Posted by gilmourr on January 3, 2013, at 8:25:27
In reply to Re: SLS you've tried lithium and nardil right? » gilmourr, posted by SLS on January 3, 2013, at 7:19:23
> > Right now I'm doing lamictal + zoloft + maybe 1-2 mg of abilify later on for major depression and panic.
>
> Good luck with that. I would not abandon the Zoloft until you also try adding nortriptyline or desipramine. Tricyclic antidepressants (TCA) have long been ascribed anti-panic properties, especially imipramine
>
> > If this doesn't work I'm going to probably try nardil again (which would be in 3 months if this fails).
>
> 3 months is an interesting choice. Some of my doctors have found that a 3-month holiday from Nardil after its pooping-out allows for a return of a robust response when the Nardil is restarted.
>
> > Reason I might give it a shot is because I think being 4 times over the limit of B6 screwed with it and possibly the amlodipine interaction when I started it might've messed it up.
>
> I guess it's possible. I am aware of the Nardil - B6 interaction. However, I have yet to actually witness someone lose an antidepressant effect because of it. I would take a rechallenge to confirm such a thing. That said, I agree with you that it makes sense not to take megadoses of B6
>
> > ANYWAYS, question. On nardil the worst symptom I have is shivers/cold intolerance.
>
> For how long did you experience these things? How many weeks did you remain on Nardil once they first appeared. I ask this because I have experienced this transiently with both Nardil and Parnate. I would actually continue to increase the dosage despite the appearance of this phenomenon. You might be caught "in-between" response and relapse.
>
> > - Do you think these shivers are caused by norepinephrine or a metabolite of nardil? Cymbalta and Parnate made me extremely cold.
>
> I think it makes sense to have your thyroid checked.
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> > And parnate is more NE based I believe.
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> I agree, although a serotonin syndrome drug interaction is no less a risk with Parnate than it is with Nardil.
>
> > - Would lithium handle this?
>
> Taking low-dose lithium wouldn't hurt to try as an augmenter (300 - 600 mg/day).
>
> > I heard it converts Norepinephrine to serotonin.
>
> Lithium does not convert norepinephine into serotonin.
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> > If there's a better balance it would get rid of the coldness and help with any insomnia + give me the great efficacy of nardil.
>
> Lithium does a great many things in the brain, one of which is an increase in the release of serotonin. So, I guess you could theorize that there might be a better balance. Your reasons for taking lithium are good ones.
>
> > Thoughts?
>
> :-)
>
>
> - Scott
Thanks for all of the responses SLS!I actually have nortryptiline on hand, I'm just hesitant to use it to augment anything (and waste anymore time) because of my past history with norepinephrine meds. Cymbalta made me suicidal, effexor gave me 165/120 BP at 75 mg I believe, parnate made me hypothermic. And nortryptiline is pretty potent on NE if I recall correctly.
I like that you've heard about a 3 month break from nardil. Because I was on it... and it was working 80% on anxiety, 60% on depression. I literally thought I was going to be in remission, but then I bumped it up to 60 mg, and in 2 weeks major major depression came back and I was so cold I had to go see my doctor because of my limbs being like blue. I don't think higher is an option for me.
When I came off nardil for 15 days and restarted it didn't work that well, and it stopped working completely for the first time ever while I was still on 45 mg.
(But then again, this was the only time I took B6 everyday, and my levels were 4 times above the limit). There was a thread you participated in a while back with ron hill and two other users where they said they became suicidal or depressed after using B6 or something too.As for the shivers...they started on day 10 and went until day 50. I wasn't cold, I just kept shivering and having chills 24/7. Very odd. This happens to me at 60 mg+, but never on 45 mg, which was why I was confused this past Nardil trial.
Checked my thyroid twice, not sure if one was while taking nardil (can nardil affect my thyroid) but the tests were around 2.0 (can't remember if they were while I was on nardil).
True, I just remember this from wiki "interacts with a number of neurotransmitters and receptors, decreasing norepinephrine release and increasing serotonin synthesis." So it doesn't convert it like you said. But the end result will be more serotonin and less NE then right? You commented on the serotonin part but not the NE part.
Thanks SLS big time. Really trying to kick this mental health issue to the curb. It's been almost 2 years since it started out of nowhere.. just horrible genes I guess? I do have a spot for rTMS very soon. I know it helps release SERT and dopamine, but I'm not sure if it affects your vagus nerve for more GABA, because that would be an incredible treatment.
poster:gilmourr
thread:1034303
URL: http://www.dr-bob.org/babble/20121231/msgs/1034548.html