Posted by gilmourr on June 6, 2013, at 19:06:30
In reply to Re: SLS - Do you think less Nardil might help? » gilmourr, posted by SLS on June 6, 2013, at 17:41:44
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> > Hey SLS
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> Hi.
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> You ask brilliant questions.Lol, thanks. You answer them brilliantly!
> > I was thinking that by day 70 if Nardil isn't giving me more benefit in the depressive/mood swing area that I might drop it down to 30 mg since it was working much better between days like 20-40.> 1. What do you mean by "mood swing"? Can you describe what happens?
What I mean by a mood swing is that at night or sometimes during the day I have 4-6 hour swings where I get really irritable/frustrated, moderately/severely depressed with thoughts of suicide/death and such. I don't get highs, it just returns to baseline low afterwards.
> 2. How much Nardil are you currently taking, and for how long have you been at that dosage?I've been taking 45 mg of Nardil for 49 days now. Same dosage for the entire 49 days.
> 3. Your improvement between days 20-40 might have been more time dependant than dosage dependant. My guess is that Nardil would have pooped-out on you, regardless of dosage.
Hmm, that is quite possible. It has done this to me in the past where it causes mood swings and such, but it's always around day 40+. If it pooped out, wouldn't it not work the next time trialing Nardil? I've been on it 4 times now, at 75, 60mg, 60mg and now 45 mg. Each time it seems to get worse at the 40 days+ mark. BTW, it seems as if NE is related to mood swings for me. It has happened on Parnate and Cymbalta--Never on SSRI's.
> 4. Nardil does build up in the body at an accelerated rate as the dosage is increased. This is because Nardil inhibits its own metabolism. The difference in effect between Nardil 45mg to 60 mg is greater than Parnate 40 mg to 60 mg. Most people don't respond well to Nardil until they reach a dosage of 60 mg/day. Generally, the more you weigh, the more Nardil you need. A formula that works pretty well is to take 1 mg Nardil per 1 kg body weight. (1 kg = 2.2 pounds).
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> 100 pounds = 45 kg
> 125 pounds = 56 kg
> 150 pounds = 68 kg
> 175 pounds = 79 kg
> 200 pounds = 91 kg
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> You can see why most people need a minimum of 60 mg/day of Nardil for it to produce a robust therapeutic effect.According to that I would need 80 mg about. But I get about 1 hour of sleep on 75 mg, urinary retention that requires a cathedar almost and other really bad side effects. Also the mood swings seem more volatile and frequent on higher doses.
> > Is it possible that it was building up in my body (and it was working at 30 mg and not so much once it hit 45 mg) or does a MAO inhibitor usually inhibit the MAO according to dose and not really build up? (neurotransmitter wise)
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> I don't know how quickly and to what degree neurotransmitter stores are increased once MAO is inhibited.
I guess I'll just have to test it. I have noticed that when I lower it always to come off of it I feel a bit better actually. Last time when I came down from 45 to 15 over 2 days I was definitely hypomanic or something. I had so much energy I wanted to jump out the window and I felt so happy that I felt like I could stab myself without feeling any pain + racing thoughts. Weird.> > Also, do you know what dose of seroquel starts affecting 5HT2A receptors?
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> Seroquel (quetiapine) is only moderate in its affinity for 5-HT2a receptors and approximates its affinity for D2 receptors. I don't really know at what dosage significant antagonism at these receptors occur, but I imagine one would need more than 100 mg/day. 400 mg/day seems to be the sweet-spot for Seroquel's therapeutic benefits on psychosis and depression. At 100 mg/day and lower, I think its antihistamine (H1 antagonism) effects predominate. Interestingly, Seroquel has relatively stong affinity for NE alpha-1b receptors. This property is also expressed by prazosin. I would not be surprised if Seroquel were to exert some of its antidepressant effect via this receptor.K. I think I will try a dose between 100-200 mg of seroquel, see how it goes. Been taking 75 mg for the last 4-5 days, I figure I can bump it up to 100 or 125.
> > I've been using it...3rd day I felt awesome for like 8 hours, but then it died down... I was thinking this might've been the effect on 5HT2A or maybe some hypomanic swing caused by more NET inhibition from norquetiapine. (Though I don't know if I'm BP2, still assuming I'm MDD)
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> You have used the terms "hypomanic" and "mood swing". These phrases are generally not used by people with unipolar depression to describe their condition. If true hypomania and mood-swings occur, I would be inclined to look more closely at a BD II diagnosis. You may need a mood stabilizer in your treatment regime.
Yeah I agree, I probably do. I can't use lamictal as it closes my throat as a side effect unfortunately. So it's depakote/seroquel or lithium. Lithium is more common I've seen with Nardil, it might be a good idea, but I'll need to get it from my psych as I can't get it from my GP. Which will be another 1-2 weeks :(> - Scott.
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>Thanks for the replies!
**BTW, is this reply system a little wack on this forum? It seems really UI unfriendly
poster:gilmourr
thread:1044784
URL: http://www.dr-bob.org/babble/20130527/msgs/1044798.html