Posted by Ron Hill on September 2, 2009, at 5:15:21
In reply to Re: Nardil: first time user, posted by jpiper on September 1, 2009, at 20:16:27
> The effective dosage for me then would be 45 mg based on my weight. I'm wondering when I get to that dosage if I can take one in morning and two at night - or, is there any benefit to splitting up the dosage equally through out the day?
>
> I have depression, GAD, and SAD. Im not bipolar and not taking any other meds.jpiper,
So, you weight about 99 pounds. Please correct me if I am wrong.
Nardil is good for GAD, SAD, and atypical depression.
I take 45 mg at noon and 45 at bedtime. For me, if I take Nardil (phenelzine) first thing in the morning, I can get sleepy-tired during the day. But, that is just me.
As for you, spreading out the daily dosage into three equal doses might be the best approach for two reasons.
First, the mean elimination half-life for a single 30 mg dose is 11.6 hours. Therefore, if you take 15 mg when you get up each morning and wait until bedtime to take the rest, your brain may be eager for more Nardil in the late afternoon and evening. But, it really is just trial-and-error to see what works best for you.
Second, some of the Nardil side effects can be minimized by spreading out the daily dosage. For example, most patients experience postural hypotension (an abnormal decrease in blood pressure when the patient stands up which may lead to fainting) at least for a while as a start-up side effect. The severity of this side effect might be minimized by spreading out the dosage.
But, having said that, postural hypotension while you are sleeping should not be a problem unless you get up in the middle of the night.
Like I said above, I take 45 mg of Nardil at bedtime. Many times I have gotten up to use the restroom in the middle of the night, and have almost lost my balance and fell down.
Ms. J. Piper, Nardil has a lot of side effects: weight gain (belly fat), carb craving, sexual dysfunction, sleepiness during the day, and etc. Some go away with time, but some do not.
I wish you were working with a p-doc instead of a family doc.
I know I keep going back to the bipolar thing, and I sense that you would prefer that I get off that topic. I just want you to make double sure.
Bipolar disorder is not an on-or-off kind of thing. Instead, it is a spectrum from very mild to very severe. My concern is that if a bipolar patient is given an antidepressant without moodstablizers fully on-board beforehand, the antidepressant can induce mania or hypomania (either euphoric or dysphoric).
Two things you have said in this thread make me think it is worth a double check for bipolar:
> Also, I've been reading about the "euphoria" episodes that some people have on Nardil. I really don't want that. I just want to be calm and get a grip on my racing thoughts so I can start thinking in a more logical fashion again.
> I'm not bipolar. I have no ups at all. I'm usually pretty low and then at times deeply low. I guess my thoughts are more repetitive than racing.
Your repetitive thoughts could be a marker, and your mood fluctuations from a usually pretty low and then at times deeply low could also be a marker. As a bipolar, I have had times when I have cycled from bad depression to worse depression with no hypomanic ups for long periods of time.
Id like to send you links to a couple of documents that I think you will find of interest. However, I do not want to overwhelm you with a bunch of reading all at once. So, Ill start by sending you the Nardil Prescribing Information document:
http://www.pfizer.com/files/products/uspi_nardil.pdf
Please note that the dosing information provided on page 11 in the Nardil Prescribing Information document (above) is wrong in most doctors opinion. It should be 1 mg/kg (1 mg Nardil/ 2.2 pounds of body weight) and maintained at that level.I could provide you with a ton of references to support the 1mg/kg dosage, but Ill just send one unless you want more. In the following document, on page three, in the center column, read the short section on Nardil (phenelzine):
http://www.thecarlatreport.com/documents/general/TCR.pdf
We crossed over each other on our last post exchange. Apparently, I was writing my post while you already posted yours.At any rate, if you are willing, Id still like to see the results of the screening tests, and a list of your symptoms of depression. But, if you dont want to, I will understand. Side note: Id also like to see your husband/significant-other take the screening test while pretending to be you. But, you know whats best.
Lastly (for this time), please remember that when you say I just want to be calm and get a grip on my racing thoughts so I can start thinking in a more logical fashion again that kind of feeling is what I use Trileptal to treat. It mellows my thoughts, eases my pressured speech, and allows me to focus on one thing at a time.
-- Ron
dx: Bipolar II and mild OCPD
600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
90 mg/day Nardil
poster:Ron Hill
thread:911112
URL: http://www.dr-bob.org/babble/20090902/msgs/915357.html