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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 25 to 49 of 49. Go back in thread:
Posted by ace on April 7, 2010, at 3:10:34
In reply to Re: Help! Not Responding to Nardil :(, posted by GreenP on April 7, 2010, at 0:41:44
> Thanks so much to both of you for your speedy responses! Sorry about the mix up... what I meant is that I've been on Nardil a total of 5 weeks and 3 days. 4 weeks on 40 mg and 1 week and 3 days on 60... and also, what I meant to say was that I am feeling worse than I was when I was on SSRI's.
Were you on a medication prior to starting Nardil?
At what dose?
Until it kicks in you may indeed feel worse, certainly you can not attribute this worse feeling to Nardil at present.
(I went off of SSRI's hoping that an MAOI would help more with all the other messed up feelings I am still having.)What feelings?
I kind of wrote this post in a desperate scramble so sorry about all the typos.
>
> It's so good to hear that there might be a surprise around the corner,Hang in there!
I've been so lost ever since I went off the SSRIs. My family's really starting to worry about me and they want me off of this stuff. But the way I was living on SSRIs wasn't truly living either. The depression wasn't gone, more like muted, and I never got excited about anything.
SSRI's, in many cases, 'numb' the depression, so we can't feel it as much. This is consistent with your statements above.
We don't want that! We want you to feel happy!
It's like I was watching the world go on from a distance. But I wasn't crying all the time, so it seems to outsiders that I'm doing worse. I have such high hopes for this medication. And I don't want to go off of it if there's any chance that it may work. I'm desperate enough for a chance at a real life to wait and stay on it.Good idea!
It's just tough sometimes, you know? I get tired of feeling crazy all the time. All of my anxiety is centered around things that I cognitively know aren't things to be afraid of. When I talk to people, I know that even if I am awkward, it doesn't matter. Who cares? If anything they will think, "oh that chic was awkward" and then they'll forget about it. But it's more than that, it's the feeling. There is this feeling that arises in me when I am around people. It happens no matter what, even when I know it's not warranted.
It's a feeling of anxiety, of being overly concerned what others think of you? Of being uncomfortable in the presence of others? Constantly thinking people are judging you and having an internal negative dialogue?
Do you feel this worse around the opposite sex?
It's the same with the depression,
separation anxietyWhen did the SA take hold? What specific syptoms?
and sensitivity to rejection.
Do you feel you are 'different' from others?
All things that I can cognitively sort out, but the feeling remains. And it exhausts me. It makes me gray. It hurts so badly. It has stolen my life. So if there's any chance in the world that this could help me with that, then I will wait. I have to.
Please answer the above if possible, but I indeed think you are on the right track. I feel that your dose must be sorted out ASAP.
Peace,
Ace
Posted by Economist on April 7, 2010, at 15:56:37
In reply to Re: Help! Not Responding to Nardil :(, posted by GreenP on April 6, 2010, at 4:26:25
GreenP,
Can you please post an update as soon as you notice a difference in your mood, if it ever happens? I have been on EMSAM now for 4 weeks and nothing is different. But some people tell me MAOIs can suddenly kick in one moment after 6 weeks. I need something to motivate me to continue this MAOI up to the six week mark.
Please update and let me know, or send me a babblemail.
Thanks,
Economist
Posted by mike0388 on April 7, 2010, at 16:01:01
In reply to Re: Help! Not Responding to Nardil :( » GreenP, posted by Economist on April 7, 2010, at 15:56:37
I've just started Nardil at a 30mg/day dosage, that increases to 45mg/day in 2 weeks. Have seen small changes, small but were changes. Kind of interesting.
Posted by GreenP on April 8, 2010, at 2:43:11
In reply to Re: Help! Not Responding to Nardil :( » GreenP, posted by ace on April 7, 2010, at 3:10:34
Responses to Ace's questions:
Before Nardil I was on Effexor 150mg and Zoloft 200mg at the same time. I was also on 100 mg Lamictal (which I am still on) and 10 mg Zyprexa (which I am also still on). The doctor also tried me on an ADD medication recently when I told him I wasn't getting excited about anything. He said that the ADD medication would raise my dopamine. It didn't make me feel any better but I think it's important to note that I was on 5 medications at once. Clearly something wasn't working correctly.
The other messed up feelings are as follows. When I wake up in the morning I am deeply depressed. When I get in the shower I am obsessing about everything, the shampoo, the temperature of the water, who I'm going to talk to, how I look. Negative chatter that doesn't stop. Again, I know these thoughts are unwarranted and crazy. But there's an indescribable feeling, almost like a pull that drives the thoughts. It hurts. I also get the feeling that I'm being physically violated a lot, not so much in the shower, but mostly when I put on clothes. Just general feelings of being overwhelmed, constantly.
SA was always there, since I was a little kid, but it didn't infiltrate every aspect of my life. I always had groups of people I was comfortable around, and then there were groups of people I wasn't. It's recently gotten to the point where there aren't people I feel comfortable around at all. I fluctuate in and out of feeling comfortable around my family.
Posted by SLS on April 8, 2010, at 5:09:07
In reply to Re: Help! Not Responding to Nardil :(, posted by GreenP on April 8, 2010, at 2:43:11
> When I wake up in the morning I am deeply depressed.
> When I get in the shower I am obsessing about everything, the shampoo, the temperature of the water, who I'm going to talk to, how I look.
> Negative chatter that doesn't stop. Again, I know these thoughts are unwarranted and crazy. But there's an indescribable feeling, almost like a pull that drives the thoughts. It hurts.
Although not an exact match, your depression seems to have some characteristics of melancholic (endogenous) depression. It might respond to tricyclic antidepressants. If you doctor is up to it, you can even add nortriptyline to Nardil.
- Scott
Posted by GreenP on April 8, 2010, at 15:59:23
In reply to Re: Help! Not Responding to Nardil :( » GreenP, posted by Economist on April 7, 2010, at 15:56:37
I will definitely post on any changes. There's still time for this story to have a happy ending!
P
Posted by GreenP on April 9, 2010, at 15:19:12
In reply to Re: Help! Not Responding to Nardil :(, posted by GreenP on April 6, 2010, at 4:26:25
I am so happy to report that the depression is lifting! The last couple of days I even went for a walk downtown. Yesterday I even bought something at a store. I know this isn't monumental in the life of a normy, but for me it means a lot :)
The anxiety is still there, I still wake up and feel incredibly overwhelmed, making it hard to get out of bed. I'm still having trouble when I have to pay for something, or have to pass someone walking down the street. And I still experience heavy pulses of distress over little things and sometimes nothing at all throughout the day, but I haven't cried in two days, and I'm actually going outside. Looks like things are actually turning around!
My question is, can the Nardil continue to work more and more on the same does as time goes on? Or to receive a better effect, is it necessary for me to increase my dose?60 mg Nardil
4 weeks on 40mg plus 1 week and 5 days on 60mg for a total of 5 weeks and 5 days on Nardil (wow, people were right about the 6 week mark)P
Posted by Economist on April 9, 2010, at 15:59:09
In reply to Re: Help! Not Responding to Nardil :(, posted by GreenP on April 9, 2010, at 15:19:12
Wow, that's great GreenP. Did you suddenly notice the mood life today, or was it gradual and subtle?
Posted by mike0388 on April 9, 2010, at 19:59:33
In reply to Re: Help! Not Responding to Nardil :(, posted by GreenP on April 9, 2010, at 15:19:12
Keep working on it! I've only been on a Nardil for a week, and I can feel a difference, I can just imagine how I'll feel 6 months into it. I cannot wait, honestly. But patience is a virtue, i'm on 45mg/day. Wish you the best, you'll be fine, remember patience patience patience!
Posted by Economist on April 12, 2010, at 1:26:11
In reply to Re: Help! Not Responding to Nardil :(, posted by GreenP on April 9, 2010, at 15:19:12
Hey GreenP,
I read your april 10, 2010 blog update. It sounded like you were a bit hopeless about your situation -- does this mean the Nardil pooped out on you? Please update us about your current feelings on Nardil.
Posted by mike0388 on April 12, 2010, at 14:29:42
In reply to Re: Help! Not Responding to Nardil :( » GreenP, posted by Economist on April 12, 2010, at 1:26:11
I think you have me mistaken with someone else.
I've only been on Nardil 2 weeks and feel alot better.
Posted by GreenP on April 13, 2010, at 1:59:35
In reply to Re: Help! Not Responding to Nardil :( » GreenP, posted by Economist on April 12, 2010, at 1:26:11
Economist,
You need not worry. The Nardil is still working, but I'm still having ups and downs. The good thing is that I am actually having some ups, and I do feel up most of the time. People around me notice it too, so it's not all in my head. I think I tend to blog when I'm feeling bad, it's kind of a release. It may be time for me to up my dose. I would do it now, but I have finals and college applications to take care of and I can't afford to have any initially sedating side effects as of right now. But over all I am much happier and calmer, just still down at times.
p.s. thanks for checkin out my Nardil blog! Here it is if anyone is interested: http://yaprettymuch.blogspot.com/
Posted by bulldog2 on April 14, 2010, at 15:34:23
In reply to Re: My thoughts/experiences on Nardil, posted by willyee on May 30, 2005, at 21:56:19
> > OT: First off, I was on vacation, so if anyone was trying to contact me via babblemail or email, try again, and I will respond.
> >
> > I am on week two of Nardil at 90mg, and I love it. I never thought I'd find something that worked better than the Parnate I was on, but indeed it does. I do miss the dopaminergic "push" that Parnate provided, but Nardil's effect on my anxiety is magical. My social phobia and other anxiety issues are simply gone, and I love it. Needless to say, I'm not depressed; I can't wait to see what this is like after two more weeks.
> >
> > Regarding the anorgasmia: I have a fantastic solution: cabergoline. I take more (500mcg once daily) than the dose recommended for prolactin suppression (500mcg twice weekly), but that is what it took to get a response. I have no side effects from the cabergoline whatsoever, just increased drive and a return of orgasm! There is NO NEED for anyone to suffer this side effect, because cabergoline is available to treat it. It also jacks up the libido quite nicely. My med cocktail:
> >
> > 22.5mg (total 90mg) Nardil qid (taking it this way minimizes the "Nardil nod" that I hope goes away at some point)
> > 4mg buprenorphine sublingual qid (goes wonderfully with the Nardil for both motivation, mood elevation and anxiety)
> > 500mcg cabergoline qd
> >
> > I also take 20mg Cialis fairly regularly, as I buy it (and cabergoline) from a research chemical supplier so I can afford to do this. If anyone needs an affordable source for these, babblemail me and I can help you.
> >
> > What I'm wondering about Nardil:
> >
> > 1) Has anyone had any success minimizing/eliminating carb cravings and/or weight gain? I am working out 4-5 times per week (30-45 mins cardio + 30-45 mins weight training--IN PUBLIC AT A GYM(!)--neither of which I could do without my meds!) but still worry about gaining weight and/or keeping fat on despite working out. Will this suffice? I try to keep snacking to a minimum, and when I do, I usually make it a piece of fruit or whatnot.
> >
> > 2) Drowsiness. Sometimes about 1-2 hours after I take a dose, I feel like going to sleep, but only if I am sitting still. If I am walking around, I do not get nearly as drowsy. Does this ever go away, or will I have to take modafinil/pemoline/etc for it?
> >
> > 3) Edema. Slight swelling in my feet. Does this ever go away?
> >
> > Thanks for your help and support, guys. I never imagined such a normal[ly pleasurable] existence was possible! Rather, it seemed as if such a life was reserved for others, but not for me. I am so grateful for my second chance at life at only 25 years old!
> >
> > Again, if anyone needs an affordable way to obtain tadalafil or cabergoline, babblemail me. There is no reason why anyone should trade a sex life for relief with Nardil.
> >
> > --cm
>
>
> I need an affordable source for nardil,im in a program for parnate and i dont wanna take the chance of giving it up if nardil doesent work,the program is very hard to enroll in,my email is brklyn234@yahoo.com......any ideas?
> >
> >
> >
> >
> >
> >
>
>Metformin is for appetite suppression as it normalizes blood sugar levels. 850 mg to 1000mg a day for appetite suppression. Just make sure the two can be taken together.
So what made you make the switch? I thought you were totally loyal to nardil.
Brilliant idea to add the carbergoline for prolactin suppression as that will also keep your testosterone levels up.
However isn't there something out there about carbegoline being toxic to the heart? Or only at certain doses.
Posted by bulldog2 on April 14, 2010, at 15:38:54
In reply to Re: My thoughts/experiences on Nardil, posted by willyee on May 30, 2005, at 21:56:19
> > OT: First off, I was on vacation, so if anyone was trying to contact me via babblemail or email, try again, and I will respond.
> >
> > I am on week two of Nardil at 90mg, and I love it. I never thought I'd find something that worked better than the Parnate I was on, but indeed it does. I do miss the dopaminergic "push" that Parnate provided, but Nardil's effect on my anxiety is magical. My social phobia and other anxiety issues are simply gone, and I love it. Needless to say, I'm not depressed; I can't wait to see what this is like after two more weeks.
> >
> > Regarding the anorgasmia: I have a fantastic solution: cabergoline. I take more (500mcg once daily) than the dose recommended for prolactin suppression (500mcg twice weekly), but that is what it took to get a response. I have no side effects from the cabergoline whatsoever, just increased drive and a return of orgasm! There is NO NEED for anyone to suffer this side effect, because cabergoline is available to treat it. It also jacks up the libido quite nicely. My med cocktail:
> >
> > 22.5mg (total 90mg) Nardil qid (taking it this way minimizes the "Nardil nod" that I hope goes away at some point)
> > 4mg buprenorphine sublingual qid (goes wonderfully with the Nardil for both motivation, mood elevation and anxiety)
> > 500mcg cabergoline qd
> >
> > I also take 20mg Cialis fairly regularly, as I buy it (and cabergoline) from a research chemical supplier so I can afford to do this. If anyone needs an affordable source for these, babblemail me and I can help you.
> >
> > What I'm wondering about Nardil:
> >
> > 1) Has anyone had any success minimizing/eliminating carb cravings and/or weight gain? I am working out 4-5 times per week (30-45 mins cardio + 30-45 mins weight training--IN PUBLIC AT A GYM(!)--neither of which I could do without my meds!) but still worry about gaining weight and/or keeping fat on despite working out. Will this suffice? I try to keep snacking to a minimum, and when I do, I usually make it a piece of fruit or whatnot.
> >
> > 2) Drowsiness. Sometimes about 1-2 hours after I take a dose, I feel like going to sleep, but only if I am sitting still. If I am walking around, I do not get nearly as drowsy. Does this ever go away, or will I have to take modafinil/pemoline/etc for it?
> >
> > 3) Edema. Slight swelling in my feet. Does this ever go away?
> >
> > Thanks for your help and support, guys. I never imagined such a normal[ly pleasurable] existence was possible! Rather, it seemed as if such a life was reserved for others, but not for me. I am so grateful for my second chance at life at only 25 years old!
> >
> > Again, if anyone needs an affordable way to obtain tadalafil or cabergoline, babblemail me. There is no reason why anyone should trade a sex life for relief with Nardil.
> >
> > --cm
>
>
> I need an affordable source for nardil,im in a program for parnate and i dont wanna take the chance of giving it up if nardil doesent work,the program is very hard to enroll in,my email is brklyn234@yahoo.com......any ideas?
> >
> >
> >
> >
> >
> >
>
>It's always been my position that p-docs would get more compliance if they thought of some of these innovative solutions. Do some homework on solutions that would make these drugs more tolerable.
Metformin has good reviews at low doses for appetite suppression. Just make sure you can take it with an maoi.
Posted by bulldog2 on April 14, 2010, at 15:43:35
In reply to Re: Help! Not Responding to Nardil :( » GreenP, posted by Economist on April 7, 2010, at 15:56:37
> GreenP,
>
> Can you please post an update as soon as you notice a difference in your mood, if it ever happens? I have been on EMSAM now for 4 weeks and nothing is different. But some people tell me MAOIs can suddenly kick in one moment after 6 weeks. I need something to motivate me to continue this MAOI up to the six week mark.
>
> Please update and let me know, or send me a babblemail.
>
> Thanks,
> EconomistWhat dose? My p-doc say most will not respond until the 12 mg patch.
Posted by Economist on April 14, 2010, at 19:25:45
In reply to Re: Help! Not Responding to Nardil :( » Economist, posted by bulldog2 on April 14, 2010, at 15:43:35
I've been one week on the 9 mg patch.
Posted by GreenP on April 25, 2010, at 14:58:30
In reply to Re: Help! Not Responding to Nardil :(, posted by GreenP on April 6, 2010, at 4:26:25
I recently upped my dosage from 60 mg to 75 mg (which I feel is working for me). I take 30 in the AM and 45 in the PM. Yesterday I took my nighttime dose and my heart rate shot up. I'm worried this means I can't continue the 75 mg dosage, as it is described as a serious side effect. Anyone have an experience or suggestions? I really want to make this new dose work : /
P
Posted by ed_uk2010 on April 25, 2010, at 15:23:18
In reply to Nardil Fast Heart Rate, posted by GreenP on April 25, 2010, at 14:58:30
>Yesterday I took my nighttime dose and my heart rate shot up. I'm worried this means I can't continue the 75 mg dosage, as it is described as a serious side effect.
It's probably not serious, but your doctor may want to check BP and ECG to be sure.
Posted by desolationrower on April 27, 2010, at 0:33:10
In reply to Nardil Fast Heart Rate, posted by GreenP on April 25, 2010, at 14:58:30
how fast? is bp normal?
-d/r
Posted by GreenP on April 27, 2010, at 3:42:58
In reply to Re: Nardil Fast Heart Rate, posted by desolationrower on April 27, 2010, at 0:33:10
My bp is usually really low. When my blood pressure increased, I didn't have a cuff around to take my bp so I'm not sure. It felt like I had just gone sprinting or something. I'm thinking of trying splitting up the dosage. Just not sure if this is really serious or not.
Posted by desolationrower on April 27, 2010, at 22:01:47
In reply to Re: Nardil Fast Heart Rate, posted by GreenP on April 27, 2010, at 3:42:58
youre not on other meds, like a beta blocker?
if its hypotension along with high heart rate, it sounds like an imbalance of alpha and beta receptor action (in your case, too much beta agonism, not enough alpha).
-d/r
Posted by GreenP on April 28, 2010, at 0:15:12
In reply to Re: Nardil Fast Heart Rate, posted by desolationrower on April 27, 2010, at 22:01:47
Is it common to be on a beta block when you're on an MAOI?
I don't really think I have hypotension, low blood pressure just runs in my family (it's a good thing, not a dangerous thing).
Alpha beta..wha?
Any suggestions on what I should be doing?P
Posted by GreenP on May 18, 2010, at 23:19:24
In reply to Re: Nardil Fast Heart Rate, posted by GreenP on April 28, 2010, at 0:15:12
I'm now up to 90 and am feeling worlds better. The blood pressure thing is still an issue IF I take 45 mg at once. I have to split it all into 3 30mg doses and I'm fine. :)
Posted by GreenP on August 12, 2010, at 0:09:26
In reply to Re: Nardil Fast Heart Rate, posted by GreenP on May 18, 2010, at 23:19:24
The final verdict: Nardil was a fail. I thought I was doing well until my roommate moved out and I realized how depressed I really still was. I was just so hopeful that I was in denial. I also had horrible side effects. I gained 35 pounds and was always hungry, I was dizzy, at one point the doctor told me I had toxic levels in my body and took me back to 75mg. My urine was dark dark brown. I was sooo dumb. I couldn't remember anything. It was so hard to zone in and get studying done. I finally just got to the point where I couldn't take it anymore. It didn't help with my anxiety one bit, and even though it did help with my depression a little, it would be much safer to take an SSRI. I was on the Nardil because it promised social anxiety relief, which did not come. In the end I was on the Nardil for 6 months.
I am now taking Zoloft 150mg and Wellbutrin 350mg and am finally getting the relief that I need. It may not be perfect, but I am far more resilient, and now have the energy to do the thing in life that will make me feel better, and keep me from being depressed.
Just wanted to let you in on my personal experience. If Nardil doesn't work for you, there are other options. Good luck to us all in finding our peace!
P
Posted by angels78 on August 12, 2010, at 1:00:22
In reply to Re: Nardil Fast Heart Rate, posted by GreenP on August 12, 2010, at 0:09:26
Hey from my experience 75 mg was too much, when I went down to 60 mg, alot of side effects went away except weight gain. Did you ever try dropping your dose? I couldnt take 75, i tried, but i was zoned out. 60 mg i could do anything.
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