through feelings of almost panic attacks (which I have had only a handful of in my life), flu-like symptoms, no appetite, and extreme dizziness which came and went. I noticed a sense of internal "calmness" that was awesome about 4 days in. I then noticed some increased motivation. Even though I felt like crap a few days it was nice to see some initial positive reactions. I was VERY nervous about everything that I put in my mouth for fear of a food reaction. I noticed these same effects when I went from 15mg daily to 30mg daily and felt a bit more "wiped out" and just wanted to lay around for a couple of days.
I tolerated the side effects and I am very happy that I did. As stated above, I now feel like I am regaining my life. While I understand that it is early in the Nardil treatment and there is often a feeling of hypomania associated with this med, I am hopeful that I am experiencing the real effects and that they last. My pdoc, who takes Nardil himself, has told me that he expects the effects to continue to improve over the next 3-6 weeks, albeit maybe not as pronounced as I what I have seen so far.
The diet restrictions to me have been nothing so far. When first staring I was incredibly nervous to eat or drink anything that could remotely contain large amounts of tyramine. Now, partly thanks to the Nardil I feel, my anxiety level around food is next to nothing. I have been trying things in moderation to determine any possible effects, and have yet to find any. I feel that the side effects of this med are substantially less than any other AD I have been on in the past, and the positive effects have been substantially greater.
To those of you considering or beginning Nardil, I will echo what others have said on this board "give it a shot", I am so glad that I did!
I should also mention that I have seen the anticipated decrease in BP and my pdoc anticipates that I will be able to stop the lisinopril due to the reduction we have seen so far.
4F
Posted by blueboy on August 20, 2008, at 11:40:46
In reply to Positive Nardil Experience, posted by Four Feathers on August 19, 2008, at 17:47:12
Yeah, Nardil and Parnate can be extremely effective when no other antidepressant has much effect. I had the same experience. Although I had a lot of side effects, it was so helpful that I just dealt with them.
I would advise you not to screw around with tyramine rich foods. You're playing with fire. It's not the 999 times out of 1000 that you "get away with it" that matter; it's the one time out of 1000 that you don't. You can run your BP up enough to have a mini-stroke without even realizing it.
Posted by elbee on August 20, 2008, at 12:45:00
In reply to Re: Positive Nardil Experience, posted by blueboy on August 20, 2008, at 11:40:46
That's great that Nardil worked so well for you!!! Happy for you!! I just started it myself. So far no difference...but it has been less than a week. So good to hear your success story.
Posted by Four Feathers on August 20, 2008, at 13:04:54
In reply to Re: Positive Nardil Experience, posted by blueboy on August 20, 2008, at 11:40:46
> Yeah, Nardil and Parnate can be extremely effective when no other antidepressant has much effect. I had the same experience. Although I had a lot of side effects, it was so helpful that I just dealt with them.
>
> I would advise you not to screw around with tyramine rich foods. You're playing with fire. It's not the 999 times out of 1000 that you "get away with it" that matter; it's the one time out of 1000 that you don't. You can run your BP up enough to have a mini-stroke without even realizing it.Thanks for the post. While I have been experimenting with different foods, I have been doing this very cautiously and in moderation, paying attention to changes in BP from the food. I am not one to throw caution to the wind when dealing with potential serious consequences. Medications, on the other hand, I will not even consider "experimenting" with. I have been told, by pdoc and others, that the majority of serious MAOI interactions have been due to taking prohibited OTC meds.
Posted by Four Feathers on August 20, 2008, at 13:06:34
In reply to Re: Positive Nardil Experience, posted by elbee on August 20, 2008, at 12:45:00
I wish you the best with your Nardil trial. Please keep the board informed of your experiences.
Posted by Vik07 on August 20, 2008, at 15:17:21
In reply to Re: Positive Nardil Experience, posted by blueboy on August 20, 2008, at 11:40:46
I am on the same med for social anxiety, and I felt calm through the whole day today. Only been on Nardil 60 mgs for five days. Made conversations, went shopping, eye contact. Feel a little bit "foggy", but no bad side effects yet. Already this med has done more for anxiety than any AD ever did. And I've tried many over the years. Hope the Nardil continues to work for you.
Posted by UGottaHaveHope on August 22, 2008, at 20:10:25
In reply to Re: Positive Nardil Experience, posted by Vik07 on August 20, 2008, at 15:17:21
Posted by uncouth on August 23, 2008, at 18:00:46
In reply to Re: Positive Nardil Experience, posted by Vik07 on August 20, 2008, at 15:17:21
I seem to be at a similar stage in my nardil trial as some of you all. Close to five weeks ago I started out at 30 and quickly titrated up to 60, and last week went to 90. Unbelievably I'm not feeing much of anything, except for two days last week when I definitely felt soem sort of stimulation...felt a bit like methylphenidate. But then it went away.
At 90, I am just starting to get occasional orthostatic hypotension. Only other effect I feel is a slight increased-increase in mood from vigorous (45 minutes) cardio.
I'm also getting some afternoon sedation but my sleep is relatively OK. I'm taking it with a low dose of lithium which I want to decrease (450mg now) as I feel as though it's fogging up my cognition a bit.
I'm extremely disappointed I haven't felt much of anything from nardil yet. No social anxiety improvement, no mood lift, and only a day or two of stimulation which went away. My next pdoc appointment is on Tuesday and as I'm hte only person he has on nardil right now, I'm not sure what he's going to advise. Last time he suggested a combo of Effexor and Cymbalta as Effexor has definitely worked in the past for me, often rapidly, but it has the tendency to push me into a bit of a blissed out hypomanic-like state, and what's worse, it seems to be killer for apathy and just sorta numbs my emotions. I was on effexor for a very long time at one point and it also eventually pooped out.
I guess there is always a combo I could use with Effexor to also hit dopamine, but I really wished that Nardil would do the trick, and I also really hoped it would resolve my longstanding social isolation (unnecessarily isolating myself) problems. I just can't believe it's not working, it makes me very sad. I was hoping to be able to look for work again about htis time, and i'm not sure I can take another med change, as the last time I moved from an MAOI (Emsam patch) to Effexor (this was 4 mos ago) I sunk into the worst, suicidal, depression of my life.
Anyone know if it is worth staying on Nardil? Does Nardil ever NOT work? I'm BP2, social phobia, and probably have some ADHD and addictive tendencies as well.
Sometimes I'm afraid that I'm just afraid of feeling better, and it's not necessarily wrong to feel blissed out on Effexor. But I know how my life was the last time I was on long term SSRIs, and I just didn't care that I was alone, without a girlfriend, and engaged in compulsive internet use. I knew intellectually, but it didn't "feel" bad, I didn't feel any motivation to change things. It's all psychodynamic as well and I have certainly long-standing family and self-esteem issues that I'm dealing with in therapy, but I was so hoping Nardil would give me the relief, motivation, I needed -- giving me my spirit back so I can live life. I'm 28 and the best years have passed me by and it's getting to a point of being unbearable, living at a capacity such a low percent of my capability. I know drugs are not necessarily the full solution and I often wonder what people who felt like I did 70 years ago did -- certainly many of them were able to come out of it by themselves - and often I feel like i'm asking too much of medication especially when these multiple trials and self-knowledge of these effects are considered. Perhaps I just need to fight the fear and get a job or start dating in spite of the daily misery I feel...but I sure was hoping Nardil would help.
Posted by Tomatheus on August 23, 2008, at 18:42:57
In reply to Re: Positive Nardil Experience, posted by uncouth on August 23, 2008, at 18:00:46
uncouth,
You've only been at your current dose of 90 mg/day for a week. In my experience with Nardil, it took two weeks at any given therapeutic dose before I started to feel Nardil's antidepressant effects. I also think that the daytime sedation that you're experiencing is a sign that the medication's longer-term effects have yet to kick in. I understand that not everybody's experiences with Nardil have been the same, but when I took the medication, the daytime sedation started to fade right around the same time that the medication's therapeutic benefits began to kick in.
So, I would definitely give it at least another week (maybe two or three) at 90 mg before I'd begin to question whether or not the Nardil that you're taking will work in the long run. There's still a good chance that Nardil may work well for you.
Tomatheus
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