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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by gardenergirl on January 18, 2009, at 13:16:43
Hi all,
Just an update...
I do have to go off Nardil in order to have elective surgery. It's not an absolute, but the anesthesiologist convinced me that the added risks are just not worth it. My pdoc instructed me to go down one tablet/day (15 mg) every two weeks, i.e. from 60 mg to 45 mg for two weeks, 45 to 30 for two, etc. This is in order to avoid the flu-like symptoms and other discontinuation effects that I could have if going off faster.I found it iteresting that he was able to give me this info in a return phone call, but never when I asked him in person, even though he says he has experience with multiple patients on MAOI's and that how to discontinue is info readily available from his memory and experience. I still think he had to look it up and isn't comfortable admitting that, but that's something he and I will have to discuss the next time I see him. As it is, I'm finding myself less confident and less trusting of his honesty. Either that or he just decided on his own whenever I asked him before that I didn't really need to know or something, and that's also problematic. I'm having a really hard time coming up with any other reasonable and/or charitable explanation for his not ever giving me this info until now despite asking at least five times over the last year.
Anyway, so far I've had some REM rebound, which is common for me whenever I lower my dose. I usually associate excessive sleeping with feeling depressed, but right now I can honestly say that I don't feel depressed. I really do think it's just the rebound, and that gets better as I get into the second week of the lower dose. I've had some nausea at times, and feel almost fluish the last few days, which corresponds with going to 30 mg recently, but it's not anything that is unbearable.
And the best part? Pounds seem to be melting off me. I've lost 20 pounds from my peak weight, and at least 10 of those have been just in the last month. I'm finding that whatever part of the brain Nardil seemed to have "shut off" related to knowing when to stop eating before getting to a binge state seems to be working again. That is I find that I recognize in my brain and my body that if I don't stop eating, I'm going to feel sick, whereas when on my usual Nardil dose, that recognition doesn't seem to kick in physiologically, just intellectually. That might be a strong incentive to not go back on Nardil after the surgery, assuming I continue to not feel depressed.
So anyway, so far so good. Hope it continues down this path.
gg
Posted by Phillipa on January 18, 2009, at 13:29:21
In reply to Tapering Nardil for surgery going okay so far, posted by gardenergirl on January 18, 2009, at 13:16:43
GG good luck with the taper. Yes I would think he had to look it up also or consult with others. Well you'll be okay safer is better to me. Glad you not depressed and intersting about the weight loss. I guess Congratulations on that. Any ideas what you would try if decide not to continue the nardil. Wouldn't it be great if the depression didn't come back? I don't know if it was your first episode or not. But sounds like you're doing well. Love Phillipa
Posted by SLS on January 18, 2009, at 16:18:32
In reply to Tapering Nardil for surgery going okay so far, posted by gardenergirl on January 18, 2009, at 13:16:43
Some people get a sort of antidepressant "kick" when discontinuing Nardil gradually. In fact, mania is sometimes a problem under these circumstances. I hope that you get a rebound improvement that can carry you as long as you need it to. It is possible.
Good luck.
- Scott
Posted by mav27 on January 18, 2009, at 16:59:42
In reply to Tapering Nardil for surgery going okay so far, posted by gardenergirl on January 18, 2009, at 13:16:43
At least you are a lot smarter than me... i went off it cold turkey and got the worst ever rebound depression.
Posted by gardenergirl on January 24, 2009, at 16:13:58
In reply to Re: Tapering Nardil for surgery going okay so far » gardenergirl, posted by Phillipa on January 18, 2009, at 13:29:21
Thanks Phillipa. I'm not sure what I'd try if I didn't go back on Nardil. I have recurrent depression. I would never recommend treating a single depressive episode with an MAOI.
gg
Posted by gardenergirl on January 24, 2009, at 16:18:08
In reply to Re: Tapering Nardil for surgery going okay so far » gardenergirl, posted by SLS on January 18, 2009, at 16:18:32
> Some people get a sort of antidepressant "kick" when discontinuing Nardil gradually. In fact, mania is sometimes a problem under these circumstances. I hope that you get a rebound improvement that can carry you as long as you need it to. It is possible.
>
> Good luck.
>Thanks Scott. That must be what happened, because now I'm definitely into depression again. I just went down to 15 mg yesterday. Hopefully the depression won't get worse with an even lower dose. Bleah. And I'm not looking forward to experiencing all the start-up side effects I had when I started Nardil before. Any chance those won't come back when/if I restart it?
gg
Posted by gardenergirl on January 24, 2009, at 16:21:18
In reply to Re: Tapering Nardil for surgery going okay so far, posted by mav27 on January 18, 2009, at 16:59:42
> At least you are a lot smarter than me... i went off it cold turkey and got the worst ever rebound depression.
Yikes!
Though tapering doesn't seem to prevent depression from returning, I assume because it's now under-treated. The feeling good was good while it lasted. Wish it would come back, sigh.
gg
Posted by Phillipa on January 24, 2009, at 21:10:22
In reply to Re: Tapering Nardil for surgery going okay so far » Phillipa, posted by gardenergirl on January 24, 2009, at 16:13:58
GG read the next posts and I'm so sorry your not feeling well. When's the surgery now how much longer? I also hope no start-up when you resume the nardil. Love Phillipa
This is the end of the thread.
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