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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by zonked on June 15, 2011, at 21:49:36
OK guys,
Second day on 60mg with MD permission. Nardil has started to work consistently - great! I feel like the old me again.
HOWEVER:
I forgot how bad the insomnia can be. I used to have a temazepam Rx, but won't see my provider until next week.
In the meantime, I have a few options:
1. Take more Klonopin at bedtime, then tell the doc I had to do this.
I am OK with this for the time being.
2. Unisom (doxylamine succinate)
Cheap, OTC. Have heard that antihistamines don't produce a refreshing sleep, and wonder about cumulative effect of "unrefreshing" sleep. Are there problems with long term use of antihistamines for sleep?
THEN:
When I see my provider, temazepam is the only hypnotic I've been able to tolerate which does not produce a hangover. Other options, with the exclusion of antipsychotics, are worth considering.
I appreciate everyone's input ahead of time, and thanks for sticking with me while I waited for the Nardil to start working,
-z
Posted by jono_in_adelaide on June 15, 2011, at 22:17:31
In reply to Nardil HAS kicked in! But the insomnia...?, posted by zonked on June 15, 2011, at 21:49:36
I'd go diphenhydramine (Sominex, Unisom Sleep Gells, Nytol) rather than doxylamine, because it has a shorter half life, so less chance of hangover. I found that it gave a refreshing sleep. It would probably work best with a small dose of Klonopin at the same time.
Posted by zonked on June 15, 2011, at 22:40:40
In reply to Re: Nardil HAS kicked in! But the insomnia...?, posted by jono_in_adelaide on June 15, 2011, at 22:17:31
> I'd go diphenhydramine (Sominex, Unisom Sleep Gells, Nytol) rather than doxylamine, because it has a shorter half life, so less chance of hangover. I found that it gave a refreshing sleep. It would probably work best with a small dose of Klonopin at the same time.
>
Jono,Great, it's dirt cheap as well. You can get single-dose diphenhydramine (Benadryl) at any liquor store or gas station, so I can try it without investing in an entire pack...
I'll keep the board updated in this thread.
So nice to feel like myself again... something I do not, at all, take for granted. THANK YOU, Nardil!
*W H E W*
-z
Posted by Christ_empowered on June 16, 2011, at 3:52:17
In reply to Re: Nardil HAS kicked in! But the insomnia...? » jono_in_adelaide, posted by zonked on June 15, 2011, at 22:40:40
I don't really have any advice on the insomnia (I like temazepam, personally don't like benadryl), but I do wish you well with all this. I hope you continue to benefit from your medication(s).
Posted by jedi on June 16, 2011, at 10:42:47
In reply to Nardil HAS kicked in! But the insomnia...?, posted by zonked on June 15, 2011, at 21:49:36
Hey z,
Glad it is getting there for you. Are you getting the hypomania at all? When I first started Nardil, I had this side effect for a long time. On subsequent restarts, it never happened. Kind of missed it. LOL Guess it is nothing to laugh about; it can be serious enough for some people to have to discontinue. A few mistake this "HIGH" for the actual antidepressant effect of Nardil, and end up chasing the dragon! Not a good thing.I use my .5mg of clonazepam with 50mg of Benadryl for insomnia. I have been using Benadryl for years with really no tolerance. I am so affected by the sleep inducing antihistamines, that they just keep working. Used TRAZ when I first started Nardil, but that was just to much of a drugged feeling for me. Also used small doses of Seroquel at 12.5 to 25mg. I'm just lucky that the histamine medications affect me like this, they don't work for everybody.
Be well,
Jedi
Posted by Phillipa on June 16, 2011, at 10:58:58
In reply to Re: Nardil HAS kicked in! But the insomnia...? » zonked, posted by jedi on June 16, 2011, at 10:42:47
Benydryl doesn't touch me. Never did no idea why? Zonked so glad things are working well for you congrats to you!!! Phillipa
Posted by zonked on June 16, 2011, at 11:23:49
In reply to Re: Nardil HAS kicked in! But the insomnia...? » zonked, posted by jedi on June 16, 2011, at 10:42:47
> Hey z,
> Glad it is getting there for you. Are you getting the hypomania at all? When I first started Nardil, I had this side effect for a long time. On subsequent restarts, it never happened. Kind of missed it. LOL Guess it is nothing to laugh about; it can be serious enough for some people to have to discontinue. A few mistake this "HIGH" for the actual antidepressant effect of Nardil, and end up chasing the dragon! Not a good thing.Eh, I hope not! A family member was a little concerned, but reassured that it was relief from depression, not hypomania. Hypomania danger signs: spending money, staying up all night (neither have happened.) The person in question is just accustomed to me being depressed, that's all. The reason for the concern is that Parnate did cause hypomania. It is something I'm keeping an eye on.
> I use my .5mg of clonazepam with 50mg of Benadryl for insomnia. I have been using Benadryl for years with really no tolerance. I am so affected by the sleep inducing antihistamines, that they just keep working. Used TRAZ when I first started Nardil, but that was just to much of a drugged feeling for me. Also used small doses of Seroquel at 12.5 to 25mg. I'm just lucky that the histamine medications affect me like this, they don't work for everybody.
The antihistamines work well for me too, I am glad that long term use seems not to have affected you. I would have no problem taking nightly Benadryl or doxyalamine if it resolves the symptoms. I'll pick up one of those one-dose Benadryl packets they sell at liquor stores today and see if it does the trick this time.
BTW, trazodone made me wake up groggy and cranky. (And have a weird taste in my mouth.) Yuck.
> Be well,
> JediI will. Thanks again to you, and everyone else, for listening to me whine while I was waiting. I will never go off this med again, I'm a Nardil lifer, so long as it continues to work for me. Thank you, Warner Lambert and also thank you Gavis for coming onto the scene. =]
The relief from depression and SA/GAD make everything else - going to psychotherapy appointments, exercising, engaging in structured activity - possible, which will help me get a firm grapple on the disorder (and get my life back!)
-z
Posted by floatingbridge on June 16, 2011, at 11:56:11
In reply to Nardil HAS kicked in! But the insomnia...?, posted by zonked on June 15, 2011, at 21:49:36
Yay, zonked. Glad you have extra klonopin if necessary. Don't know the other name for temazapam.
So glad you are responding. Now the sleep piece and hopefully all will be (relatively) well.
peace,
fb
Posted by larryhoover on June 16, 2011, at 12:48:28
In reply to Re: Nardil HAS kicked in! But the insomnia...? » jedi, posted by zonked on June 16, 2011, at 11:23:49
Hey zonker. Good to see a positive med response going on.
I'm still getting my bearings again on what's going on, but I note your mention of social anxiety. You might be interested to learn that extroversion is correlated with vitamin D status.
http://www.ncbi.nlm.nih.gov/pubmed/21274699Best,
Lar
Posted by floatingbridge on June 16, 2011, at 13:27:47
In reply to Re: Nardil HAS kicked in! But the insomnia...? » zonked, posted by larryhoover on June 16, 2011, at 12:48:28
Larry,
My d is low no matter what. (4-25). There are supplement controversies around d.
Someone gave me a tiny squeeze bottle called Biotics Research: Bio-D-Mulsion Forte.
Yes, supposed to work when others don't
A friend had some pricey work done to confirm her body doesn't absorb regular
otc D. Vitamin D as cholecalciferol. Heard of this stuff?Anyways, I'm trying it.
Thanks for the link.
And Zonked, hope you don't mind too much my hitchhiking on your thread.
fb
Posted by larryhoover on June 16, 2011, at 15:47:49
In reply to Re: Nardil HAS kicked in! But the vit d? » larryhoover, posted by floatingbridge on June 16, 2011, at 13:27:47
> Larry,
>
> My d is low no matter what. (4-25). There are supplement controversies around d.I am a controversy debunker. What concerns you about these controversies?
> Someone gave me a tiny squeeze bottle called Biotics Research: Bio-D-Mulsion Forte.I looked it up. I'm not convinced of the premise (gum arabic as an emulsifier), given that bile does the job for the rest of us. Can't hurt to try. I can only assure you of one thing: your vitamin D status will not improve unless you do something to improve it.
> Yes, supposed to work when others don't
There are certain disorders that do make vitamin D absorption problematic. There are injections available.
> A friend had some pricey work done to confirm her body doesn't absorb regular
> otc D.Hmmm. I'm a little bit skeptical. More likely her body doesn't efficiently convert D3 to its intermediate storage form, 25-hydroxycholecalciferol (also known as calcifediol). That could be caused by many things, including magnesium deficiency, or low zinc or vitamin A.
> Vitamin D as cholecalciferol. Heard of this stuff?
Supplemental vitamin D should always be taken as cholecalciferol, also known as D3.
> Anyways, I'm trying it.
>
> Thanks for the link.
>
> And Zonked, hope you don't mind too much my hitchhiking on your thread.
>
> fbMy recommendation to you would be cod liver oil, taken with the fattiest meal of the day. You get some omega-3s, some vitamin A. Or some natural source D3 (which would be cod liver oil stripped of some or all of the vitamin A, which can be toxic in overdose). But hey, if this emulsified stuff does the trick.....
Lar
Posted by floatingbridge on June 16, 2011, at 16:10:33
In reply to Re: Nardil HAS kicked in! But the vit d? » floatingbridge, posted by larryhoover on June 16, 2011, at 15:47:49
Larry, thanks. There is way too much info for me as me to wade through.
Cod oil makes sense as does the d3. And the price is better :) And cod is cod. A nutrional building block of nations.
I also take krill oil. But for input regarding that, I'll post on alt.
Super thanks!
fb
(Apologies zonked. But you can take cod oil, too. Hope your response is continuing!) (And insomnia help?)
Posted by zonked on June 16, 2011, at 16:30:35
In reply to Re: Nardil HAS kicked in! But the vit d? » larryhoover, posted by floatingbridge on June 16, 2011, at 16:10:33
> (Apologies zonked. But you can take cod oil, too. Hope your response is continuing!) (And insomnia help?)No need to apologize! Insomnia, we'll see...
Response continuing. :D-z
Posted by zonked on June 16, 2011, at 16:32:20
In reply to Re: Nardil HAS kicked in! But the insomnia...? » zonked, posted by larryhoover on June 16, 2011, at 12:48:28
> Hey zonker. Good to see a positive med response going on.
>
> I'm still getting my bearings again on what's going on, but I note your mention of social anxiety. You might be interested to learn that extroversion is correlated with vitamin D status.
> http://www.ncbi.nlm.nih.gov/pubmed/21274699
>
> Best,
> LarLarry,
Is there a standard lab I can ask my MD to order to check on this? Interesting. Maybe that's why surfers seem so social :D
-z
Posted by jono_in_adelaide on June 16, 2011, at 18:27:15
In reply to Re: Nardil HAS kicked in! But the insomnia...? » larryhoover, posted by zonked on June 16, 2011, at 16:32:20
So, how'd you sleep on benadryl + klonopin?
Posted by zonked on June 16, 2011, at 18:39:27
In reply to Re: Nardil HAS kicked in! But the insomnia...?, posted by jono_in_adelaide on June 16, 2011, at 18:27:15
> So, how'd you sleep on benadryl + klonopin?
Won't be able to tell until at least tomorrow night, possibly the night after. I literally have been so busy I haven't had time to drop by the store to pick up the benadryl! Will use extra Klonopin if necessary until then.
Posted by emmanuel98 on June 16, 2011, at 20:42:01
In reply to Nardil HAS kicked in! But the insomnia...?, posted by zonked on June 15, 2011, at 21:49:36
When I started on parnate, I was also on perphenazine because the doc at the hospital wanted to try something to get me out of bed during the two-week wash out period. I got akathisia bad from the 36mg perphenazine I was taking. The p-doc at the day program told me to take some benadryl. But I called the pharmacy and they told me not to take benadryl with parnate. So you might want to call the pharmacist about anti-histamines for sleep. They are contra-indicated with MAOIs.
Posted by desolationrower on June 16, 2011, at 21:00:47
In reply to Re: Nardil HAS kicked in! But the vit d? » floatingbridge, posted by larryhoover on June 16, 2011, at 15:47:49
I think bile acids and vitamin D are both made from cholesterol. If you had particularly low cholesterol, that might cause low vitamin D and poor absorbtion. You'd probably notice hte diahreah of poor fat absorbtion, though.
the nature's answer vitamin D drops is what i use, almost a year's worth at 4kIU/day for under ten bucks. it tastes of olive oil (carrier)
-d/r
Posted by zonked on June 16, 2011, at 21:41:53
In reply to Re: Nardil HAS kicked in! But the insomnia...?, posted by emmanuel98 on June 16, 2011, at 20:42:01
> When I started on parnate, I was also on perphenazine because the doc at the hospital wanted to try something to get me out of bed during the two-week wash out period. I got akathisia bad from the 36mg perphenazine I was taking. The p-doc at the day program told me to take some benadryl. But I called the pharmacy and they told me not to take benadryl with parnate. So you might want to call the pharmacist about anti-histamines for sleep. They are contra-indicated with MAOIs.
That's what the PDR and the monograph say, but I can tell you from personal experience that Benadryl is safe with MAOIs... my doctor cleared it with Parnate and, so, I do not feel uncomfortable doing it with Nardil.
Benadryl is a very (too weak to worry) weak serotonin reuptake inhibitor.
-z
Posted by jedi on June 16, 2011, at 21:55:51
In reply to Re: Nardil HAS kicked in! But the insomnia...?, posted by emmanuel98 on June 16, 2011, at 20:42:01
>So you might want to call the pharmacist about anti-histamines for sleep. >They are contra-indicated with MAOIs.
I have been taking antihistamines for years with Nardil. Also took them with Parnate. As long as they don't mix in a cough suppressant or some other med the straight antihistamine should not cause a problem. You will now find a MAOI warning on about every cough suppressant, pseudoephedrine, etc. You will not see it on pure antihistamines. That said, please check out each individual medication for MAOI reactions. A Canadian pharmacist tried to kill me one time with some pseudoephedrine mixed in with codeine. The codeine is fine, the pseudoephedrine is not. I no longer trust pharmacists, MDs, or any other medical professionals with my life on MAOIs. I do all of my own research. The medications are just not in wide enough use, and are too potentially dangerous, to trust information from sources who are not experts in their use. In my opinion, a choice to use MAOIs is a decision to take your knowledge to the next level; and to take responsibility for all of the food and medications you mix with them.
Take care,
Jedi
Posted by Lamdage on June 20, 2011, at 0:32:21
In reply to Re: Nardil HAS kicked in! But the insomnia...? » jedi, posted by zonked on June 16, 2011, at 11:23:49
Hey zonked,
glad its working for you! I hope i have the fortune when i start soon.
Vitamin D, i believe that Vitamin D supplementation can help Seasonal Affective Disorder.
Low levels are not great, id do sth about it.
Cheers
Ld
Posted by creepy on June 24, 2011, at 19:15:36
In reply to Nardil HAS kicked in! But the insomnia...?, posted by zonked on June 15, 2011, at 21:49:36
prazosin is an alpha blocker that was pretty good for me. Just be wary of any low blood pressure weirdness if you have to go up on the dose. It has a short halflife though and should be out of your system the next day.
Hydroxyzine is an antihistamine with a short half-life that I had so-so results with. Might have been dosage.
seroquel and trazodone get a fair amount of use for sleep too.
I dont think theres anything wrong with antihistamines for sleep. I mean docs prescribe them pretty frequently. But there are other alternatives to antihistamines and benzos too.
Antihistamines seem to give me RLS when I try to sleep it drives me crazy. =(
Posted by zonked on June 24, 2011, at 19:51:01
In reply to Re: Nardil HAS kicked in! But the insomnia...?, posted by creepy on June 24, 2011, at 19:15:36
The insomnia seems to have gone away as long as I don't drink caffeine too late in the day, which, unfortunately, brings up another issue:
That weird, but familiar, Nardil thing where you get very tired/sleepy/fatigued mid-afternoon.
I've accepted that all drugs have side effects, and my treatment goal is no longer to be side-effect free but get the maximum relief from symptoms and put up with the side effects. Preferrable to my unmedicated state (severe depression and anxiety.)
Posted by floatingbridge on June 24, 2011, at 20:45:22
In reply to Re: Nardil HAS kicked in! But the fatigue...? » creepy, posted by zonked on June 24, 2011, at 19:51:01
Sounds very sane, zonked. Glad the insomnia has remitted.
Posted by jedi on June 24, 2011, at 20:57:46
In reply to Re: Nardil HAS kicked in! But the fatigue...? » creepy, posted by zonked on June 24, 2011, at 19:51:01
> The insomnia seems to have gone away as long as I don't drink caffeine too late in the day, which, unfortunately, brings up another issue:
>
> That weird, but familiar, Nardil thing where you get very tired/sleepy/fatigued mid-afternoon.
>
> I've accepted that all drugs have side effects, and my treatment goal is no longer to be side-effect free but get the maximum relief from symptoms and put up with the side effects. Preferrable to my unmedicated state (severe depression and anxiety.)Hi z,
The afternoon tiredness stayed with me for a long time. It was almost impossible not to nap at times. It is one side effect that does go away with time. I still treat my insomnia with antihistamines, but that nap attack no longer hits me. Sorry, it has been a long time, and I can't remember how long it takes, but in my experience, it does get better.
We well,
Jedi
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