Posted by Girlnterrupted78 on August 21, 2007, at 0:25:24
In reply to Re: My pdoc: 'After Nardil, that's it with meds. ECT', posted by stargazer2 on August 20, 2007, at 8:47:07
Thanks for your message, Stargazer.
>Sorry to hear your pdoc's stance on MAO's since it seems so obvious to me that Nardil has caused all of your side effects since they appeared after starting Nardil, right?
Yeah, that's correct. I find it so unbelievable that my pdoc could pretend nothing at all is related to Nardil, even when every symptom appeared for the FIRST time EVER after starting Nardil!?
Can't he just log online and read a few pages about Nardil? I mean, anyone with knowledge of the Internet can do that.. how come an MD who is prescribing the actual medication is incapable of reading a couple of pages about a medication he's prescribing? Shocking!!
>Do you have access to the package insert for Nardil? I think both the rash and blacking out are the direct cause of Nardil, perhaps they are dose related in your case.
I don't have access to the package insert, but I accessed the Pfizer website and found a pdf file on Nardil named:
"U.S. physician prescribing information for this medication."
http://media.pfizer.com/files/products/uspi_nardil.pdfIt says:
"All patients undergoing treatment with NARDIL should be closely followed for symptoms of postural hypotension. Hypotensive side effects have occurred in hypertensive as well as normotensive and hypotensive patients. Blood pressure usually returns to pretreatment levels rapidly when the drug is discontinued or the dosage is reduced."
Definition of POSTURAL HYPOTENSION:
Orthostatic hypotension (also known as postural hypotension, orthostatic intolerance and, colloquially, as head rush or a dizzy spell) is a sudden fall in blood pressure, typically greater than 20/10 mm Hg, that occurs when a person assumes a standing position, usually after a prolonged period of rest.
Symptoms, which generally occur after sudden standing, include dizziness, lightheadedness, headache, blurred or dimmed vision (possibly to the point of momentary blindness), and FAINTING. They are consequences of insufficient blood pressure and cerebral perfusion (blood supply).http://en.wikipedia.org/wiki/Postural_hypotension
There it is, right? From the Pfizer website itself!! How could he not read any info related to Nardil before prescribing?
> I can take 30 mg of Nardil but at 45 mg, I start to have enough negative effects that prevent me from increasing the dose any higher. My side effects are extreme gas pains, which cause me to double up, along with constipation. The blacking out effect has mostly gone away for me.
Wow. So you may never get the full effect of the medication with such a low dose.. My pdoc STARTED me on 45mgs, and once that didn't do much, took me straight to 90mgs. 30mgs might be way too low to actually work. Is there anything you can take for those side-effects, in order to be able to raise your dose? Sorry to hear about the side-effects.
> I have been thinking more and more about ECT out of desperation but I am too scared to try it. I think the right meds have just as much a chance of working as ECT does. Out of frustration and not finding a med to work, it is sometimes used as a last resort. But then many do not respond to this either and are they better or worse off for trying it? I don't know.
I would try other things before ECT. I do meditation (which believe it or not, when done right and reaching good concentration, has an amazing antidepressant effect.) It WORKS like if I had taken an antidepressant--and a free one at that!
But I need to figure out how to get that working better because sometimes I can't concentrate well enough to achieve the dramatic results I have achieved in the past.
> Your pdoc does not seem to know much about MAO's despite prescribing Nardil. Rather than say a rash or blacking out is not related to Nardil, a good MD would say something vague like "It may be related since I haven't had much experince with presribing Nardil" or "let me check the package insert"(If I can find the package insert, I'll send the link).
>
> Parnate supposedly works very differently than Nardil, as does Marplan. Success with one does not automatically mean you would have success with another as so many here can attest to.
>
> What are you leaning towards doing? I feel for you as this decision is not an easy one. Good luck with whatever you do...I will be following your posts.
>
> StargazerThank you Stargazer. I agree with most of what you wrote above. I honestly don't even know what I'm leaning towards. I will remain on Nardil for a while. I get the feeling that the blackouts are starting to diminish, and there's one VERY good thing about Nardil: I start feeling sleepy early at night (10-11pm) and I'm usually up by 5 or 6am. That's like a dream come true. I used to waste my days living with horrible insomnia--going to bed at 3am, getting up at 12pm, being unable to change my schedule in years. And suddenly, it's done!!
Anyway, I will probably explore a little more regarding meditation. When my friend told me about it, I thought it was BS. But it's been a year, and I can't stop going back to it when I'm depressed. I have no clue what it does, but it has the true effect of an antidepressant. So I guess I'm leaning toward doing research on this while still doing research on antidepressants until finding something that sounds just as good as Nardil used to sound--if that ever happens.
I'm starting to lose hope with medications though... I mean.. even if they work beautifully, we all know they might eventually poop-out, right? And then what? I'm very confused, and I really have no idea what I'll do next. So I will just do what I can (meditation and medication research) and will continue in therapy and visiting this website for support.
Thanks a lot for keeping in touch, I will also follow your case and hope the best for you!
GI78
poster:Girlnterrupted78
thread:777268
URL: http://www.dr-bob.org/babble/20070815/msgs/777516.html