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Dr. Bob is Robert Hsiung, MD,
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Posted by JonW on August 21, 2002, at 18:11:14
In reply to Nardil, posted by cosis on August 21, 2002, at 17:46:28
> I have been taking Nardil 45g/day for the last 5 day's for Social Anxiety Disorder... Can anyone please share their experiences on when the drug "kicked in" and started to work.. I haven't noticed a difference yet.. And I haven't experienced any side effects except a little sleepiness....
Hi cosis,
When I was seeing Dr. Liebowitz (from Columbia) for Social Phobia he told me that 60mg is really the dose at which it starts to work for SP. Obviously, anyone can respond to any dose but keep this in mind. For me it took about 6 weeks before I noticed anything. Some people claim it is like a light switch (maybe that's just for depression, though) but it was more gradual in my case. Dr. Liebowitz also said that the clinical studies showed twice the efficacy at 12 weeks compared to 6 weeks so if you reach that point don't be discouraged by a partial response. I just couldn't take the side-effects (which took weeks to appear) so I discontinued it and am about to start moclobemide tomorrow -- fingers crossed! Anyway, my advice is find something with proven efficacy for SP that you can tolerate and stick it out -- which means 12 weeks in most cases.
Good Luck,
Jonp.s. Don't rule out a CBGT program when you are ready. Get your meds in order and take it from there... Also, comming off of Nardil, for me at least, has been pure hell and I sure wish someone had told me this before I went on it. So if an when you come off of it -- take it s l o w!!!
Posted by cosis on August 21, 2002, at 19:24:02
In reply to Re: Nardil » cosis, posted by JonW on August 21, 2002, at 18:11:14
Thanks for the response.. I think my doctor put me on 45g to start out with and get use to the medicine... What kind of side effects did you get?
I hope this works, I am tired of living like this.. I tried CBT and it helps but the physical symptons are still there, panic, heart beating fast, sweating, a total uncomfortable feeling...One guy I talked to said he noticed a difference in 3 day's.. I have little depression, mostly SA & Panic.....
Thanks
Nick
Posted by missliz on August 22, 2002, at 1:31:22
In reply to Re: Nardil, posted by cosis on August 21, 2002, at 19:24:02
Everyone is different- I only needed 30 to 45 mg tops and loved the stuff. I had the light switch effect, but the drug takes at least eight weeks to run in. Partly because an MAOI has a "rewiring" effect that takes time, and partly because you need a learning curve to be well. It was a big shock to me to find out how other people live.
I loved the stuff, it really gave me my life back.
Posted by JonW on August 22, 2002, at 6:09:26
In reply to Re: Nardil, posted by cosis on August 21, 2002, at 19:24:02
> Thanks for the response.. I think my doctor put me on 45g to start out with and get use to the medicine... What kind of side effects did you get?
Obviously, sexual dysfunction (though some people don't seem to get it and still others say it can diminish with time). Also, urinary retention, dry mouth, weird sensations where I lost sense of time, floaters, I'd hear things, and the worst insomnia one could possibly imagine. I thought this drug was benign -- no side-effects for the first couple of weeks -- but then everything just started piling on and getting worse!
> I hope this works, I am tired of living like this.. I tried CBT and it helps but the physical symptons are still there, panic, heart beating fast, sweating, a total uncomfortable feeling...
Have you tried Klonopin?
Jon
Posted by cosis on August 22, 2002, at 8:04:46
In reply to Re: Nardil » cosis, posted by JonW on August 22, 2002, at 6:09:26
Hi John,
This is the first drug I've ever tried before...
Nick
Posted by cosis on August 22, 2002, at 8:06:09
In reply to Re: Nardil, posted by missliz on August 22, 2002, at 1:31:22
Wow that is a long time, I am going to try to be patient!
Thanks!
Posted by JonW on August 22, 2002, at 14:04:57
In reply to Re: Nardil, posted by cosis on August 22, 2002, at 8:04:46
> Hi John,
>
> This is the first drug I've ever tried before...
>
> NickWell, it is the single most effective drug for Social Phobia so it is a good drug to be on. However, it *is* a little odd that your doctor would put you on this before trying something without the restrictions or interactions and with fewer side-effects first.
Please tell me your doctor also prescribed something like nifedipine to take in the event of a hypertensive crisis. If not, you might want to find a more experienced pdoc.
Good Luck,
Jonp.s. You might also want to invest in a blood pressure monitor just to give yourself peace of mind from time to time. You'll know if you're having a hypertensive crisis, but it is nice to see the numbers that say everything is just fine :)
Posted by cosis on August 22, 2002, at 14:21:53
In reply to Re: Nardil » cosis, posted by JonW on August 22, 2002, at 14:04:57
Hi John
I already bought a blood pressure kit so I can check it daily.. My doctor gave me an option to try Paxil or Nardil.. I chose Nardil knowing the restrictions.. the fact that I didn't drink might be why he suggested it.. The food restrictions does not bother me either.
My SA is really getting bad, and I already tried CBT alone which helped some but I think a drug in combination w/ CBT is what I needed...
My pdoc said he has been prescribing Nardil for over 20 years and only heard of 4 hypertensive crisis situations.. Right now I fully plan to avoid the foods on the list he gave me..
Thanks for your help
Nick
Posted by JonW on August 22, 2002, at 14:43:25
In reply to Re: Nardil, posted by cosis on August 22, 2002, at 14:21:53
> My SA is really getting bad, and I already tried CBT alone which helped some but I think a drug in combination w/ CBT is what I needed...
Research confirms this so I think you're definitely on the right track. I understand bad SP -- last year I couldn't even go out to get the mail. I had to go on disability and now I'm out of a job because of SP and Bipolar disorder. It's kind of funny how such a silly disorder can cause such a serious problem in life. So many people don't understand how big of a deal it is to have social anxiety disorder. I wish you all the best.
> My pdoc said he has been prescribing Nardil for over 20 years and only heard of 4 hypertensive crisis situations.. Right now I fully plan to avoid the foods on the list he gave me..
Sticking to the diet isn't hard at all... you get used to it real quick. Cutting cheese out is probably healthier anyway. There seems to be controversy on how strictly you have to follow the diet. My attitude was always 'better safe than sorry', but to each their own... Good for you and not drinking. I gave it up because of bipolar disorder, and it really doesn't mix with any mental illness. Try to stick it out with the Nardil and I bet you'll be amazed!
Hang in there,
Jon>
> Thanks for your help
> Nick
Posted by gypsea on August 23, 2002, at 14:47:45
In reply to Nardil, posted by cosis on August 21, 2002, at 17:46:28
> Hi,
>
> I have been taking Nardil 45g/day for the last 5 day's for Social Anxiety Disorder... Can anyone please share their experiences on when the drug "kicked in" and started to work.. I haven't noticed a difference yet.. And I haven't experienced any side effects except a little sleepiness....
>
> Thanks
>Hey Cosis,
I've been on 45 mgs of Nardil for most of the past 11 years. (I was able to effectively drop back to 30 mgs for a while.) As I recall, it took about 2 weeks for the lightswitch effect. But, WOW... what a difference!!! It certainly gave me my life back. In fact, it's the only thing that's worked for my Generalized Anxiety Disorder. I've been pretty much asymtomatic ever since. The side effects are significant, however. The most disruptive for me have been partial anorgasmia and insomnia. They come and go, but when they're here... YUK! Much better than dealing the anxiety, though. I also take 1 mg of Clonazepam in the morning. The cocktail works well for me, though you may find the Nardil to be sufficient. As JonW noted, I find it interesting that your doctor didn't have you try... well... everything else available before prescribing Nardil. It's usually a last resort. I'm also surprised that he only knows of 4 hypertensive crisis after 20 years experience with the drug. I can beat that hands down with only my own episodes. You've got to be careful with the diet and more particularly with conta-indicated pharmaceuticals. I haven't always been. Though I've never kept them around myself, I agree with JonW's recommendation that you carry something with you to counter a hypertensive crisis. As with everything else, each individual seems to respond differently to MAOIs. Personally, Nardil's been a Godsend! I do wish someone could tell me how to relieve the anorgasmia, though!!
Posted by gypsea on August 23, 2002, at 15:05:24
In reply to Re: Nardil » cosis, posted by JonW on August 21, 2002, at 18:11:14
> > I have been taking Nardil 45g/day for the last 5 day's for Social Anxiety Disorder... Can anyone please share their experiences on when the drug "kicked in" and started to work.. I haven't noticed a difference yet.. And I haven't experienced any side effects except a little sleepiness....
>
> Hi cosis,
>
> When I was seeing Dr. Liebowitz (from Columbia) for Social Phobia he told me that 60mg is really the dose at which it starts to work for SP. Obviously, anyone can respond to any dose but keep this in mind. For me it took about 6 weeks before I noticed anything. Some people claim it is like a light switch (maybe that's just for depression, though) but it was more gradual in my case. Dr. Liebowitz also said that the clinical studies showed twice the efficacy at 12 weeks compared to 6 weeks so if you reach that point don't be discouraged by a partial response. I just couldn't take the side-effects (which took weeks to appear) so I discontinued it and am about to start moclobemide tomorrow -- fingers crossed! Anyway, my advice is find something with proven efficacy for SP that you can tolerate and stick it out -- which means 12 weeks in most cases.
>
> Good Luck,
> Jon
>
> p.s. Don't rule out a CBGT program when you are ready. Get your meds in order and take it from there... Also, comming off of Nardil, for me at least, has been pure hell and I sure wish someone had told me this before I went on it. So if an when you come off of it -- take it s l o w!!!Hey JonW,
Has Moclobemide finally been approved by the FDA? Does your doctor expect it to work as well as Nardil? What have you heard about the difference in side effects and contra-indications? I'm most interested losing the insomnia and anorgasmia. I wouldn't mind not having to battle weight gain either, although it is forcing me to excersize.
Good luck,
Gypsea
Posted by JonW on August 23, 2002, at 15:34:06
In reply to Re: Nardil » JonW, posted by gypsea on August 23, 2002, at 15:05:24
> Hey JonW,
>
> Has Moclobemide finally been approved by the FDA? Does your doctor expect it to work as well as Nardil? What have you heard about the difference in side effects and contra-indications? I'm most interested losing the insomnia and anorgasmia. I wouldn't mind not having to battle weight gain either, although it is forcing me to excersize.Hi gypsea,
It's my understanding that the side-effects are like night and day. This has been my experience as moclobemide has been very kind to me. The only side-effect I had was headache last time I was on it for 4 weeks. It was starting to help but I stopped because I am stupid and impatient :) My hope is after 12 weeks and possibly a higher dose it will work as well as Nardil might have for me. It was and is a little harder for me to fall asleep on moclobemide but nothing I would call insomnia. Absolutely no sexual dysfunction either. However, moclobemide appears to be less potent than other drugs. This doesn't mean that it won't be a godsend for any given person, and I hope I am that person :) If a four week trial is any indication it looks like it might do the trick for me. Moclobemide has not been approved by the FDA, but your pdoc can write a prescription and you can order from Canada, etc. Dietary restrictions are not necessary, but I'm not sure about interactions. I believe it is less of a concern, but I really don't know for sure.
Jon
Posted by cybercafe on August 23, 2002, at 15:55:35
In reply to Moclobemide side-effects » gypsea, posted by JonW on August 23, 2002, at 15:34:06
>was on it for 4 weeks. It was starting to help but I stopped because I am stupid and impatient :) My hope is after 12 weeks and
what dose were you taking?
Posted by gypsea on August 23, 2002, at 16:12:57
In reply to Moclobemide side-effects » gypsea, posted by JonW on August 23, 2002, at 15:34:06
> > Hey JonW,
> >
> > Has Moclobemide finally been approved by the FDA? Does your doctor expect it to work as well as Nardil? What have you heard about the difference in side effects and contra-indications? I'm most interested losing the insomnia and anorgasmia. I wouldn't mind not having to battle weight gain either, although it is forcing me to excersize.
>
> Hi gypsea,
>
> It's my understanding that the side-effects are like night and day. This has been my experience as moclobemide has been very kind to me. The only side-effect I had was headache last time I was on it for 4 weeks. It was starting to help but I stopped because I am stupid and impatient :) My hope is after 12 weeks and possibly a higher dose it will work as well as Nardil might have for me. It was and is a little harder for me to fall asleep on moclobemide but nothing I would call insomnia. Absolutely no sexual dysfunction either. However, moclobemide appears to be less potent than other drugs. This doesn't mean that it won't be a godsend for any given person, and I hope I am that person :) If a four week trial is any indication it looks like it might do the trick for me. Moclobemide has not been approved by the FDA, but your pdoc can write a prescription and you can order from Canada, etc. Dietary restrictions are not necessary, but I'm not sure about interactions. I believe it is less of a concern, but I really don't know for sure.
>
> JonTo your knowledge, can someone go directly from Nardil to Moclobemide, or would I have to take a break from Nardil?
Posted by JonW on August 23, 2002, at 17:56:47
In reply to Re: Moclobemide side-effects, posted by cybercafe on August 23, 2002, at 15:55:35
> >was on it for 4 weeks. It was starting to help but I stopped because I am stupid and impatient :) My hope is after 12 weeks and
>
> what dose were you taking?600mg by the end of 4 weeks.
Jon
Posted by JonW on August 23, 2002, at 18:03:19
In reply to Re: Moclobemide side-effects » JonW, posted by gypsea on August 23, 2002, at 16:12:57
> To your knowledge, can someone go directly from Nardil to Moclobemide, or would I have to take a break from Nardil?
There doesn't seem to be a definite answer to how long to wait between stopping Nardil and starting moclobemide. I asked a couple of pdocs who said to wait the 2 weeks to be safe so that is what I did. If it weren't for Geodon the depression would have hit kicked my arse.
Jon
Posted by cybercafe on August 24, 2002, at 1:22:01
In reply to Re: Moclobemide side-effects » gypsea, posted by JonW on August 23, 2002, at 18:03:19
> There doesn't seem to be a definite answer to how long to wait between stopping Nardil and starting moclobemide. I asked a couple of pdocs who said to wait the 2 weeks to be safe so that is what I did. If it weren't for Geodon the depression would have hit kicked my arse.
hmm... are you able to hold down a job while going through all of this ?
i am wondering how much to expect of myself ...
Posted by JonW on August 24, 2002, at 10:01:30
In reply to Re: Moclobemide side-effects, posted by cybercafe on August 24, 2002, at 1:22:01
> hmm... are you able to hold down a job while going through all of this ?
>
> i am wondering how much to expect of myself ...Well, I'm not able to hold down a job because of my illness so I can't really help you there. However, the depression didn't get significantly worse when I stopped -- which I attribute to Geodon, but I could be wrong. The withdrawal, for me, was pure hell and that would definitely get in the way of your job! If you do go this route you might want to try to keep working as usual, but be prepared to take some time off if you can. The withdrawal hit the hardest once I stopped completely. I did come off of Nardil relatively quickly so you may not have the problems I had if you go slow, but it is not uncommon to experience the flu-like withdrawal symptoms when stopping Nardil.
Good Luck,
Jon
Posted by cybercafe on August 24, 2002, at 21:39:26
In reply to Re: Moclobemide side-effects » cybercafe, posted by JonW on August 24, 2002, at 10:01:30
I'm hoping it's somewhat stimulating, since I tend to sleep too much as it is ....
Posted by JonW on August 24, 2002, at 22:03:20
In reply to Is moclobemide sedating or stimulating? , posted by cybercafe on August 24, 2002, at 21:39:26
> I'm hoping it's somewhat stimulating, since I tend to sleep too much as it is ....
For me it is stimulating and this would likely be the case for you as well. In clinical trials, placebo was more sedating than moclobemide.
Jon
Posted by cosis on August 25, 2002, at 15:57:01
In reply to Re: Nardil » cosis, posted by gypsea on August 23, 2002, at 14:47:45
Thanks for your information, I hope I have the same success as you do... I still havent noticed any difference but I guess a majority feel a difference in 2-4 weeks?
Yesterday I was at Old Navy and felt super anxiety, I was sweating and avoiding all eye contanct.. It was embarrassing for some reason.. I have been like this the last 2-3 years.. It is just getting worse..
When Nardil kicked in did you just feel no anxiety or self consciousness(sp) anymore? I don't understand how it can just work like that after being like this for years..
thanks
nick
Posted by gypsea on August 26, 2002, at 5:55:47
In reply to Re: Nardil, posted by cosis on August 25, 2002, at 15:57:01
> Thanks for your information, I hope I have the same success as you do... I still havent noticed any difference but I guess a majority feel a difference in 2-4 weeks?
>
> Yesterday I was at Old Navy and felt super anxiety, I was sweating and avoiding all eye contanct.. It was embarrassing for some reason.. I have been like this the last 2-3 years.. It is just getting worse..
>
> When Nardil kicked in did you just feel no anxiety or self consciousness(sp) anymore? I don't understand how it can just work like that after being like this for years..
>
> thanks
> nickNick,
It's been years, but I can relate so well to the sensation you describe having in Old Navy. Yes, that's exactly what happened once Nardil kicked in. It was incredible! All of a sudden, I had my life back! Please keep me posted as you continue with Nardil. I pray that you get the same relief! Everyone has different physiologies, so it could take a bit longer than it did for me. Also keep in mind that I take 1 mg of Klonapin as well. I've never used Nardil by itself.
All the best...
Gypsea
Posted by cosis on August 28, 2002, at 12:33:16
In reply to Nardil, posted by cosis on August 21, 2002, at 17:46:28
Hi
Just an update, my pdoc upped my dosage to 60g a day.. It's now day twelve and still not feeling any different.. My pdoc say's typically takes 2 weeks until people feel a change and sometimes up to 5 weeks, I am keeping my fingers crossed :)
Posted by gypsea on August 28, 2002, at 19:28:37
In reply to Re: Nardil, posted by cosis on August 28, 2002, at 12:33:16
> Hi
>
> Just an update, my pdoc upped my dosage to 60g a day.. It's now day twelve and still not feeling any different.. My pdoc say's typically takes 2 weeks until people feel a change and sometimes up to 5 weeks, I am keeping my fingers crossed :)Hang in there and best wishes for relief soon!
Gypsea
Posted by lawrence s. on August 29, 2002, at 1:21:10
In reply to Re: Nardil » cosis, posted by JonW on August 21, 2002, at 18:11:14
For me it seemed to take 3 to 4 months before I really knew for sure it was working on my social anxiety.
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