Posted by Questionmark on March 13, 2004, at 3:11:49
In reply to Re: Nardil Qs, posted by sobeit on March 13, 2004, at 0:27:21
> > Thanks for the input. Actually, I read an article from another post in a different thread that suggests 1mg of Nardil per kg of body weight. That would put me at 75 mg. But your explanation of why I might be feeling worse at 60mg than at 45mg also makes sense. And it would explain the excessive sleeping. Ugh.
> >
> > Although I do feel better since I talked about this with some people. I'm beginning to suspect it's the dissertation anxiety that is the biggest part of all this. Just need to do it, darn it!
> >
> > Thanks again,
> > gg
>
>
> Although it appears you've ended this thread, I thought I would add my experience should you come back to read any new postings. With more than 15 years dedicated to Nardil therapy, I've experienced most of the potential side-effects associated with this med - except a tyramine reaction! I began at 45mg (weight 155 lbs) and initialy experienced insomnia, hyper-reflexia, bradycardia, orthostatic hypotension, urinary retention, slowed bowel transit, weight gain, dry mucosal tissues, geographic tongue, anorgasmia, tinnitus at bedtime, worsening dermatitis, cramps of the lower extremities, and an incredible chocolate craving. These gradually began to lessen in intensity, with many becoming "acceptable" in exchange for the benefit derived (increased social interaction, improved mood, reduced anxiousness). The one side-effect that did not lessen over time for me was the insomnia. It was just as easy for me to stay awake the entire night as it was to try to fall asleep. I became accustomed to getting 4-5 hours sleep per night, but constantly struggled with difficult awakening in the morning. The first 5-6 years, I would reduce my dosage to 15mg during the summer to get a break from the insomnia and, although my mood would be stable, the social anxiety always returned. During the first 3 years, my dosage varied from 45mg to 105mg - learning that anything over 75mg was intolerable for me. I've learned that many of the side effects are dose-dependent and that optimal dosage needs to be titrated per individual. Early on I would experience a mild serotonin-reaction if I took more than 30mg at one time, but now I find the most effective method for taking the med is a single 60mg dose at bedtime. I've constantly struggled with the sleep issue, so initiated an investigation through the university hospital neurology department to include PSG/MSLT ("sleep studies"),sleep apnea workup, CPAP trial, stimulant trials, and sedative/hypnotic trials - all failing to produce an answer or benefit. Of interest to me was the complete lack of REM sleep and reduced stage 4 sleep of 75%, recorded during the PSG. It's still the best explanation for the insomnia, easy awakening during the first half of the night, and the resultant difficulty awakening in the morning. You may be experiencing a similar sleep pattern as you increase the dosage, since the loss of REM sleep appears to be dose dependent. You should continue titrating the dosage to determine your optimal level of function.
>
Thanks Sobeit, that was a pretty informative Nardil post (although it wasn't directed to me specifically). i'm fortunate, Nardil has never noticeablly made my insomnia any worse. If anything it may have helped it a tad.
The lack of REM sleep is caused by-- or at least caused more than anything by (i'm almost positive)-- the marked increase in synaptic serotonin levels. SSRIs decrease REM sleep dramatically as well, and Nardil completely obliterates it and is even more serotonergic than SSRIs (based entirely on personal experience, but i'd bet my left arm on that one-- that Nardil has an even greater effect on serotonin levels).
poster:Questionmark
thread:319742
URL: http://www.dr-bob.org/babble/20040308/msgs/323863.html