Psycho-Babble Medication Thread 1022439

Shown: posts 1 to 17 of 17. This is the beginning of the thread.

 

Nardil and falls

Posted by ChicagoKat on July 30, 2012, at 17:11:47

Hello,

Has anyone else ever been on Nardil and experienced the side effect of ataxia (incoordination) that led to falls? I had 4 falls while on Nardil-it was like one minute i was up and the next, boom, I was down.

If you have ever experienced this, what did you and your doc do about it? In my case my doc took me off the Nardil, which was a crying shame b/c it was working so well
Thanks,
Kat

 

Re: Nardil and falls » ChicagoKat

Posted by jedi on August 1, 2012, at 0:19:21

In reply to Nardil and falls, posted by ChicagoKat on July 30, 2012, at 17:11:47

Hi Kat,
Did you fall shortly after getting up from a sitting or lying position? Sounds like orthostatic hypotension to me. This is a common side effect of Nardil. Your blood pressure decreases on standing, sometimes low enough to make you pass out. It gets better with time, usually. Or, it can be medicated. I'm sorry your Dr. took you off of a working medication for this. Sometimes these drugs that work are few and far between.
Good Luck,
Jedi
Reference:
http://www.ccjm.org/content/77/5/298.full

> Hello,
>
> Has anyone else ever been on Nardil and experienced the side effect of ataxia (incoordination) that led to falls? I had 4 falls while on Nardil-it was like one minute i was up and the next, boom, I was down.
>
> If you have ever experienced this, what did you and your doc do about it? In my case my doc took me off the Nardil, which was a crying shame b/c it was working so well
> Thanks,
> Kat

 

Re: Nardil and falls

Posted by SLS on August 1, 2012, at 1:26:24

In reply to Re: Nardil and falls » ChicagoKat, posted by jedi on August 1, 2012, at 0:19:21

> Hi Kat,
> Did you fall shortly after getting up from a sitting or lying position? Sounds like orthostatic hypotension to me. This is a common side effect of Nardil. Your blood pressure decreases on standing, sometimes low enough to make you pass out. It gets better with time, usually. Or, it can be medicated.

Florinef (fludrocortisone) can help with hypotension.

If what you describe as "ataxia" is actually being produced by hypotension, I would agree with Jedi that it was probably premature to discontinue your treatment with Nardil. Hypotension can ameliorate with continued treatment, although not entirely. Orthostatic effects might persist, but are not nearly so problematic. For me, this side effect was well worth the improvements I saw with Nardil. Unfortunately, the improvements did not last.

Was there some concern that the ataxia was the result of mechanisms other than hypotension?


- Scott

 

Re: Nardil and falls

Posted by SLS on August 1, 2012, at 1:27:29

In reply to Re: Nardil and falls, posted by SLS on August 1, 2012, at 1:26:24

> > Hi Kat,
> > Did you fall shortly after getting up from a sitting or lying position? Sounds like orthostatic hypotension to me. This is a common side effect of Nardil. Your blood pressure decreases on standing, sometimes low enough to make you pass out. It gets better with time, usually. Or, it can be medicated.
>
> Florinef (fludrocortisone) can help with hypotension.
>
> If what you describe as "ataxia" is actually being produced by hypotension, I would agree with Jedi that it was probably premature to discontinue your treatment with Nardil. Hypotension can ameliorate with continued treatment, although not entirely. Orthostatic effects might persist, but are not nearly so problematic. For me, this side effect was well worth the improvements I saw with Nardil. Unfortunately, the improvements did not last.
>
> Was there some concern that the ataxia was the result of mechanisms other than hypotension?


I forgot to ask: What other medications are you taking?


- Scott

 

Re: Nardil and falls

Posted by chicagokat on August 1, 2012, at 19:27:22

In reply to Re: Nardil and falls » ChicagoKat, posted by jedi on August 1, 2012, at 0:19:21

> Hi Kat,
> Did you fall shortly after getting up from a sitting or lying position? Sounds like orthostatic hypotension to me. This is a common side effect of Nardil. Your blood pressure decreases on standing, sometimes low enough to make you pass out. It gets better with time, usually. Or, it can be medicated. I'm sorry your Dr. took you off of a working medication for this. Sometimes these drugs that work are few and far between.
> Good Luck,
> Jedi
> Reference:
> http://www.ccjm.org/content/77/5/298.full
>
>
>
> > Hello,
> >
> > Has anyone else ever been on Nardil and experienced the side effect of ataxia (incoordination) that led to falls? I had 4 falls while on Nardil-it was like one minute i was up and the next, boom, I was down.
> >
> > If you have ever experienced this, what did you and your doc do about it? In my case my doc took me off the Nardil, which was a crying shame b/c it was working so well
> > Thanks,
> > Kat
>
>
Nope, it was definitely due to ataxia. I could tell because my gait while walking became uncoordinated. And I was perfectly aware that nardil can cause orthostatic htn and made sure to always stand up very slowly. And the falls never happened right after or recently after standing up. Unfortunately it was indeed ataxia, a rare, but definitely possible side effect of the MAOIs. I just wondered if anyone else had ever experienced it!
Thanks for your input,
Kat

 

Re: Nardil and falls

Posted by chicagokat on August 1, 2012, at 19:31:10

In reply to Re: Nardil and falls, posted by SLS on August 1, 2012, at 1:26:24

Hi Scott,
Thanks for your input, but as I told Jedi, there was no doubt at all that it was ataxia. As far as other meds I was on at the time, well it wasn't a lot, since so many interact with nardil! In fact, I really don't think I was on anything else at the time.

I'm sorry it's good effect didn't last for you; that must have been disappointing.
Thanks again,
Kat

 

Re: Nardil and falls » chicagokat

Posted by SLS on August 1, 2012, at 21:09:12

In reply to Re: Nardil and falls, posted by chicagokat on August 1, 2012, at 19:31:10

> Hi Scott,
> Thanks for your input, but as I told Jedi, there was no doubt at all that it was ataxia. As far as other meds I was on at the time, well it wasn't a lot, since so many interact with nardil! In fact, I really don't think I was on anything else at the time.

How demoralizing it must have been to be forced to discontinue Nardil. Damned drugs.

I wonder if Marplan would produce the same side effect. It might not. Although Marplan and Nardil are related structurally, they really do feel different from each other when taking them. Marplan has fewer and less severe side effects.

> I'm sorry it's good effect didn't last for you; that must have been disappointing.

I have been disappointed by Nardil many times. The first time I tried taking more than 45 mg/day, I entered a period of complete remission that lasted for a few weeks before tachyphylaxis (rapid relapse) raised its ugly head. My usual pattern of response to a new drug is to experience a robust antidepressant effect that approximates remission for a period of exactly three days, followed by complete relapse. This has occurred with tricyclics, SSRIs, SNRIs, and MAOIs. It is only when I combine a MAOI with a tricyclic that I receive any sort of persistent improvement.

Last autumn, I became quite demoralized, somber, and dejected when my response to Viibryd failed to continue beyond the second week of treatment. It is unusual for me to feel helpless and hopeless, but when it does happen, I have a difficult time rejecting suicide as an option. Last year, I had exhausted my list of things to try. This had not occurred since I began making my list in 1983. I always had several treatment alternatives waiting to explore should my new treatment have failed. For now, I am responding to the addition of prazosin, a drug originally indicated for hypertension. It has been found to enter the brain readily and acts to ameliorate PTSD. For me, it acts as an antidepressant when combined with other drugs.

Currently:

Parnate 80 mg
nortriptyline 150 mg
Lamictal 200 mg
Abilify 10 mg
lithium 300 mg
prazosin 8 mg

I am having trouble maintaining a stable remission, and need to constantly adjust my prazosin dosage and dose timing. It works very well when I am in a "window" of effectiveness. However, prazosin has a half-life of only 3 hours. The therapeutic window is very narrow, so it is difficult for me to get things right. I recently discovered that a sister drug, doxazosin, which has a half life of 22 hours, is also being looked at for treating PTSD with good preliminary results. I am hoping that my doctor will prescribe doxazosin. It might yield a more stable remission. He needs to review the information I provided for him. In the meantime, improvements in my condition are only partial and episodic. I have had glimpses of remission, though, so I place a great deal of hope in doxazosin.


- Scott

 

Re: Nardil and falls » ChicagoKat

Posted by viper1431 on August 3, 2012, at 14:38:08

In reply to Nardil and falls, posted by ChicagoKat on July 30, 2012, at 17:11:47

How long had you been on the Nardil? After i've been on it for a short while i go through a period where i'll be walking around (always seems to happen when i'm at the shopping centre just to make it more intresting) where i'll be walking like i'm a little drunk, so far it hasn't gone beyond stumbling though thankfully.

> Hello,
>
> Has anyone else ever been on Nardil and experienced the side effect of ataxia (incoordination) that led to falls? I had 4 falls while on Nardil-it was like one minute i was up and the next, boom, I was down.
>
> If you have ever experienced this, what did you and your doc do about it? In my case my doc took me off the Nardil, which was a crying shame b/c it was working so well
> Thanks,
> Kat

 

Re: Nardil and falls

Posted by chicagokat on August 4, 2012, at 16:47:45

In reply to Re: Nardil and falls » chicagokat, posted by SLS on August 1, 2012, at 21:09:12

> > Hi Scott,
> > Thanks for your input, but as I told Jedi, there was no doubt at all that it was ataxia. As far as other meds I was on at the time, well it wasn't a lot, since so many interact with nardil! In fact, I really don't think I was on anything else at the time.
>
> How demoralizing it must have been to be forced to discontinue Nardil. Damned drugs.
>
> I wonder if Marplan would produce the same side effect. It might not. Although Marplan and Nardil are related structurally, they really do feel different from each other when taking them. Marplan has fewer and less severe side effects.
>
> > I'm sorry it's good effect didn't last for you; that must have been disappointing.
>
> I have been disappointed by Nardil many times. The first time I tried taking more than 45 mg/day, I entered a period of complete remission that lasted for a few weeks before tachyphylaxis (rapid relapse) raised its ugly head. My usual pattern of response to a new drug is to experience a robust antidepressant effect that approximates remission for a period of exactly three days, followed by complete relapse. This has occurred with tricyclics, SSRIs, SNRIs, and MAOIs. It is only when I combine a MAOI with a tricyclic that I receive any sort of persistent improvement.
>
> Last autumn, I became quite demoralized, somber, and dejected when my response to Viibryd failed to continue beyond the second week of treatment. It is unusual for me to feel helpless and hopeless, but when it does happen, I have a difficult time rejecting suicide as an option. Last year, I had exhausted my list of things to try. This had not occurred since I began making my list in 1983. I always had several treatment alternatives waiting to explore should my new treatment have failed. For now, I am responding to the addition of prazosin, a drug originally indicated for hypertension. It has been found to enter the brain readily and acts to ameliorate PTSD. For me, it acts as an antidepressant when combined with other drugs.
>
> Currently:
>
> Parnate 80 mg
> nortriptyline 150 mg
> Lamictal 200 mg
> Abilify 10 mg
> lithium 300 mg
> prazosin 8 mg
>
> I am having trouble maintaining a stable remission, and need to constantly adjust my prazosin dosage and dose timing. It works very well when I am in a "window" of effectiveness. However, prazosin has a half-life of only 3 hours. The therapeutic window is very narrow, so it is difficult for me to get things right. I recently discovered that a sister drug, doxazosin, which has a half life of 22 hours, is also being looked at for treating PTSD with good preliminary results. I am hoping that my doctor will prescribe doxazosin. It might yield a more stable remission. He needs to review the information I provided for him. In the meantime, improvements in my condition are only partial and episodic. I have had glimpses of remission, though, so I place a great deal of hope in doxazosin.
>
>
> - Scott
>

Dear Scott,
I'm so sorry to read that you are having such a tough time. I'll keep all fingers and toes crossed that the doxazosin helps. I must say, that you remind me an awful lot of myself; I have exhausted all possible meds and treatments - stims were my last chance, and now I'm having a tough time with my Ritalin: it either doesn't work or gives me horrible anxiety. I'm afraid I'm gonna have to give up on that, too, and then I'll be left with nothing. Which leaves me so depressed and anxious that I, too, start thinking about suicide. Actually, what I most wish I could do is be put in a coma until a new drug with a new mech of action comes out that might help. ha ha.
Oh, btw, thanks for suggesting Marplan; my pdoc also said it seems to have less severe side effects, so we tried it too, unfortunately with the same result.
I'm at the point that I would rather have the ataxia and risk of falls than feel the way I do now.
Anyways, thanks again, and hang in there; I really hope the doxazosin helps.
All my best,
Kat

 

Re: Nardil and falls

Posted by chicagokat on August 4, 2012, at 16:53:07

In reply to Re: Nardil and falls » ChicagoKat, posted by viper1431 on August 3, 2012, at 14:38:08

> How long had you been on the Nardil? After i've been on it for a short while i go through a period where i'll be walking around (always seems to happen when i'm at the shopping centre just to make it more intresting) where i'll be walking like i'm a little drunk, so far it hasn't gone beyond stumbling though thankfully.
>
> > Hello,
> >
> > Has anyone else ever been on Nardil and experienced the side effect of ataxia (incoordination) that led to falls? I had 4 falls while on Nardil-it was like one minute i was up and the next, boom, I was down.
> >
> > If you have ever experienced this, what did you and your doc do about it? In my case my doc took me off the Nardil, which was a crying shame b/c it was working so well
> > Thanks,
> > Kat
>
>

I had been on Nardil about 3 weeks when the symptoms started...and it was just like you: walking like I was drunk at first, then I guess it started getting more severe cos I'd be walking (stumbling) along and one second I'd be up and the next I was flat on my face. You're lucky you never got to the point where you had falls....tell me, did the stumbling eventually go away? If it did, maybe I could tell my pdoc and tell him I'll use a walker and wear a helmet (ha ha) until the ataxia wore off. That would be better than feeling as awful as I do now b/c the Nardil REALLY made me feel better.
Thanks,
Kat

 

Re: Nardil and falls » chicagokat

Posted by SLS on August 4, 2012, at 18:42:22

In reply to Re: Nardil and falls, posted by chicagokat on August 4, 2012, at 16:53:07

Hi CK.

As far as the ataxia is concerned, how did you rule out the possibility that it might be due to a persistent hypotension that occurs in the absence of orthostatic challenge? Florinef (fludrocortisone) would help if this is indeed the case.

Are you taking lithium or trazodone?


- Scott

 

Re: Nardil and falls » chicagokat

Posted by viper1431 on August 4, 2012, at 19:32:40

In reply to Re: Nardil and falls, posted by chicagokat on August 4, 2012, at 16:53:07

Yeah 3 weeks sounds about the same for me.
It's always gone away. I actually use the drunk stumbling as a sign that it's starting to work properly and that's when i lower the dose for a few days (or even stop for a few days) otherwise i do get to the point where if i don't sit down right away i know i will just collapse. When it has stopped i then up the dose again and it usually doesn't happen anymore.

I just have to watch out for the ortho hypotension after that.

> > How long had you been on the Nardil? After i've been on it for a short while i go through a period where i'll be walking around (always seems to happen when i'm at the shopping centre just to make it more intresting) where i'll be walking like i'm a little drunk, so far it hasn't gone beyond stumbling though thankfully.
> >
> > > Hello,
> > >
> > > Has anyone else ever been on Nardil and experienced the side effect of ataxia (incoordination) that led to falls? I had 4 falls while on Nardil-it was like one minute i was up and the next, boom, I was down.
> > >
> > > If you have ever experienced this, what did you and your doc do about it? In my case my doc took me off the Nardil, which was a crying shame b/c it was working so well
> > > Thanks,
> > > Kat
> >
> >
>
> I had been on Nardil about 3 weeks when the symptoms started...and it was just like you: walking like I was drunk at first, then I guess it started getting more severe cos I'd be walking (stumbling) along and one second I'd be up and the next I was flat on my face. You're lucky you never got to the point where you had falls....tell me, did the stumbling eventually go away? If it did, maybe I could tell my pdoc and tell him I'll use a walker and wear a helmet (ha ha) until the ataxia wore off. That would be better than feeling as awful as I do now b/c the Nardil REALLY made me feel better.
> Thanks,
> Kat
>
>

 

Re: Nardil and falls » ChicagoKat

Posted by pedr on August 4, 2012, at 20:28:04

In reply to Nardil and falls, posted by ChicagoKat on July 30, 2012, at 17:11:47

Hi, yes I had "the wobbles" as I called them throughout my 2 or so years on Nardil. Playing soccer was challenging, to say the least... Particular triggers for me were walking up a flight of stairs and turning my head quickly. Oddly getting out of bed never triggered it. I was so pleased to feel intermittently better that I just put up with it and the other SE's
Pedr

 

Re: Nardil and falls

Posted by SLS on August 5, 2012, at 2:06:49

In reply to Re: Nardil and falls » chicagokat, posted by viper1431 on August 4, 2012, at 19:32:40

> Yeah 3 weeks sounds about the same for me.
> It's always gone away. I actually use the drunk stumbling as a sign that it's starting to work properly and that's when i lower the dose for a few days (or even stop for a few days) otherwise i do get to the point where if i don't sit down right away i know i will just collapse. When it has stopped i then up the dose again and it usually doesn't happen anymore.
>
> I just have to watch out for the ortho hypotension after that.
>
>
>
> > > How long had you been on the Nardil? After i've been on it for a short while i go through a period where i'll be walking around (always seems to happen when i'm at the shopping centre just to make it more intresting) where i'll be walking like i'm a little drunk, so far it hasn't gone beyond stumbling though thankfully.
> > >
> > > > Hello,
> > > >
> > > > Has anyone else ever been on Nardil and experienced the side effect of ataxia (incoordination) that led to falls? I had 4 falls while on Nardil-it was like one minute i was up and the next, boom, I was down.
> > > >
> > > > If you have ever experienced this, what did you and your doc do about it? In my case my doc took me off the Nardil, which was a crying shame b/c it was working so well
> > > > Thanks,
> > > > Kat
> > >
> > >
> >
> > I had been on Nardil about 3 weeks when the symptoms started...and it was just like you: walking like I was drunk at first, then I guess it started getting more severe cos I'd be walking (stumbling) along and one second I'd be up and the next I was flat on my face. You're lucky you never got to the point where you had falls....tell me, did the stumbling eventually go away? If it did, maybe I could tell my pdoc and tell him I'll use a walker and wear a helmet (ha ha) until the ataxia wore off. That would be better than feeling as awful as I do now b/c the Nardil REALLY made me feel better.
> > Thanks,


Interestingly, when Nardil makes me feel weird, foggy, and otherwise "drunk", it means that the drug is going to work. These side effects occur once I reach a dosage of 60 mg/day. They always go away. Unfortunately, with me, the more robust antidepressant response is transient, although I can remain partially improved for an extended period of time.

The walking up a flight of stairs thing is probably transient low blood pressure. As one climbs the stairs, the large muscles of the legs contracting rhythmically act as secondary pumps to move blood around, and the heart is "told" by the CNS via baroreceptors that it can beat less forcefully. Once the secondary pumping action stops abruptly at the top of the stairs, there is a lag time before the heart is told to resume its normal forcible contractions. Actually, much of these changes in blood pressure are determined by changes in blood vessel dilation and constriction. As a side effect, these transient dizzy spells might not disappear entirely, but they can mitigate to some degree over time.


- Scott

 

Re: Nardil and falls

Posted by chicagokat on August 5, 2012, at 11:52:49

In reply to Re: Nardil and falls » chicagokat, posted by SLS on August 4, 2012, at 18:42:22

> Hi CK.
>
> As far as the ataxia is concerned, how did you rule out the possibility that it might be due to a persistent hypotension that occurs in the absence of orthostatic challenge? Florinef (fludrocortisone) would help if this is indeed the case.
>
> Are you taking lithium or trazodone?
>
>
> - Scott

Hi Scott,
Thanks for always taking the time to add your thoughts to my posts. I thought about it being from hypotension period, but decided not since my gait was being adversely affected, it was really weird, I just couldn't walk normally, and was constantly afraid of falling, which, unfortunately, I finally did. I'm really reaching the point where I'm gonna beg my pdoc to give it another try b/c at this point I am so miserable I'd rather risk falling than continue to feel this way. I'll tell him I'll use a walker and wear a helmet if it will make him feel better about it!
Thanks again,
Kat

 

Re: Nardil and falls

Posted by chicagokat on August 5, 2012, at 11:54:06

In reply to Re: Nardil and falls, posted by chicagokat on August 5, 2012, at 11:52:49

Oh, and no, I'm not taking either lithium or trazodone

 

Re: Nardil and falls

Posted by chicagokat on August 5, 2012, at 11:57:08

In reply to Re: Nardil and falls » chicagokat, posted by viper1431 on August 4, 2012, at 19:32:40

> Yeah 3 weeks sounds about the same for me.
> It's always gone away. I actually use the drunk stumbling as a sign that it's starting to work properly and that's when i lower the dose for a few days (or even stop for a few days) otherwise i do get to the point where if i don't sit down right away i know i will just collapse. When it has stopped i then up the dose again and it usually doesn't happen anymore.
>
> I just have to watch out for the ortho hypotension after that.
>
>
>
> > > How long had you been on the Nardil? After i've been on it for a short while i go through a period where i'll be walking around (always seems to happen when i'm at the shopping centre just to make it more intresting) where i'll be walking like i'm a little drunk, so far it hasn't gone beyond stumbling though thankfully.
> > >
> > > > Hello,
> > > >
> > > > Has anyone else ever been on Nardil and experienced the side effect of ataxia (incoordination) that led to falls? I had 4 falls while on Nardil-it was like one minute i was up and the next, boom, I was down.
> > > >
> > > > If you have ever experienced this, what did you and your doc do about it? In my case my doc took me off the Nardil, which was a crying shame b/c it was working so well
> > > > Thanks,
> > > > Kat
> > >
> > >
> >
> > I had been on Nardil about 3 weeks when the symptoms started...and it was just like you: walking like I was drunk at first, then I guess it started getting more severe cos I'd be walking (stumbling) along and one second I'd be up and the next I was flat on my face. You're lucky you never got to the point where you had falls....tell me, did the stumbling eventually go away? If it did, maybe I could tell my pdoc and tell him I'll use a walker and wear a helmet (ha ha) until the ataxia wore off. That would be better than feeling as awful as I do now b/c the Nardil REALLY made me feel better.
> > Thanks,
> > Kat
> >
> >
>
>
Thanks for the info Viper. I will talk to my doc about it, b/c when the weird gait starts, I have tried backing off on my dosage, and the gait has improved, but I still feel good. I'll see if I can try your method and make the Nardil work for me without having any falls.
Thanks again,
Kat


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