Psycho-Babble Medication Thread 1096995

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Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 2, 2018, at 2:01:48

In reply to Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin, posted by SLS on April 1, 2018, at 22:39:39

> > Sls:
> >
> > Taking a day or two of 90 to try to kick start Nardil would not be worthwhile would it? To knock out some extra Mao?
> >
> > I'm also taking it spread throughout the day pretty much 1 at time (6/8/10/12/4). Marplan k always too all at once at night......maybe that did better kicking out Mao and not affecting me in other ways.
>
> I usually take Nardil as 30 mg t.i.d. - 9 AM / 12 PM / 3 PM. I did it that way because I thought this would minimize the insomnia that it gave me. I don't think you should take extra Nardil at this juncture. It might confound your ability to evaluate your present dosage and could trigger side effects unnecessarily. My main concern is urinary retention.
>
>
> - Scott
>
>


Thanks that's helpful. Insomnia is never really an issue for me thanks for a small 25mg dose of Seroquel (been taking that as well since 2007.

So of course I actually had a pretty good night. One great sign is that I actually forgot about taking my last Nardil of the day (only by an HR or so) instead of dying for the time to come hoping for relief.

It's odd but I seem to bitch about it not working just before it kicks a little. I really do have hope that the timing and the lower dose of lamictal might finally get me to a good (and consistent) place. Im sure I'll feel ok in the morning but it's usually short after that (9/10am) that I don't feel like doing things I'd usually do at that time.....hopefully tomorrow will be different.

Thanks for the discussion.

 

Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin

Posted by SLS on April 2, 2018, at 7:52:05

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 2, 2018, at 2:01:48

What time do you take Lamictal?


- Scott

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 2, 2018, at 20:23:55

In reply to Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin, posted by SLS on April 2, 2018, at 7:52:05

> What time do you take Lamictal?
>
>
> - Scott

Nighttime.

I take TEVA on that too. I find different lamictal generics affect me differently.

Another not so great day. Did manage to get some stuff done this morning (artistic project) but was tired the whole time. Took a nap at 1, woke up at 3:30, ate, and now I'm a little irritable/don't want to do anything but go back to bed.

I'm sure the lamictal drop is part of this but I'm beginning to think the metformin (recently switched generics on that) could be at play too. I'm taking all of that (extended release 1500) at night for the past couple days but was spliting it prior. Also was taking a different generic (Sun). I think there may be minor interaction w lamictal levels - have to look that up again.

Notwithstanding the Nardil doesn't seem to be helping much at all. I used to get very driven w Marplan and there's non of that right now. No interest in doing what I'd usually do at this time of day in past months/weeks.....

 

Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin

Posted by SLS on April 2, 2018, at 21:12:12

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 2, 2018, at 20:23:55

How long did you stay at 150 mg/day of Lamictal before cutting back?

You were optimistic and described feeling better up until now.

I remain suspicious that you need to return to higher dosages of Lamictal. I think it is a worthwhile experiment. I appreciate your being concerned with cognition and memory. These things happened to me at first with Lamictal and at every dosage increase - but they disappeared.


- Scott

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 4, 2018, at 8:17:46

In reply to Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin, posted by SLS on April 2, 2018, at 21:12:12

I've been on lamictal since 2007. Going above 225 always made me flat/fatigued. On Marplan I could never take more than 125 or I'd get really tired. I was fine for years on Marplan 30(sometimes 40) + lamictal 100.

I was up on lamictal a bit I think since I was taking modafinil/armodafinil all last year. I figured I could handle the extra. Was s high as 200 for a few weeks but again just didn't like it. Modafinil/armodafinil didn't work for me....some don't respond to it....I guess I'm one of those people (could sleep after taking it / would often make me tired or just spaced out).

Anyway I'm definitely feeling Nardil this morning. First time since a tinge of it after a month on 60. I've been on 75 for just under a month. Feel very much like I did on Marplan - up early and ready to go. The trend has been to crash in a few hrs though before actually being productive. Hopefully today will be different.

Thanks for the discussion as always.

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 4, 2018, at 8:23:34

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 4, 2018, at 8:17:46

Also of note Teva brand Metformin ER seems to be helping with the weight again. I started this Nardil journey on Jan 25 at 216.9. Have been on a few different generics + immediate and extended after reading tons of discussion about vastly different effects per brand (10+ companies make it).

Today (after 5days on Teva) I'm at 217.1. Was 221 at a point early last week. Have been making the gym too but I think Metformin is def helping w the carb cravings and going to the bathroom (been doing that quit a bit where constipation was a big issue in the past w Marplan and other meds).

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by SLS on April 4, 2018, at 8:51:31

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 4, 2018, at 8:23:34

> Also of note Teva brand Metformin ER seems to be helping with the weight again. I started this Nardil journey on Jan 25 at 216.9. Have been on a few different generics + immediate and extended after reading tons of discussion about vastly different effects per brand (10+ companies make it).
>
> Today (after 5days on Teva) I'm at 217.1. Was 221 at a point early last week. Have been making the gym too but I think Metformin is def helping w the carb cravings and going to the bathroom (been doing that quit a bit where constipation was a big issue in the past w Marplan and other meds).

Thanks for reporting your experience with metformin. I'm going to the doctor later in the month to see if I can get a prescription.


- Scott

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 6, 2018, at 22:43:49

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by SLS on April 4, 2018, at 8:51:31

Awesome- I hope it works for us both. Please update if you take it.

Nardil definitely kicked in last night and this morning. Feels very much like Marplan did but maybe a touch stronger. Up very early + getting the woosh sound in my ear if I sit down after standing for a bit (blood pressure changes)

Mood is very positive and I'm definitely more chatty. I'm slightly more spacey than I'd like to be but I'm not sure I can blame that on the Nardil. I just hope the progress continues and I find balance through the day (seems to still be a bit up and down perhaps due to my dosing schedule).

 

Re: Metformin may help w/ Nicotine w/d (New study)

Posted by PeterMartin on April 8, 2018, at 11:17:19

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by SLS on April 4, 2018, at 8:51:31

ther meds).
>
> Thanks for reporting your experience with metformin. I'm going to the doctor later in the month to see if I can get a prescription.
>
>
> - Scott

New study out today (Rats) shows Metformin may help w/ quitting nicotine too (if you smoke): https://medicalxpress.com/news/2018-04-animal-common-diabetes-drug-nicotine.html

--

My weight has been up a touch the past few days (only to 219.6). It's frustrating because everytime it fluctuates I assume I'm on a bad generic and want to switch back to the previous one I still have pills of (or find internet support for others). I need to just forget about it and see the changes weekly or monthly.

I'm still only on 1500 and most people get to and stick w/ 2000 for full effect.

 

Re: Metformin may help w/ Nicotine w/d (New study)

Posted by Lamdage22 on April 8, 2018, at 13:47:35

In reply to Re: Metformin may help w/ Nicotine w/d (New study), posted by PeterMartin on April 8, 2018, at 11:17:19

The word needs to go out about Metformin. I think it is a really good thing for those of us that only tolerate those "weight gain" meds.

Need those kidney checks though. Its very rare but you could get in trouble if your kidney doesnt work while taking Metformin.

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 15, 2018, at 15:26:36

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 6, 2018, at 22:43:49

Back to the bottom again. Terrible.

Had two days of nonstop sleep. Finally snapped out of it yesterday but now I don't really feel like myself. Not interested in doing anything but going back to bed.

I feel like I'm going to lose the weight battle. Haven't gained a ton but bloating now....up to 220 or so from 116. That's with making the gym every morning and trying offset with metformin. It's helped and maybe my mood is just caving me in bad food but I feel sorta helpless. 230 is the max I've ever been. If I cross there I'm sure I'll quit.

I miss Marplan. Hate that only one company makes it and it costs $1500+ a month w.o. insurance....

Maybe Nardil still hasn't kicked in.....doubt it.

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 15, 2018, at 15:27:31

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 15, 2018, at 15:26:36

220 from 216 (obviously a typo - ~4lbs)

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 17, 2018, at 2:09:17

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 15, 2018, at 15:27:31

And tonight was great. Dunno. I took half of my lamictal in the morning (50) which I don't usually do and took 75 tonight. Maybe you are right SLS and I should head back to 150 at least until I get Nardil figured out.

I've also switched back to Metformin ER by Sun (not Teva) and my BMs seem to be more frequent which is definitely what I want. I'd switched to Teva Metformin on March 28 and then tried an IR brand as well for a few days when I started obsessing over weight.

I know I need to stop fiddling with this stuff. Luckily I see my doctor next week. My hope is to go to 2000 on Metformin (I'm sticking w Sun ER now) and prob leave the Nardil at 75 unless i get depressed yet again.

It's been extremely up and down since I began Nardil. There have been other changes though: Discontinuing Marplan (have heard that can cause mania), Discontinuing Nuvigil (felt o had a minor addiction to that but was ineffective), starting Metformin (and trialing different brands), and reducing Lamictal from 150 to 100. If I continue to feel like tonight I definitely won't make any adjustments. My problem is that when I get down I seek something to fix it.....I do keep a notebook (have for 3yrs now) and while that helps I still need to focus on being letting meds settle in. Weight gain might be the one thing that would still push me to rock the boat......I'm really afraid of gaining at this point...

Thanks for letting me vent a bit. I feel good tonight and that's really nice after a couple days of depersonalization and complete lack of interest in anything.

 

Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin

Posted by SLS on April 17, 2018, at 8:49:14

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 17, 2018, at 2:09:17

> And tonight was great. Dunno. I took half of my lamictal in the morning (50) which I don't usually do and took 75 tonight. Maybe you are right SLS and I should head back to 150 at least until I get Nardil figured out.

Supposedly, Lamictal has a 24 hour half-life. It feels shorter than that to me, though. Regardless, you can simply skip doses if 150 mg/day ends up being too much. You should be okay within 24 hours. If you increase the dosage of Lamictal, it might take a week or so for side effects to disappear. I would still push it to 200 mg/day gradually. There are some people who experience "brain-fog" cognitive and memory disturbances at low dosages, but this reaction does not occur steadily in the majority of people. Of course, you might be in the minority.

> Thanks for letting me vent a bit. I feel good tonight and that's really nice after a couple days of depersonalization and complete lack of interest in anything.

Do you experience both anhedonia and anxiety?


- Scott

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 20, 2018, at 9:00:17

In reply to Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin, posted by SLS on April 17, 2018, at 8:49:14

Nardil has been terrible for me. Maybe it's because I didn't do a washout from Marplan and thus didn't get a "kick in" effect I may have otherwise.


6wks of 60
6wks of 75

I've had a few good periods of days on both dosages but it's been a while now. My weight has started to creep up and a study I found suggests Nardil may raise weight regardless of insulin (https://link.springer.com/article/10.1007/s00702-012-0951-3) so now I'm less optimistic about the Metformin I've been taking to be effective.

Metformin could be contributing to my crappy moods too - hard to say.

I see my doc next week and I guess I need a plan - ugh.

Scott (or anyone) have you ever tried Zonegran for weight loss as an adjunct? I know it's very likely to cause rough side effects but maybe I'd be a lucky one it'd work for in terms of mood & weight loss.....

Mood sucks today. Anxiety even using the computer to type this. It's 7am and I just grabbed mcdonalds breakfast but going right back to sleep after I walk my dogs.

 

Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin

Posted by SLS on April 20, 2018, at 10:43:08

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 20, 2018, at 9:00:17

> Nardil has been terrible for me.

In what ways?

> Maybe it's because I didn't do a washout from Marplan and thus didn't get a "kick in" effect I may have otherwise.

I doubt that this is the explanation. It is not unusual for people to get a euphoric reaction to Nardil in the beginning. You may have experienced an initial improvement due to factors that do not involve MAO inhibition. There must be something about Nardil that creates a state of arousal in a way not seen with Marplan or Parnate.

> 6wks of 60
> 6wks of 75

That's usually enough time to evaluate Nardil for efficacy. You could go up to 90 mg/day, but I wouldn't invest more than another 3 weeks at this dosage without trying an augmenting medication.

Are there any other medications that make sense for you to try next? Are MAOIs the only drugs that you respond to? Without knowing what you have tried in the past, it is difficult for one to suggest alternatives.

> I've had a few good periods of days on both dosages but it's been a while now.

This is an unfortunate truth about Nardil. It can produce an improvement or euphoric reaction briefly upon dosage changes. Some people chase the high and end up taking 120 mg/day and still be disappointed.

Have you discussed adding drugs to Nardil as augmenters?

> Scott (or anyone) have you ever tried Zonegran for weight loss as an adjunct?

I found Zonegran to suppress appetite to a moderate degree. It seemed like a rather clean drug otherwise. I can't remember it having any side effects.

Obviously, the easiest thing to do would be to try augmenting Nardil with another medication. Not too many doctors would go along with adding a TCA. Are there any drugs to which you had a partial response? I realize that you won't be able to add a serotonin reuptake inhibitor, but it would be helpful to have a list to refer to in the future.


- Scott

 

Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin

Posted by SLS on April 20, 2018, at 11:35:35

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 20, 2018, at 9:00:17

What I wrote might have been confusing. I reworded my comment:

> > 6wks of 60
> > 6wks of 75

You could go up to 90 mg/day, but I wouldn't invest more than 3 weeks at that dosage (90 mg/day) without trying an augmenting medication.


- Scott

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 22, 2018, at 0:12:25

In reply to Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin, posted by SLS on April 20, 2018, at 10:43:08

Thanks for all the help Scott. It's good to know you didn't have a terrible experience on Zonegran. It's good to know it's a potential option.

So today was the best day I've had probably since I started Nardil. It's baffling. But today was "me" - in to my projects, not euphoric, but just on point. My weight was also miraculously down a bunch this morning. Perhaps the Metformin is working better - they say it can take months. I'm really hoping so.

The only real change I made was 1) giving Nardil more time at 75, 2) Switching back to Metformin ER Sun (instead of Teva), 3) Quickly returned to 100mg on Lamictal after a couple terrible days, and 4) I started taking cayenne pepper (Solaray 40,000) after meals a couple days ago to try to reduce my appetite.

Honestly it's probably just needing time to settle in. This trial of Nardil has been so up and down though I'm not certain my feeling of "self" will stay. I really hope so. I feel like I could be productive and social. Maybe this is Nardil really kicking in vs. a few spikes of that euphoria every talks about. I am about a month off of Nuvigil now (which I was on for a year and could take a toll on dopamine).

Fingers crossed once again that I stay well and manage to hold a steady weight.

 

Re: Hoping Nardil kicks in at 60 (wk3)

Posted by PeterMartin on April 23, 2018, at 19:05:20

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 22, 2018, at 0:12:25

Still doing great and this feels different. Confidence and some excitement to do what I like to do.

If Metformin keeps holding my weight and my mood continues I'll be quite happy. I see my doc in 2days.

Will update.

 

Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin

Posted by SLS on April 23, 2018, at 20:33:45

In reply to Re: Hoping Nardil kicks in at 60 (wk3), posted by PeterMartin on April 23, 2018, at 19:05:20

> Still doing great and this feels different. Confidence and some excitement to do what I like to do.
>
> If Metformin keeps holding my weight and my mood continues I'll be quite happy. I see my doc in 2days.
>
> Will update.


<smile>


- Scott

 

Re: Hoping Nardil kicks in at 60 (wk3) - up to 90

Posted by PeterMartin on May 7, 2018, at 15:56:04

In reply to Re: Hoping Nardil kicks in at 60 (wk3) » PeterMartin, posted by SLS on April 23, 2018, at 20:33:45

Still been very up and down on Nardil. My Metformin is now at 2000mg (past week) and maybe that's having more of an affect on my mood than I realize.

Anyway today marked 2 months on 75mg. I woke up not wanting to get out of bed / depressed. it's been 4 or 5 days since Ive really felt pretty good. I called my doc and he oked me to try 90mg.

Hopefully the side effects (wt particularly) won't be extremely tough w/ this increase. I'm a fairly heavy person so I'm also very hopeful that I needed this higher dose to get to a proper level of MAO inhibition.

I'll update at some point...

 

Re: Hoping Nardil kicks in at 60 (wk3) - up to 90 » PeterMartin

Posted by SLS on May 7, 2018, at 21:10:02

In reply to Re: Hoping Nardil kicks in at 60 (wk3) - up to 90, posted by PeterMartin on May 7, 2018, at 15:56:04

> Still been very up and down on Nardil. My Metformin is now at 2000mg (past week) and maybe that's having more of an affect on my mood than I realize.
>
> Anyway today marked 2 months on 75mg. I woke up not wanting to get out of bed / depressed. it's been 4 or 5 days since Ive really felt pretty good. I called my doc and he oked me to try 90mg.
>
> Hopefully the side effects (wt particularly) won't be extremely tough w/ this increase. I'm a fairly heavy person so I'm also very hopeful that I needed this higher dose to get to a proper level of MAO inhibition.
>
> I'll update at some point...

Good luck at 90 mg. I would be optimistic. I'm sure you know the general formula for arriving at a target dosage of Nardil = 1 mg per kg (body weight).

75 mg: 165 lbs

90 mg: 200 lbs

If you continue to experience a partial and episodic improvement, perhaps adding another drug would help.

Intuitively, one would think that adding a mood stabilizer would make sense. Have you ever tried lithium? I find that 300 mg/day helps with depression, but not mania, when combined with Parnate. I experienced a mild improvement using Trileptal, Lamictal and Topamax. Abilify would be a good choice therapeutically, but it causes weight gain. Saphris represents an alternative to Abilify.


- Scott

 

Re: Hoping Nardil kicks in at 60 (wk3) - up to 90

Posted by PeterMartin on May 10, 2018, at 22:44:10

In reply to Re: Hoping Nardil kicks in at 60 (wk3) - up to 90 » PeterMartin, posted by SLS on May 7, 2018, at 21:10:02

I used to take Lithium w/ Marplan for a number of years until I realized it was elevating my BP a great deal (160/95 average to 200+/100+ when I started noticing). That was only taking 600mg and even a decreased 300.

I read a ton of backthreads on all of these things - didn't you have a serotonin syndrome issue w/ Lithium & an MAOI? I thought you might have. I do think it helped but in general I can only tolerate low dose Li. When I get in to therapeutic range it makes me very flat and unmotivated...depressed. I do like it in theory though (grows grey matter). I've heard microdosing might even be helpful....one in a while if I'm depressed I'll take a 1/4 cap I have left over and placebo or not I seem to calm a bit.

Trileptal was a med I've never tried that I considered. It seems more likely to flatten you out that give you a spark which is really what I need. I was on Abilify for a few months in the late 00s and it caused pretty bad akathesia after a bit. RLS at night...that kinda stuff and I can't tolerate that side effect. I've seen a few studies that would make me feel confident about Metformin holding off Abilify wt gain.

Saphris is interesting. I'm curious to see how you do on that. I hadn't originally realized it was a sublingual medicine. My doctor isn't super familiar with Nardil so I'm not sure he'd be comfortable w/ adding too much on top of it.

It's still very early at 90 for me. I definitely feel the hypotension today and dizzyness at time after sitting for a while then standing. I have a good deal of brain fog but I'd say outwardly I'm cheerful and doing what I'd usually do. Hopefully this is an indication that the true therapeutic effect is aroudn the corner.

My wt crept up about 5lbs but I was going out for pancakes everymorning and only on 1500 metformin. I've just kicked that up the max 2000 and have eliminated my daily diner run. Metformin can take months to full work so I'd be ecstatic to get relief and a slight decrease in my wt. We'll see......I know that's a lot to expect w/ Nardil (wt).

I called the Marplan support yesterday (they know me ha). They couldn't say when it would be available again but I'm pretty sure I could get that patience assistance once it is. Talking to them and having them tell me the assistance program would be possible in my case makes me feel a little better about the bumpy start w/ Nardil. If I keep rolling and never reach stability at somepoint I should be able to get back on Marplan which worked amazing for me for 7yrs....

Thanks for given me a reason to ramble....

Hoping I wake up tomorrow "clicked in".....

 

Re: Hoping Nardil kicks in at 60 (wk3) - up to 90 » PeterMartin

Posted by SLS on May 11, 2018, at 7:10:29

In reply to Re: Hoping Nardil kicks in at 60 (wk3) - up to 90, posted by PeterMartin on May 10, 2018, at 22:44:10

> I used to take Lithium w/ Marplan for a number of years until I realized it was elevating my BP a great deal (160/95 average to 200+/100+ when I started noticing). That was only taking 600mg and even a decreased 300.

That sucks.

> I read a ton of backthreads on all of these things - didn't you have a serotonin syndrome issue w/ Lithium & an MAOI?

No. My episode of SS occurred when I introduced Effexor to Parnate. I took about 10-25 mg. The episode lasted for several hours. I was babbling gibberish, was incoherent in thought, and experienced muscle rigidity.

> I thought you might have. I do think it helped but in general I can only tolerate low dose Li.

Can you handle 150 mg taken at night?

> When I get in to therapeutic range it makes me very flat and unmotivated...depressed.

Exactly. Me, too.

> I do like it in theory though (grows grey matter). I've heard microdosing might even be helpful....one in a while if I'm depressed I'll take a 1/4 cap I have left over and placebo or not I seem to calm a bit.

I think 150 mg/day could possibly help with depression, elongate telomeres, and reduce the risk of contracting Alzheimer's Dementia.

> Trileptal was a med I've never tried that I considered. It seems more likely to flatten you out that give you a spark which is really what I need.

Actually, I didn't find it flattening at all. It was neutral with respect to sedation and flat affect. It helped clear up thinking and gave me some improvement in thought speed and clarity. Tegretol is the drug that can produce sedation.

> I was on Abilify for a few months in the late 00s and it caused pretty bad akathesia after a bit.

How many days or weeks did it take for the akathisia to appear? Can you describe what you experienced.

> I've seen a few studies that would make me feel confident about Metformin holding off Abilify wt gain.

Thanks for telling me this. If I continue to experience weight gain, I will definitely ask my primary care provider for it.

> Saphris is interesting. I'm curious to see how you do on that. I hadn't originally realized it was a sublingual medicine. My doctor isn't super familiar with Nardil so I'm not sure he'd be comfortable w/ adding too much on top of it.

That's understandable. Saprhis is an antipsychotic that is incidated for schizophrenia and mania. It also has antidepressant effects and generally does not produce much weight gain. I just wish that it were delivered orally. I'm sure this will be but a minor inconvenience should Saphris give me my life back.

> It's still very early at 90 for me. I definitely feel the hypotension today and dizzyness at time after sitting for a while then standing.

This might remain a problem, but the frequency and intensity of the dizziness might lessen over time. It did for me. In my experience, the dizziness is an indicator that you are at a therapeutic dosage. The brain fog will disappear completely if Nardil is the right drug for you.

> I'd say outwardly I'm cheerful and doing what I'd usually do. Hopefully this is an indication that the true therapeutic effect is aroudn the corner.

Those are monumental improvements, even if they are mild by degree. I am optimistic for you.

> My wt crept up about 5lbs but I was going out for pancakes everymorning and only on 1500 metformin. I've just kicked that up the max 2000 and have eliminated my daily diner run. Metformin can take months to full work so I'd be ecstatic to get relief and a slight decrease in my wt. We'll see......I know that's a lot to expect w/ Nardil (wt)

Let me know how the metformin works for you.

I was talking with my doctor yesterday about Nardil and Marplan. He characterized Marplan as being predominantly a drug for depression while Mardi is better for anxiety. I wish Marplan was less expensive. What they charge for this old drug is unconscionable. Even if it is fully covered by insurance, this mammoth price ultimately costs the entire middle class more money in increased premiums, Medicare and Medicaid coverage, and higher taxes.

> I called the Marplan support yesterday (they know me ha). They couldn't say when it would be available again but I'm pretty sure I could get that patience assistance once it is. Talking to them and having them tell me the assistance program would be possible in my case makes me feel a little better about the bumpy start w/ Nardil. If I keep rolling and never reach stability at somepoint I should be able to get back on Marplan which worked amazing for me for 7yrs....

I think you just convinced me to try Marplan before going back to Nardil.

> Thanks for given me a reason to ramble....

Thanks for giving me the opportunity to ramble back!

> Hoping I wake up tomorrow "clicked in".....

I hope so too. I greatly appreciate your posts.


- Scott

 

Re: Hoping Nardil kicks in at 60 (wk3) - up to 90

Posted by PeterMartin on May 16, 2018, at 0:42:22

In reply to Re: Hoping Nardil kicks in at 60 (wk3) - up to 90 » PeterMartin, posted by SLS on May 11, 2018, at 7:10:29

Sorry to not answer the questions but I just wanted to post that I'm having a really rough time. Man this has been a real rollercoaster and I'm in the pit of it right now.

I started 90mg on the 6th so this is day 9 and a day where I felt like I was fighting myself. I stayed in bed most of the day. Had no interest in using the computer or doing other things I usually do. At the same time I felt this hunch like I'm on the cusp of relief. As if the chemicals are all there but I'm just not getting that flick over to feeling better....instead I'm in this terrible hole.

I had a lot of Orthostatic hypotension so I take that as a good sign. But it's just so odd that after periods of success at 60mg and 75mg that I'd be completely starting over almost at 90......waiting for it to kick in again. I just keep believing it will and if the trend of complaining about it to relief continues it may be very soon. At the same time it's very much night and day...and when I'm in the night (like now) I can't remember what it's like in the day.

I had some bad thoughts of maybe taking a small amount of marplan to try to kick me over the edge but I resisted that. I just need to wait it out and I guess I'll do it in bed - at least I'm content there and not dreading it. If anything I'm grumpy/irritable about my lack of motivation/adhedonia.

I'm still taking 2000 metformin and my wt is 221ish (it was 216ish at start on Jan 25). I can't complain about that.....I'm recently up on that from 1500 so it could be another factor in my depression. I'm not sure. I'm just frustrated. I won't be full frustrated for another few weeks at 90mg but it baffles me that at this dose I feel probably the worst I've felt (just today really)......

Hopefully I'm just really treatment _resistant_ and my "ego" or whatever will lose the battle to feel better even if it's artificially induced....


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