Psycho-Babble Medication Thread 1099088

Shown: posts 1 to 9 of 9. This is the beginning of the thread.

 

B12 shot caused a relapse / (Nardil 90)

Posted by PeterMartin on June 6, 2018, at 10:52:18

I've been on Nardil for 4 months now. Today marks 1 month at 90mg. It's been a total rollercoaster with good days and bad days. I had high hopes that going up to 90 would finally get me some consistency at feeling better. I did extremely well on Marplan for the past 7 years and everyone talks about how Nardil is the stronger med.

On Saturday (~3days ago) I was w/ my GF at a clinic and got a B12 shot. I'm also taking Metformin to try to hold off weight gain and Met is said to decrease B12. After getting the B12 shot my mood tanked a lot a few hours later. I got extremely anxious and slept pretty much all day Sunday. Monday and Tuesday were similar - less sleep but I still felt _horrible_.

I feel like I'm doing a little better today but it's like I'm completely unable to feel good.

I found one old thread where Scott (hope you read this) mentioned he had a bad reaction to B12 where Bleaberry chimed in about B12 shots causing a relapse (http://www.dr-bob.org/babble/20080420/msgs/825632.html)

Has anyone had this happen? It seems like 6 days is what it'll take to get over it :( At the moment Nardil doesn't seem to be doing anything at all. Any idea if it'll kick back in once the excess b12 leaves my system? I'd been weary of taking B6 since I know it can deactivate Nardil but this B12 reaction was a total surprise and really sucks.....

Thanks for any support. I probably just need to wait but I'm open to any suggestions.

 

Re: B12 shot caused a relapse / (Nardil 90)

Posted by Hugh on June 6, 2018, at 12:21:17

In reply to B12 shot caused a relapse / (Nardil 90), posted by PeterMartin on June 6, 2018, at 10:52:18

A B12 injection made me feel wired for the rest of the day and night. Then I felt exhausted for a few days. The I felt normal again.

 

Re: B12 shot caused a relapse / (Nardil 90)

Posted by PeterMartin on June 6, 2018, at 13:16:14

In reply to Re: B12 shot caused a relapse / (Nardil 90), posted by Hugh on June 6, 2018, at 12:21:17

Thanks Hugh! Hopefully the funk will lift soon. Don't feel like my medicines are working at all at the moment. All I want to do is sleep.

 

Re: B12 shot caused a relapse / (Nardil 90) » PeterMartin

Posted by SLS on June 6, 2018, at 23:01:43

In reply to Re: B12 shot caused a relapse / (Nardil 90), posted by PeterMartin on June 6, 2018, at 13:16:14

> Thanks Hugh! Hopefully the funk will lift soon. Don't feel like my medicines are working at all at the moment. All I want to do is sleep.

I've been following your posts closely. I would not give up on Nardil until you try some adjuvant medication. It appears that you can:

1. Wait longer at 90 mg/day.
2. Increase the dosage now. How much do you weigh?
3. Focus on mood stabilization while at 90 mg/day using lithium or anticonvulsants.
4. Add Lamictal.
5. Add nortriptyline.
6. Add Abilify.
7. Add amphetamine.
8. Add thyroid hormone. T3 has been reported to work with Nardil.
9. Add buspirone.
10. Add Wellbutrin.
11. Add Latuda.

What are your thoughts on these?

I favor adding something now, mainly because your improvements have been episodic since early in treatment. Perhaps you can begin Lamictal now while you continue Nardil at 90 mg/day. It will take you 4 weeks to reach a therapeutic dosage. In the meantime, you will be giving 90 mg/day a fair trial.

Lamictal titration for bipolar disorder in the absence of valproate and carbamazepine:

Weeks 1 and 2 - 25 mg/day
Weeks 2 and 3 - 50 mg/day
Week 4 - 100 mg/day
Week 5 - 200 mg/day

* I once added methylphenidate to Nardil. It was somewhat helpful. However, serotonin syndrome is a concern with this combination.

* Although I had a bad experience with adding Saphris to Parnate, I would not condemn Saphris. It might work for you. Saphris has a unique pharmacological profile. It does a bunch of different things.


- Scott

 

Re: B12 shot caused a relapse / (Nardil 90)

Posted by PeterMartin on June 7, 2018, at 11:16:08

In reply to Re: B12 shot caused a relapse / (Nardil 90) » PeterMartin, posted by SLS on June 6, 2018, at 23:01:43

Thanks Scott.

I'm already on Lamictal but I'd dropped it to 100mg for a while to try to limit memory issues and bloating. I've been back up at 150mg for a week or so now.

The others are good options but I'm obsessed w/ my weight and I'm beginning to think Metformin might be a problem. I tried taking an immediate release last night instead of the extended and felt horrible this morning (verge of crying). Everytime I've gone up on Nardil I've increased my Metformin dose also to work towards 2000mg (max). Doing this because I know if I gain weight and get over 230, 240, 250lbs I'll quit Nardil regardless of any progress. I'm 223 now (up from 216 at start).

But I have a hunch that that could be my problem. I'm going to try taking much less Metformin tonight (probably 750 or 1000) and see if I feel better tomorrow. I haven't gotten the weight _loss_ effect many people report in spite of trying dosages as high as 2500. So maybe a lower dose will keep me weight stable and not mess w/ my moods (if it is in fact the culprit).

I was horrible about an hr ago but a coffee and some time helped. I should have a little less MET in me today since I took less extended last night. I could really use a recovery day....been a while.

 

Re: B12 shot caused a relapse / (Nardil 90)

Posted by PeterMartin on June 8, 2018, at 11:21:48

In reply to Re: B12 shot caused a relapse / (Nardil 90), posted by PeterMartin on June 7, 2018, at 11:16:08

I'm slightly better today (5 days post shot) but still don't feel like Nardil is doing anything at all and I'm on the "max" 90.

I know b6 deactivates Nardil and vice versa but could it be possible that a high dose of B12 could do that as well? Or would a high dose of B12 (shot) cause b6 levels to rise too?

I went back and looked at notes I had from a previous B12 shot a few months ago and I had a similar bad period but didn't connect the dots. It was also on a Saturday and the next "good day" I had was the exactly a week later (tomorrow).

Nardil has been a complete frustration for me. It could be in part due to Metformin being too high (going to taper back a bit) but the B12 must have done something too.

 

Re: B12 shot caused a relapse / (Nardil 90)

Posted by PeterMartin on June 10, 2018, at 15:50:59

In reply to Re: B12 shot caused a relapse / (Nardil 90), posted by PeterMartin on June 8, 2018, at 11:21:48

I've much improved since last night. Hoping it just took 5wks at the full 90mg to kick in. Weight is still ticking upward but still time for Metformin 2000 to lock in as well. Will update.

 

Re: B12 shot caused a relapse / (Nardil 90)

Posted by bleauberry on June 14, 2018, at 5:36:53

In reply to B12 shot caused a relapse / (Nardil 90), posted by PeterMartin on June 6, 2018, at 10:52:18

B12 has seriously destabilized me in the past. Not any more. But when I was not well, yeah, B12 was like hitting a hornet's nest with a baseball bat.

Sensitivity to B12 is a clue to me that there is a component of the immune system involved - which then triggers my next thought of an unsuspected misdiagnosed stealth chronic low level infection such as Lyme, which is all it takes to remain perpetually in a lousy mood with treatments not working like they should. In my world, that is a pretty big clue. B12 sensitivity tells me something.

Later on after I reached remission after 20 years of treatment resistant depression, schizo-affective and bipolar, after all that was gone, I can take all the B12 I want. Excess is just pissed out and there is no adverse reaction or sensitivity any more.

I'm just saying that your reaction to B12 is a clear sign to me that there is another component of your psychiatric journey that is not being addressed. There are some health issues going on that have nothing to do with psychiatry. opinion

 

Re: B12 shot caused a relapse / (Nardil 90)

Posted by PeterMartin on June 19, 2018, at 0:37:06

In reply to Re: B12 shot caused a relapse / (Nardil 90), posted by bleauberry on June 14, 2018, at 5:36:53

Interested but I looked up Lyme and I don't think I qualify for most of that.

Sometimes I wonder if I'm really more Aspbergers/Mildly-Autistic than "bipolar I" as dxed. Any idea if being Autistic would be a reason to react differently?


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.