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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by pedr on April 12, 2010, at 0:31:17
Hi babblers,
I started taking Nardil 9 months ago and hit 90mg in January. Overall it's been my wonder drug, it's lifted me up like no other, made me more like my old pre-depression self than any other. It's possibly saved my life.However I'm either experiencing "poop out" (I don't like this overused term but can't think of an improvement) or reasonably frequent deep dips in well-being.
I keep a daily log of my mood. For the last 2 weeks of March, every day was 9/10 - frikkin awesome. Since then I'm around the 5/10 mark with dips right down to "I want to be dead" level of feelings and cognitions. This is confounding, disturbing and frankly worrying. Why such variation? Will this depression continue or will it lift? Either way it's worrisome. I don't want to have unpredictable, horrible dips into strong depression. Even worse would be if the med is just waning in effect.
With my letting-this-get-to-me hat on, why can't I catch a f'ing break? I was hoping to be one of those guys who just sits at 90mg for the rest of their life. I've had this illness for 14 years now and thought I'd at last reached a stable-ish level of recovery. A level of well-being I was willing to live with, that I could function pretty well on, even with the XL belly that Nardil has kindly bestowed upon me.
I'm not really sure what the purpose of this post is. I've seen posts by others who've experienced "poop-out" at the 8-9 month stage. I know that people will recommend nortriptyline, lithium, lamictal and others to augment the Nardil. I know I could try going up to 105mg too, although my PDoc thinks 90mg is as high as I should go. Perhaps I just wanted to vent :/
Laters,
Pete
Posted by mike0388 on April 12, 2010, at 0:45:13
In reply to Potential Nardil poop-out. Feeling cheated., posted by pedr on April 12, 2010, at 0:31:17
Hey pete,
Maybe you should up your dosage 1 tablet, and see how it works for 4 weeks, then go back down to 90mg though consult your pdoc and ask what he says, maybe its just a small 'boost' you need and all will be fine :)
tc
mike
Posted by bleauberry on April 12, 2010, at 16:55:16
In reply to Re: Potential Nardil poop-out. Feeling cheated. » pedr, posted by mike0388 on April 12, 2010, at 0:45:13
I guess your question could be asked by millions of people on various drugs. It isn't just nardil. Wish we knew why things don't just stay good once they get there.
Here is something to consider. It may be relevant and maybe not.
Ever since the nardil reformulation, and generics, there have been hundreds, probably even thousands of complaints from patients. Maybe there is some efficacy fluctuation from one batch to the next? Maybe you were getting a version of nardil by one particular manufacturer for all those months but recently were substituted a different one?
Posted by pedr on April 12, 2010, at 21:24:52
In reply to Re: Potential Nardil poop-out. Feeling cheated. » pedr, posted by mike0388 on April 12, 2010, at 0:45:13
> Hey pete,
>
> Maybe you should up your dosage 1 tablet, and see how it works for 4 weeks, then go back down to 90mg though consult your pdoc and ask what he says, maybe its just a small 'boost' you need and all will be fine :)
> tc
> mikeHi Mike,
I dunno I just hate the way the A/D effect just disappeared the last week or so. 90mg is a lot already - why would this massive suppression of MAO just suddenly stop? I don't get it :/
I will speak to my PDoc this week to see what he makes of it. A very complicating factor for me is my IBS pain. Whenever that is bad, my depression is bad and recently I've had a very bad flare-up. I just don't get how IBS pain can make me feel so down, bitter, blue and horribly empty psychologically and emotionally. It's nuts.
Pete
Posted by pedr on April 12, 2010, at 22:02:35
In reply to Re: Potential Nardil poop-out. Feeling cheated., posted by bleauberry on April 12, 2010, at 16:55:16
> I guess your question could be asked by millions of people on various drugs. It isn't just nardil. Wish we knew why things don't just stay good once they get there.
Too true. I just don't get it though. I wonder why whatever changes have taken place that make me feel better would start undoing. I mean, MAOI's crush MAO and AFAIK don't stop doing so just because you've been taking the med for x months. Maybe the brain dynamically compensates in some way, reducing or changing receptors or releasing different or less neurotransmitters. Who the feck knows.
>
> Here is something to consider. It may be relevant and maybe not.
>
> Ever since the nardil reformulation, and generics, there have been hundreds, probably even thousands of complaints from patients. Maybe there is some efficacy fluctuation from one batch to the next? Maybe you were getting a version of nardil by one particular manufacturer for all those months but recently were substituted a different one?I thought that too but all of my bottles of Nardil have come branded from Parke Davis. Still doesn't rule out variation in composition of course but it makes it less likely I would have thought.
Cheers,
Pete
Posted by bleauberry on April 13, 2010, at 16:32:07
In reply to Re: Potential Nardil poop-out. Feeling cheated. » bleauberry, posted by pedr on April 12, 2010, at 22:02:35
One more thought came to me last night. Though I am not confidently schooled on it, I am aware that Nardil has a significant impact on vitamin B6 metabolism. Which of course is key in many bodily functions including making neurotransmitters. I wonder if that could be involved? It might be worth trying B6, or better yet, p5p (the version of B6 that our bodies metabolize B6 into), a combo of both, and some general B vitamins to support it all.
> > I guess your question could be asked by millions of people on various drugs. It isn't just nardil. Wish we knew why things don't just stay good once they get there.
>
> Too true. I just don't get it though. I wonder why whatever changes have taken place that make me feel better would start undoing. I mean, MAOI's crush MAO and AFAIK don't stop doing so just because you've been taking the med for x months. Maybe the brain dynamically compensates in some way, reducing or changing receptors or releasing different or less neurotransmitters. Who the feck knows.
>
> >
> > Here is something to consider. It may be relevant and maybe not.
> >
> > Ever since the nardil reformulation, and generics, there have been hundreds, probably even thousands of complaints from patients. Maybe there is some efficacy fluctuation from one batch to the next? Maybe you were getting a version of nardil by one particular manufacturer for all those months but recently were substituted a different one?
>
> I thought that too but all of my bottles of Nardil have come branded from Parke Davis. Still doesn't rule out variation in composition of course but it makes it less likely I would have thought.
>
> Cheers,
> Pete
Posted by pedr on April 14, 2010, at 8:55:06
In reply to Re: Potential Nardil poop-out. Feeling cheated., posted by bleauberry on April 13, 2010, at 16:32:07
>> One more thought came to me last night. Though I am not confidently schooled on it, I am aware that Nardil has a significant impact on vitamin B6 metabolism. Which of course is key in many bodily functions including making neurotransmitters. I wonder if that could be involved? It might be worth trying B6, or better yet, p5p (the version of B6 that our bodies metabolize B6 into), a combo of both, and some general B vitamins to support it all.
Yes I've seen a few posts here and on other sites about the role of B6. Your suggestion certainly makes sense to me and I could probably do with more vitamins in general due to my narrow IBS diet (bread, bread and maybe some bread for dessert 8o).
However I did read one chap's post that he was deliberately avoiding B6 intake when taking his Nardil doses because it can interfere with Nardil's absorption. Also, it doesn't really explain these massive dips I get into depression from feeling OK. Still, if it helps, I'm game.Thanks for the suggestion,
Pete
Posted by julie1977 on April 14, 2010, at 16:25:09
In reply to Re: Potential Nardil poop-out. Feeling cheated. » bleauberry, posted by pedr on April 14, 2010, at 8:55:06
It happened to me and I, praps unwisely, weaned off fast and had about a week or so nardil free. I promptly fell into a moderate depression. I started the nardil up again and after a couple of weeks the 'light switched on' and my depression lifted. It had a renewed effect to an extent. It is a dangerous thing to do though, I became almost psychotic in that my dreams were extremely vivid, and I no longer felt safe in my flat - strong paranoia. Strange withdrawal effects.
Posted by pedr on April 17, 2010, at 9:58:04
In reply to Re: Potential Nardil poop-out. Feeling cheated., posted by julie1977 on April 14, 2010, at 16:25:09
> It happened to me and I, praps unwisely, weaned off fast and had about a week or so nardil free. I promptly fell into a moderate depression. I started the nardil up again and after a couple of weeks the 'light switched on' and my depression lifted. It had a renewed effect to an extent. It is a dangerous thing to do though, I became almost psychotic in that my dreams were extremely vivid, and I no longer felt safe in my flat - strong paranoia. Strange withdrawal effects.
Yes my nights have become much more 'entertaining' on Nardil :
- getting up to pee 5-8 times a night (nocturia)
- physically enacting dreams, especially action out soccer kicks! (REM sleep disorder) I've fallen out of bed twice and kicked my wife a number of times...
- sudden being-electrified type violent shaking fits that last 1-3 seconds
- insomnia
- excessive sweating
- much worse snoring
- and so on :)
Posted by ace on April 19, 2010, at 8:59:56
In reply to Potential Nardil poop-out. Feeling cheated., posted by pedr on April 12, 2010, at 0:31:17
> Hi babblers,
> I started taking Nardil 9 months ago and hit 90mg in January. Overall it's been my wonder drug, it's lifted me up like no other, made me more like my old pre-depression self than any other. It's possibly saved my life.
>
> However I'm either experiencing "poop out" (I don't like this overused term but can't think of an improvement) or reasonably frequent deep dips in well-being.
>
> I keep a daily log of my mood.Something like David D. Burns, or CBT author?
For the last 2 weeks of March, every day was 9/10 - frikkin awesome. Since then I'm around the 5/10 mark with dips right down to "I want to be dead" level of feelings and cognitions. This is confounding, disturbing and frankly worrying. Why such variation? Will this depression continue or will it lift? Either way it's worrisome. I don't want to have unpredictable, horrible dips into strong depression. Even worse would be if the med is just waning in effect.
>
> With my letting-this-get-to-me hat on, why can't I catch a f'ing break? I was hoping to be one of those guys who just sits at 90mg for the rest of their life. I've had this illness for 14 years now and thought I'd at last reached a stable-ish level of recovery. A level of well-being I was willing to live with, that I could function pretty well on, even with the XL belly that Nardil has kindly bestowed upon me.
>
> I'm not really sure what the purpose of this post is. I've seen posts by others who've experienced "poop-out" at the 8-9 month stage. I know that people will recommend nortriptyline, lithium, lamictal and others to augment the Nardil. I know I could try going up to 105mg too, although my PDoc thinks 90mg is as high as I should go. Perhaps I just wanted to vent :/
>
> Laters,
> PeteI think up the Nardil to 105-120 mg as the first action. I have read of people combating 'poop-out' by upping the dose 200+ mg, although I certainly wouldn't recommend that unless I knew the full circumstances of the case.
Second, i would try augmentation.........
There are many options here
This is the end of the thread.
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