Posted by jedi on February 12, 2011, at 13:38:11
In reply to Re: Nardil side effects still a problem, posted by mantus on February 12, 2011, at 9:50:54
Hi again Mantus,
My insomnia has improved over the years and is much better at my current dosage of 60mg of Nardil. I'm just lucky in that I will respond with tiredness to the medications that are H1 receptor antagonists such as Benadryl. If I build up tolerance to the effect, I can just lay off for a few days, and they knock me out again. The insomnia is better than when I initially started Nardil, but has never gone away. For me, it will always have to be treated. Right now, I average 7 to 8 hours of sleep nightly.Nardil does reduce REM sleep and that is a bummer since I like to dream. I have had a sleep study in a sleep clinic and I do have some REM sleep, just reduced.
Another thing that Nardil does is reduce the level of B6(pyridoxine) in the body. This can lead to peripheral neuropathy, among other things, if not supplemented. Be careful with B6 dosage since ironically, too much B6, can also cause peripheral neuropathy.
The late afternoon tiredness has almost completely gone away. At first, I could not get through that period of the day without a Nardil nap! Of course, any two hour nap in the late afternoon will disrupt your sleep even more. This side effect does pass.
You must have got me thinking about my BP when I read your post yesterday. I have had some really bad tinnitus lately that relates back to a 1985 sudden hearing loss in my left ear. I know that an increase in BP will make the tinnitus worse, so I checked my BP this morning. My BP will normally run borderline high and Nardil will actually lower it somewhat. My entire extended family is on beta-blockers. The Nardil has kept me from going there. Anyway, this morning my BP was 136/75. Then because you had me thinking about the orthostatic hypotension, I stood up real fast and took it again. It was about 115/61. So I still have some orthostatic hypotension but not enough to make me dizzy. If my BP normally ran low, this postural change may have been enough to have an effect.
I have asked my MD to do the test to find my level of MAO inhibition. He didn't want to do it and it is probably unnecessary at this point for me. I have been on the medication for so long and up and down in dosage that I can feel the MAO inhibition level in my body. It will always take several weeks for a dosage change to cause changes for me, but I can always tell. If my mood does not change significantly, then I can tell by my side effects that the MAO inhibition has changed. I am assuming the side effects, like delay in orgasm, are directly related to the level of MAO inhibition in my body. The length of delay correlates almost exactly with my dosage when I give the dosage change several weeks to adjust the MAO inhibition. By the way, the delayed orgasm is another side effect that improves with time, at least for me.
If your doctor started you right out at 60mg of Nardil and you went to 75mg in three weeks, you are going to have some pretty severe side effects for a while. This is one medication that takes the body some time to get used to. I know it is hard, but you must take the dosage up slowly to avoid the severe side effects of this medication. In later years, when I've been off Nardil for several weeks, I have been able to taper up faster since my body knows what to expect from the med and I still have some residual MAO inhibition.
If I was in your shoes, I would reduce the Nardil to 60mg or even 45mg and give it several weeks before going back up again. This is one medication that can work when nothing else does, so work with it to get the right dosage for you. It takes time. I have used high dosage clonazepam, up to 4 or 5mg daily, to get me through the pain until the Nardil has a chance to kick in. MAO inhibition is not instant, it takes time, but can be a major miracle for some of us. I know it has saved my life at least a couple of times. From the sound of your posts, it appears to me that Nardil will work for you. Taper slower and don't give up because of the side effects. Better days are coming.
Be Well,
Jedi
Jedi
Treatment resistant, atypical, double depression with social anxiety.
Nardil + clonazepam
poster:jedi
thread:979083
URL: http://www.dr-bob.org/babble/20110130/msgs/979149.html