Posted by King Vultan on July 29, 2004, at 12:41:21
In reply to Nardil dosing?, posted by amdew717 on July 29, 2004, at 9:46:32
> I recently went back on Nardil but because of side-effects I had experienced previously on this med, I'm only taking 30 mg per day. I noticed when I split the dose 15mg(6AM) 15mg(Noon), I was still having problems sleeping through the night.
>
> So the past 2 weeks I'm taking all 30mg at 6AM, and sleeping better, but does anyone know if this decreases the AD benefit? I know I'd probably feel better at a higher dosage, but the increased s/e would be an all too familar price. But I AM feeling better than I was before taking it.
>
> any thoughts?
> Jim C.
IMO, what you're seeing is a good example of the increase in MAO inhibition efficiency one obtains by splitting the dose of an MAOI. The half life of Nardil is so short that the drug molecule itself is going to be long gone at bedtime in either case you describe. However, since the body is constantly making new MAO, splitting the dose gives the drug an opportunity to wipe out some of the new MAO that has been produced since the last time it was taken.I think this is what you're seeing in your case because by splitting the dose between 6 AM and noon, you are ultimately inhibiting more MAO, which means there is less available to gobble up neurotransmitters. Therefore, you will wind up with more serotonin, norepinephrine, and dopamine, more AD effect, and more side effects related to the increased availability of those neurotransmitters. In your case, the insomnia is likely from the increased amount of either serotonin or norepinephrine that has been made available.
I've been through the insomnia thing with many of the ADs I've tried. My advice is to use some kind of sleep aid to counter the insomnia. Otherwise, you are limiting yourself in dosage to an amount that you can tolerate from the standpoint of insomnia, which quite possibly is not going to be the optimum amount from a therapeutic standpoint. In my case, I used to resist using sleep aids and wound up not being able to take full advantage of the drugs I was trying.
For Nardil, dosages of 45-75 mg/day are quite typical. It seems as though 60 mg/day is more or less the standard dose. I've been up to as high as 105 mg/day but am now down to 75 mg/day as I taper off the drug.
Todd
poster:King Vultan
thread:371981
URL: http://www.dr-bob.org/babble/20040724/msgs/372049.html