Psycho-Babble Medication Thread 1105761

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Re: Depression better than Nardil

Posted by linkadge on August 18, 2019, at 14:38:46

In reply to Depression better than Nardil, posted by PCB on August 18, 2019, at 13:28:26

Lowering the dose and/or adding something for sleep might help.

As for your job, can you take a leave (to sort things out and decide whether quitting is the best option)?

Linkadge

 

Re: Depression better than Nardil

Posted by Lamdage22 on August 18, 2019, at 14:51:33

In reply to Re: Depression better than Nardil, posted by linkadge on August 18, 2019, at 14:38:46

Unemployment is not as fun as it sounds

 

Re: Depression better than Nardil

Posted by Lamdage22 on August 18, 2019, at 14:52:20

In reply to Re: Depression better than Nardil, posted by linkadge on August 18, 2019, at 14:38:46

Work life balance instead of unemployment!

 

Re: Depression better than Nardil Lamdage22

Posted by PCB on August 18, 2019, at 15:10:20

In reply to Re: Depression better than Nardil, posted by Lamdage22 on August 18, 2019, at 14:51:33

Hey Lamdage22!

Im really sorry if my post suggested disability is easy. My brother is on disability and I think it is very difficult and has worsted his moods. I work in the medical field and have to see clients very 10 minutes with life and death illness sometimes. My depression and panic started during my medical training. I have enough saved to live off of and volunteer. I wonder if I quit my stressful career if I would revert back to my old undepressed self 20 years ago.

I actually am to advise clients away from disability because we were taught it is so difficult. Once again, I am truly sorry if I implied disability is fun. I know it is anything but fun. Thank you so much for your help!

PCB

 

Re: Depression better than Nardil

Posted by Lamdage22 on August 18, 2019, at 15:13:43

In reply to Re: Depression better than Nardil Lamdage22, posted by PCB on August 18, 2019, at 15:10:20

I just started studying and have no idea if I will make it. Unemployment was painful for me and detrimental to my mental health.

 

Re: Depression better than Nardil

Posted by PCB on August 18, 2019, at 15:26:07

In reply to Re: Depression better than Nardil, posted by linkadge on August 18, 2019, at 14:38:46

Hey Linkage!

Thanks for the great post. I work in the medical field and I have keep my depression a secret from my employer. I still feel it would be held against me and my pdoc agrees with this. But I could quit and try to get a new job. But this is very hard in the city where I live. Its very competitive. But if someone told me that there is a reasonable chance my depression would be better, I would quit today. Anyone know?

Nardil 60mg causes me insomnia. I have tried 55 mg, 50 mg, 45 mg with a return of the depression. I now add in low dose lithium and lamictal and tapered down nardil to 50 mg. Benzo make me sedated in the morning not able to think clearly at work. Ambien last 4 hours so I take half at bedtime and half at two am. That is still not enough, so I eat 12 slices of bread to induce sleep. Because of that, I can on eat small meals during the. Day and Im afraid this bread eating will give me diabetes. Trazadome reverses Nardil and makes me feel depressed. I have tried several other things for the insomnia over the 20 years, but no luck!

Thank you so much!

PCB

 

My Brothers

Posted by PCB on August 18, 2019, at 15:50:55

In reply to Depression better than Nardil, posted by PCB on August 18, 2019, at 13:28:26

My older brother has depression and went through school and couldnt finish college. He is now on disability. He takes lithium and risperidol. My younger brother did not study and barely made it through college. He works 2 days a week at a low low stress jobs for a few months, then goes on unemployment for a few month. He gets headaches before depression sets in and with the headaches he leaves his job. At 42, he doesnt take any psych meds.

This is another reason why I wonder if my brother avoid chronic depression by low work stress.

What do you guys think?

 

Re: Depression better than Nardil PCB

Posted by linkadge on August 18, 2019, at 18:01:33

In reply to Re: Depression better than Nardil, posted by PCB on August 18, 2019, at 15:26:07

I've never been on Nardil, but the insomnia from Parnate was rough. I found 25mg of Seroquel really helped (seemed to augment the antidepressant effect as well).

I am in a (sort of) similar boat career wise. I work in a stressful job (in education). The behavior in schools in my area is pretty bad. You're hated not just by the students, but their parents, the media etc. etc. I've known that I hate my job which has caused me to save money like a squirrel. I could probably last a few decades off savings (but not enough to stop working entirely). I may not have to quit, because, here in Ontario a change in leadership means that I may soon be fired from my job.

Before making a quick decision, I would speak with a counselor or financial advisor. It seems strange that you couldn't take a medical leave (I'm not sure about the rules in the U.S. but in Canada you cannot be fired because of a mental illness).

Insomnia can mess with ones ability to think clearly and process emotional experiences. I know that when I don't sleep I become more impulsive and find it difficult to process my emotions.

Sorry, rambling here... but again, I would speak with H.R. collogues, your doctor etc. about your thoughts to be sure you are making the right decision. It could be that leaving your job is the right thing to do, I don't know. I just know that depression and anxiety can sometimes cause short term thinking, an inability to fully explore all available options in a situation.

Linkadge


 

Re: My Brothers PCB

Posted by linkadge on August 18, 2019, at 18:10:36

In reply to My Brothers, posted by PCB on August 18, 2019, at 15:50:55

Stress can certainly cause or contribute to depressive disorders.

For example, I often apply to jobs, get called for an interview and then back out. I've passed up on so many opportunities simply because of severe short term anxiety about change, staring a new job, doing an interview etc...

I do notice that some meds can make me more sensitive to stress at work. For example, when I was on escitalopram, I was much more sensitive to the negative criticisms of others. On the other hand, venlafaxine makes me a bit more edgy and gives me a 'don't give a sh*t what you think' attitude. I don't like being this way, but it is less stressful.

Lithium has saved me a few times from quitting a job altogether. There are times when I feel like my brain is fried and I couldn't go on another day, and increasing my lithium usually reduces this.

My feeling has always been that there are HUGE variations in how people respond to work stress. Some first responders get PDSD, some don't, for example. I've always worked to try and figure out what (biochemically) differentiates low anxiety from high anxiety.

Linkadge


 

Re: My Brothers PCB

Posted by linkadge on August 18, 2019, at 18:13:16

In reply to My Brothers, posted by PCB on August 18, 2019, at 15:50:55

Just to add.

Sleep is a HUGE factor in whether somebody will stick to something or quit. When they're torturing somebody, they first keep them awake a few days and often they'll crack without need for anything else.

Quality sleep can be the difference between nervous breakdown and normal work malaise.

If you're not getting 8 hours of quality sleep every night then I'd find a way to make that priority #1.

Linkadge

 

Re: Depression better than Nardil. Thank you! linkadge

Posted by PCB on August 18, 2019, at 18:36:16

In reply to Re: Depression better than Nardil PCB, posted by linkadge on August 18, 2019, at 18:01:33

Yes! That is exactly how my field of work is! Clients always upset that you only have 10 minutes per appt and some threaten to sue you. Then insurance companies always saying your taking to much time and spending too much money. I finally feel comforted that I'm not the only on going through this.

And a leave of absence is probably doable. I'll speak to my pdoc about this. Great idea Linkage!

Yes, parnate gave me the worse insomnia. I have been reluctant about Seroquel, although it seems like most nardil users on the boards use a second generation atypical antipsychotic for sleep. I am paranoid as it is about getting diabetes or worsening arthritis with Nardil. l am afraid Seroquel will add to the Nardil weight gain and increase my sugar levels. I see clients with diabetes all day, so I think this is just excessive worry about Seroquel. I probably should give it a try.

Amazing set of posts Linkage and everyone at here pbabble! Big thank you to everyone!

PCB

 

Re: My Brothers linkadge

Posted by PCB on August 18, 2019, at 18:48:55

In reply to Re: My Brothers PCB, posted by linkadge on August 18, 2019, at 18:10:36

Yes, we all react to stress differently. That is a great, insightful comment Linkage. Coffee, TCA's, lack of sleep made me very irritable and abrasive to my colleagues at times. Low dose lithium has smooth out some of the irritability in me as well.

Two years ago I started monitoring my sleep with my Fitbit watch, no caffeine, mediating with Headspace app 10 minutes a day, keeping a gratitude journal and read, "The Art of Happiness," by the Dalia Lama. I am much me happier and enjoying times with my colleagues. I even went back to church and have traveled a bit. Most of coworkers mentioned the difference two years ago. I have a lot more empathy, compassion with mediation, "The Art of Happiness."

 

Re: Sleep linkadge

Posted by PCB on August 18, 2019, at 18:57:03

In reply to Re: My Brothers PCB, posted by linkadge on August 18, 2019, at 18:13:16

Hey Linkage!

Yes, Sleep is everything! I would say stopping all coffee, not using computers or TV before bed and monitoring my sleep with my Fitbit watch had been the cornerstone of my change two years ago. The Fitbit tracker is great and I see how my daily stress and my bedtime routine effect my total and REM sleep. When those go down, I feel mentally sluggish the following day. When I get good Total and REM sleep, wow do I feel good the next morning.

Great post Linkage! I wish I knew about sleep, avoiding EtOH, caffeine sooner than 2 years ago. I spent so much time trying medication combinations.

Thanks a million! Great posts!

 

Re: Depression better than Nardil

Posted by atypical on August 18, 2019, at 22:51:15

In reply to Depression better than Nardil, posted by PCB on August 18, 2019, at 13:28:26

I'm close to my 10th anniversary of starting the Big N. It has been my constant companion, along with co-conspirator low dose Li. Together they keep my head above water as I swim through my world and they also keep my tummy looking full. I'm fortunate that the side effects are not too problematic and that my job doesn't get terribly stressful. If I were in your situation, I'd try to reduce the N by some and, if I'm starting to sink, I'd try a whiff of ketamine, before trying to switch to the Big P (Parnate).

Also, in my experience, the Gavis and Greenstone versions of Nardil feel like two different meds in terms of side effects, and there doses are not equivalent.

 

Re: My Brothers

Posted by Lamdage22 on August 18, 2019, at 23:54:07

In reply to Re: My Brothers PCB, posted by linkadge on August 18, 2019, at 18:13:16

Hi PCB,

do you take Metformin? Because it helps in the weight department

 

Re: Depression better than Nardil

Posted by PeterMartin on August 19, 2019, at 3:21:09

In reply to Re: Depression better than Nardil, posted by PCB on August 18, 2019, at 15:26:07

> Nardil 60mg causes me insomnia. I have tried 55 mg, 50 mg, 45 mg with a return of the depression. I now add in low dose lithium and lamictal and tapered down nardil to 50 mg. Benzo make me sedated in the morning not able to think clearly at work. Ambien last 4 hours so I take half at bedtime and half at two am. That is still not enough, so I eat 12 slices of bread to induce sleep. Because of that, I can on eat small meals during the. Day and Im afraid this bread eating will give me diabetes. Trazadome reverses Nardil and makes me feel depressed. I have tried several other things for the insomnia over the 20 years, but no luck!
>

Have you tried very low dose Seroquel? I take Nardil (60 but have been as high as 90) and 25mg of Seroquel has always put me down at night. At the moment I'm even taking Ritalin w/ the Nardil and never have a prob sleeping almost exactly 1hr after I take my 25mg of Seroquel. At such a low dose I'm pretty sure it works mostly on histamine. Shouldnt cause at gain or anything.

I also take Metformin to prevent weight gain from Nardil. Sadly I haven't lost weight w Metformin like many do but I haven't seen crazy increases like many do. If you are prediabetes I'd def ask about Metformin.

Kinda off topic buto do you know which generic manufacturer makes your lamictal? TEVA was my bongo generic for 10+ yrs but they stopped making it last year. I've tried a few others (Unichem/Taro/Alembic/Subvenite) but still haven't settled on one....lamictal is one med where the different generics seem to work differently for me. Annoying.

 

Re: Depression better than Nardil

Posted by PeterMartin on August 19, 2019, at 3:25:19

In reply to Re: Depression better than Nardil, posted by atypical on August 18, 2019, at 22:51:15


>
> Also, in my experience, the Gavis and Greenstone versions of Nardil feel like two different meds in terms of side effects, and there doses are not equivalent.


Which do you prefer? If you were to take 60mg (as I do) of one or the other would you take Gavis or Greenstone?

I agree they feel different and I've stayed w Gavis(now Lupin) as it's always felt "stronger".

 

Re: Depression better than Nardil

Posted by PCB on August 19, 2019, at 5:56:40

In reply to Re: Depression better than Nardil, posted by atypical on August 18, 2019, at 22:51:15

Thanks Atypical! I have tried 55 mg, 50 mg, 45 mg with the depression returning. I actually saw Dr Fredrick Quiten as a patient once. He did most of the studies on Nardil and was considered the expert. He said to lower the dose and try Ritalin. After one does on Ritalin, I was dysphoric/felt awful. He also said that 90% of patients do well on Nardil but only 10% of patient can tolerate it long term. Then he said, "So I just prescribe Prozac now."

For about 10 years, I did Nardil 45 mg, lithium 450 mg and 4 cups of coffee. My weight was down 20 lbs to 215. But slept poorly, was very anxious, very irritable all the time. But my Parnate trial was the worst. I have Panic Disorder with Depression, and Parnate really increased my Panic. I could only get to 40 mg.

Luckly, I haven't noticed a big difference between Nardil manufactures.

Instead of Parnate, I was think a combo of Lexapro or Effexor, 450 lithium and 0.5 Klonopin.

Great post atypical! Thank you for your help. Your a lifesaver!

 

Re: My Brothers

Posted by PCB on August 19, 2019, at 6:02:04

In reply to Re: My Brothers, posted by Lamdage22 on August 18, 2019, at 23:54:07

I have not tried Metformin. In our classes, we were taught Metformin was not a great weight loss drug. Over the long term patient may experience no weight loss to up to 3 lbs.

But we did get taught it does reverse all the metabolic changes diabetes induces. I guess that might be the important thing is to prevent diabetes. Great thought, I'll have to reconsider Metformin!

Thanks Lamdage22! I really appreciate all your help!

 

Re: My Brothers Lamdage22

Posted by PCB on August 19, 2019, at 6:02:19

In reply to Re: My Brothers, posted by Lamdage22 on August 18, 2019, at 23:54:07

I have not tried Metformin. In our classes, we were taught Metformin was not a great weight loss drug. Over the long term patient may experience no weight loss to up to 3 lbs.

But we did get taught it does reverse all the metabolic changes diabetes induces. I guess that might be the important thing is to prevent diabetes. Great thought, I'll have to reconsider Metformin!

Thanks Lamdage22! I really appreciate all your help!

 

Re: Cipla Lamical PeterMartin

Posted by PCB on August 19, 2019, at 6:16:46

In reply to Re: Depression better than Nardil, posted by PeterMartin on August 19, 2019, at 3:21:09

My whole family would laugh at this one. I ranted and raved about the phase out of Teva. I called the company 4 to 5 times. I spoke to many Pharmacist about the phase out. I read the newspapers about Teva's financial problems. I thought I was doomed because I failed Zydus and Torrent's Lamical in the past. I actually got the list of all the Lamical manufactures and found out all the excipients in them. I tried the Lamictal closes to Teva's excipients and furthest from the Zydus and Torrent's excipients.

But something happened strangely. I stopped all coffee, went to all fish diet, adjust my sleep 2 years ago. I tried tried an old Torrent bottle and it didn't work. The pharmacist though it was too old. She said she had never heard of a patient complaint about a non Teva Lamical. But then I read people were having luck with Cipla on a seizure website. I tried Cipla and it worked. Then I challenged myself to trying Zydus and Torrent with a fresh bottle, and they worked.

So I think it was the coffee, no sleep and no omega III diet that was making the non Teva brands not work. It's not sound science, but this is all I can thing of.

And with other lamictal brand now working, I wonder if I retried an SSRI or SNRI, if they would work!

Thanks for the great post. Hope you search for lamictal goes well. I would vote for Cipla.

 

Re: Depression better than Nardil

Posted by atypical on August 19, 2019, at 20:40:36

In reply to Re: Depression better than Nardil, posted by PCB on August 19, 2019, at 5:56:40

PCB: I did do the genetic test recently. The main recommendation to come out of it was to consider l-methylfolate (Deplin or OTC equivalent, which is more affordable). I started trying it starting slowly with 1 mg OTC tablets but then realized I am feeling OK right now, so why not save it for when, or if, things shift in a negative direction.

PeterMartin: I think they are probably equally effective Gavis and Greenstone. At least for me they seem to be. They just have different side effects.

 

Re: My Brothers

Posted by Lamdage22 on August 19, 2019, at 21:45:32

In reply to Re: My Brothers Lamdage22, posted by PCB on August 19, 2019, at 6:02:19

Hey PCB,

it does not work for everyone but it can really make a difference. I was gaining 2 lbs a day before Metformin. I take 800mg Seroquel and 25mg Zyprexa. I'm pretty sure I would weigh 300 pounds without it. I weigh 200.

Let us know if you do try. You probably know about the rare side effect of lactic acidosis so if you take it, you should get a kidney check from time to time.

It's great to have someone from the medical profession here!

> But we did get taught it does reverse all the metabolic changes diabetes induces. I guess that might be the important thing is to prevent diabetes. Great thought, I'll have to reconsider Metformin!
>
> Thanks Lamdage22! I really appreciate all your help!

 

Re: My Brothers

Posted by PCB on August 20, 2019, at 6:22:53

In reply to Re: My Brothers, posted by Lamdage22 on August 19, 2019, at 21:45:32

Wow! Thats a great response to Metformin. So happy for you.

Its really great to meet people who have some real life experiences with depression and meds. My medical background helps, but some of what we learn is bias from drug companies.

Hope your well

 

Re: Depression better than Nardil atypical

Posted by PCB on August 21, 2019, at 19:12:28

In reply to Re: Depression better than Nardil, posted by atypical on August 19, 2019, at 20:40:36

Thanks for your post! I just asked my pdoc last week to order the Genesights pharmacogenomic testing. ( https://genesight.com) I really want off the Nardil and I was ready to pay $1800 for it. After talking about it for a while, he thought I should wait. I agreed, but I would love to have my the l-methylfolate tested at some point. I do have a bottle of folic acid 1 mg in cabinet unopened as we speak.

I wish you the best of luck with folate supplementation if you ever need to try it in the future! Thanks again for the advise

PCP


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