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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 70. This is the beginning of the thread.
Posted by europerep on July 3, 2011, at 11:43:52
Hello there..
To make it short, I have decided to try out phenelzine (Nardil) for treatment-resistant depression. The reason for that is, on the one hand, that I want to have failed on both tranylcypromine and phenelzine before I ever consider ECT, and on the other hand, that I am wondering whether my depression isn't "atypical" after all. A couple of days ago I read a paper by Michael Thase and others that stated how positive mood reactivity may actually not be such a decisive factor in recognizing atypical depression as it was once thought, i.e. atypical depression can also be without positive mood reactivity. (The paper can be found here: http://www.cmellc.com/landing/pdf/A11001011.pdf ) In terms of other symptoms/criteria, I am pretty sure it's atypical:
- early age of onset: check
- eating (too) much: check (I am not overweight, but I eat much more than others)
- sleeping too much: double check
- rejection sensitivity: checkSo, if this is atypical, I would definitely want to try phenelzine before doing anything else. I have taken tranylcypromine before, so I know all the diet stuff and all that, and I just have a couple of questions relating specifically to phenelzine:
1) Are there any "rules" on when to take a dose? (As with tranylcypromine not after 1PM or so, in order to avoid insomnia)
2) Do those of you who take it successfully also take vitamin B6 supplements? There is this issue of phenelzine maybe causing vit B6 deficiency.
3) Concerning meals and eating, I actually have a question for the jedi(-master) here ;-)
You mentioned you have implemented a special diet that allows you to counter the weight gain side effects. What is that you eat a lot of, and what do you eat rarely or not at all? Do you know how many calories you have per day?
I'm asking because you mentioned how you wished you had started that diet right when starting nardil, so in the unlikely case that it will work for me, I would really like to "pre-emptively" implement a good diet so as to not gain too much weight from it.4) Anything else I should know about phenelzine that isn't covered by the general "MAOI rules"?
As always, thanks a lot in advance!
Bye..ER
Posted by zonked on July 5, 2011, at 13:55:19
In reply to Questions on phenelzine/Nardil (@jedi and others), posted by europerep on July 3, 2011, at 11:43:52
e- I am not the biggest fan of how DSM-IV classifies depression. For example, technically speaking during my awful depression I could laugh or smile, but it was as if someone turned down the volume to 5% of normal. I have a lot of other atypical features, rejection sensitivity yep, hypersomnia, yep, overeating, yep. I've had hypomania, but only because of an antidepressant, never alone. Thus, I've been diagnosed as either treatment resistant major depressive or bipolar type II depending on the doc. I would say Nardil would be well worth a trial for you, given your med history. B6 is controversial, but I am taking a B and C complex before bed every other day and it has not negatively affected my response. If you do try Nardil and it works for you, I'd like to welcome you to the family--for so many of us, it is the only thing that's worked. I wish you the best and keep us posted! -z
Posted by europerep on July 5, 2011, at 17:46:56
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » europerep, posted by zonked on July 5, 2011, at 13:55:19
hi zonked,
finally an answer :).. thanks a lot...
I picked up my script yesterday. My psychiatrist almost laughed at me when I said I wanted to try a second irreversible MAOI after the first one not only failed, but made me feel (much) worse. Laughing sounds a little harsh, but he knows I wouldn't misunderstand it (or so I hope, because other patients might be more sensitive to things like that). But the good thing is he quickly said "well, you don't have to try to talk me into it, you know I'll give you the script if that's what you want, but I doubt it will work out for you".
I really hope so much it will work, but I think from a logical and from a statistical point of view, I shouldn't be too hopeful.. I'll just see what happens :-/...
Any diet recommendations or anything on your part? Luckily, I lost a couple of pounds on Parnate, so I have a little window of weight gain that would be acceptable. If my weight jumps up rapidly, I'll have a little time to come up with a "contingency plan"..
Thanks again, and I'll post how things go..
bye! ER
Posted by jedi on July 7, 2011, at 2:20:42
In reply to Questions on phenelzine/Nardil (@jedi and others), posted by europerep on July 3, 2011, at 11:43:52
Sorry I missed your post ER. A lot of times I just scan through. I sure hope the phenelzine works for you. It can often work where all else has failed. 45+ different combinations of failed trials, in my case. Phenelzine can work with depressions other than atypical. But it is the "BOMB" for atypical depression and social anxiety. If you have a large anxiety component to your depression, I think phenelzine can work better than tranylcypromine. I've used them both. Had a rare auto-hypertensive episode on Parnate; that ended that one.
In my experience and from what I've read; the insomnia will probably always have to be treated. Currently I use 50mg of Benadryl and .5mg of clonazepam. The clonazepam also helps with the social anxiety, but I'm tapering it to zero because of memory issues. Dosage timing has never seemed to make much difference with me on Nardil. I've tried them all, including taking the whole daily dose at bedtime. No difference.
Most of the other side effects lessen or go away with time. The weight issue will always have to be watched. I crave the sweet carbohydrates; and even more so on Nardil. I used to be able to eat 3 peanut butter and jelly sandwiches, right before bedtime, and not even feel the least bit full. I use a low carb diet now with lots of protein and non-starchy vegetables. That and strenuous exercise control the weight for me. When my first major depression hit, I just could not exercise. I remember hitting the wall one day and I just quit. If I would have got started again, once the Nardil kicked in, I don't think I would have gained so much.
Please feel free to ask any questions or Babble-Mail me. I've been on this med for most of 12 years now. I've researched it a lot, but most of the information I pass on, I qualify as being from my own experience. As we are all so different in our reactions to these meds.
Good Luck and Be Well,
Jedi
(May the Force be with You)> Hello there..
>
> To make it short, I have decided to try out phenelzine (Nardil) for treatment-resistant depression. The reason for that is, on the one hand, that I want to have failed on both tranylcypromine and phenelzine before I ever consider ECT, and on the other hand, that I am wondering whether my depression isn't "atypical" after all. A couple of days ago I read a paper by Michael Thase and others that stated how positive mood reactivity may actually not be such a decisive factor in recognizing atypical depression as it was once thought, i.e. atypical depression can also be without positive mood reactivity. (The paper can be found here: http://www.cmellc.com/landing/pdf/A11001011.pdf ) In terms of other symptoms/criteria, I am pretty sure it's atypical:
> - early age of onset: check
> - eating (too) much: check (I am not overweight, but I eat much more than others)
> - sleeping too much: double check
> - rejection sensitivity: check
>
> So, if this is atypical, I would definitely want to try phenelzine before doing anything else. I have taken tranylcypromine before, so I know all the diet stuff and all that, and I just have a couple of questions relating specifically to phenelzine:
>
> 1) Are there any "rules" on when to take a dose? (As with tranylcypromine not after 1PM or so, in order to avoid insomnia)
>
> 2) Do those of you who take it successfully also take vitamin B6 supplements? There is this issue of phenelzine maybe causing vit B6 deficiency.
>
> 3) Concerning meals and eating, I actually have a question for the jedi(-master) here ;-)
> You mentioned you have implemented a special diet that allows you to counter the weight gain side effects. What is that you eat a lot of, and what do you eat rarely or not at all? Do you know how many calories you have per day?
> I'm asking because you mentioned how you wished you had started that diet right when starting nardil, so in the unlikely case that it will work for me, I would really like to "pre-emptively" implement a good diet so as to not gain too much weight from it.
>
> 4) Anything else I should know about phenelzine that isn't covered by the general "MAOI rules"?
>
> As always, thanks a lot in advance!
> Bye..
>
> ER
Posted by europerep on July 7, 2011, at 11:35:11
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » europerep, posted by jedi on July 7, 2011, at 2:20:42
Oh don't worry, no problem about the late reply :)..
I picked up the Nardil earlier today, but I'll be visiting my brother this weekend so I'll start taking it on Monday. I'm quite excited...
What worries me is the bad reaction I have had to Parnate ('bad' in terms of mood, not in terms of side-effects). I have found reports of people whose mood worsened on Parnate but not on other MAOIs, but I haven't found anyone who then really profited from the other MAOI. Well, I'll have to see.
I do not actually have a large anxiety component to my depression, BUT I have had bad anxiety as a kid, between 10 and 15 years.. I eventually got rid of it (mainly through forcing myself to go out alone at night and stuff), but then at 16 depression kicked in. I only later realized that what I had as a kid was "anxiety disorder", but I do think there is a relation to the depression that came afterwards. So maybe that would indicate that there are some "anxiety-prone" parts of my brain that might get better with a drug like phenelzine. But this is all speculation I guess.
I do have one more question though: my pharmacist told me that I had to keep the phenelzine tablets in the fridge, between 2 and 8 degrees Celsius (36-46F). Of course I'll put the tablets I have at home in the fridge, but I usually have a little "stash" of whichever drug I am currently taking in the backpack I usually take along when going outside. That way I don't have a problem if I am ever not at home at the time where I have to take a dose. I did this with amitriptyline, venlafaxine, buprenorphine, etc. Can I do the same with phenelzine tablets, or do phenelzine molecules really "fall apart" very quickly even at room temperature?
> Jedi
> (May the Force be with You):).. thanks! You know, maybe the fact that we both like Star Wars hints at some common neurobiological characteristics of our brains that might predict a success with the same drug for me as well ;)..
Posted by jedi on July 8, 2011, at 0:47:59
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » jedi, posted by europerep on July 7, 2011, at 11:35:11
> I do have one more question though: my pharmacist told me that I had to keep the phenelzine tablets in the fridge, between 2 and 8 degrees Celsius (36-46F). success with the same drug for me as well ;)..ER,
I've never kept my phenelzine from Pfizer and now Gavis in the fridge. Never was instructed to do so. Have had no problem with potency. I have read that one of the formulas from Europe or Australia had to be refrigerated. Not sure why.
Jedi
Posted by europerep on July 8, 2011, at 17:23:32
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » europerep, posted by jedi on July 8, 2011, at 0:47:59
> ER,
> I've never kept my phenelzine from Pfizer and now Gavis in the fridge. Never was instructed to do so. Have had no problem with potency. I have read that one of the formulas from Europe or Australia had to be refrigerated. Not sure why.
> Jedi
>Yeah, I've got the European version. In fact, I won't be taking "Nardil", but "Nardelzine", which is Pfizer's phenelzine brand over here, but I figured if I wrote I was going to take Nardelzine, noone would know what I'm talking about :)...
I'll try to keep the tabs cool whenever possible, but I guess they won't expire immediately when exposed to room temps.
The tabs smell funny by the way.. it's a typical pharmaceutical smell, but it does remind me a little bit of spray paint, which in turn reminds me of a relatively good time in my youth, so that's definitely already a positive for this drug ;). I hope other positives will add to it. I'll let you guys know how it works out after starting it on Monday..
Thanks for the help!
Bye,
ER
Posted by zonked on July 8, 2011, at 17:37:15
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » jedi, posted by europerep on July 8, 2011, at 17:23:32
Now I'm really curious - what is the imprint code on the tablets? Are they orange? American Pfizer/Greenstone tablets are orange and have a "PD 270" imprint. The smell I can only describe as being something between perfume and a skunk. We aren't told to keep ours in the fridge, I wonder if they're the same and we really SHOULD be keeping ours in the fridge? Gavis tablets are also orange but not nearly as smelly.
Posted by floatingbridge on July 9, 2011, at 9:08:34
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » jedi, posted by europerep on July 8, 2011, at 17:23:32
Posted by europerep on July 9, 2011, at 14:17:10
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » europerep, posted by zonked on July 8, 2011, at 17:37:15
> Now I'm really curious - what is the imprint code on the tablets? Are they orange? American Pfizer/Greenstone tablets are orange and have a "PD 270" imprint. The smell I can only describe as being something between perfume and a skunk. We aren't told to keep ours in the fridge, I wonder if they're the same and we really SHOULD be keeping ours in the fridge? Gavis tablets are also orange but not nearly as smelly.
Hehe, there's a couple of interesting things about these Nardelzine tablets. First, they come in a plastic bottle in which the tablets are loosely stored (the box rattles when you shake it). This is unusual for drugs here, usually they come in blisters with 10 or 14 tablets each, all of them individually sealed.
Then, after removing the seal and opening the bottle, it looks like the tablets are radioactive or something. They are colored in an extremely intense orange, you almost have to cover your eyes. (I exaggerate, but seriously, those pills have an extreme color.) The tablets look just like the phenelzine tablets that are at the bottom of the Wiki 'phenelzine' article, only that there is nothing imprinted on them on either side. Just the tablet.
Lastly, the smell.. I don't have them here right now so I can't describe it "live", but as I said it's amix between a pharmaceutical smell and the odor of spray paint. (Probably they have people sitting in the factory that spray them orange or something LOL.)
About the fridge thing:
Personally, I wonder whether it was once thought that phenelzine had to be stored in the fridge and they just didn't update it here. If it says nothing about keeping it in the fridge in the info that comes with the new generic Gavis version of phenelzine, then I doubt that it would be the other way around (i.e. that they only just discovered that phenelzine is unstable at temps above fridge level). So if I was you I wouldn't worry too much about it. Keeping them in the fridge probably doesn't hurt, but I don't think it's necessary for you. If it works for you, why change anything? (I will try to abide by the recommendation so as to rule out any possibility of the phenelzine deteriorating during the course of treatment.)So much for now. Bye,
ER
Posted by europerep on July 9, 2011, at 14:18:32
In reply to good luck er! (nm) » europerep, posted by floatingbridge on July 9, 2011, at 9:08:34
thank you! I will let you know how things go! I hope things are looking up for you, at least a little bit...
bye FB!...
ER
Posted by zonked on July 9, 2011, at 17:33:29
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » zonked, posted by europerep on July 9, 2011, at 14:17:10
Fascinating! As you may know, all our pills here come in bottles like that. I wonder if they are made go the same factory? The Pfizer/Greenstone bottles say "made in France". Might be a US government requirement that the dispensing bottles have this info-definitely a requirement that the pills have an imprint code. i notice that the top layer starts melting when the Pfizer/Greenstone tablets hit my tongue, something that doesn't happen with the Gavis. Anyway, good luck! I am crossing my fingers for you.
Posted by europerep on July 11, 2011, at 13:10:45
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » europerep, posted by zonked on July 9, 2011, at 17:33:29
I just came home and compared my tablets to the Nardil ones on wiki, and actually they are more different than I thought. The color of mine is pretty much like these shoes:
http://purchaze.com/en/290/reebok-freestyle-reign-bow-neon-orange.htmlAs I said, they look radioactive :)...
It's interesting though that the American Nardil tablets are made in France. My Nardelzines are made in the UK. The fact that Nardil is made in France raises another question for me though: unless they are being transported to the US in cooled containers (which is expensive!) I think it's likely that, during transport, they are exposed to temperatures above room temps, at least during summer. Think of containers standing in the sun, they'll get quite hot inside.
Another fun fact that I just found out:
Apparently there is a Nardil version being sold in the United Arab Emirates. I wonder what they look like.I'll probably start another thread on dosing info for phenelzine, I'd be happy about responses. :)
Posted by ger man on October 4, 2011, at 6:26:14
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » zonked, posted by europerep on July 11, 2011, at 13:10:45
> I just came home and compared my tablets to the Nardil ones on wiki, and actually they are more different than I thought. The color of mine is pretty much like these shoes:
> http://purchaze.com/en/290/reebok-freestyle-reign-bow-neon-orange.html
>
> As I said, they look radioactive :)...
>
> It's interesting though that the American Nardil tablets are made in France. My Nardelzines are made in the UK. The fact that Nardil is made in France raises another question for me though: unless they are being transported to the US in cooled containers (which is expensive!) I think it's likely that, during transport, they are exposed to temperatures above room temps, at least during summer. Think of containers standing in the sun, they'll get quite hot inside.
>
> Another fun fact that I just found out:
> Apparently there is a Nardil version being sold in the United Arab Emirates. I wonder what they look like.
>
> I'll probably start another thread on dosing info for phenelzine, I'd be happy about responses. :)The problem with cooling the tabs was very thrilling to me as im travelling around a lot. Im from europe (germany) too and first i got the uk generic version from archimedes (i think its the former concord version). When i got it they told me to store it at 2 to 8 degrees. When i heard that i told the pharmacist that it wont be possible for me to keep it under those controlled coditions so i asked the pharmacist to call archimedes pharm. if it is essential to keep it at those temperatures all the time and they said YES, just for a few hours its ok to have them at room temperature. Then i asked what to do an the pharmacist called the importer to find out if there are nardil versions that dont have to be stored in the fridge. they told to import the us version of pfizers nardil, i dont have them yet, but i will need them if i stay on it! I think it has something to do with the manufacturing process an mainly with the inactive ingredients. I could imagine that there are two places were nardil is made. the question why there are two original pfizer versions, one that has to be cooled (european) and the other that hasnt (US) remains unexplained to me!
Posted by europerep on October 6, 2011, at 14:09:37
In reply to Re: Questions on phenelzine/Nardil (@jedi and others), posted by ger man on October 4, 2011, at 6:26:14
I just saw this post of yours. I think you are definitely correct about Nardil/Nardelzine being made in (at least) two different places. Nardelzine is made by:
Recipharm Limited
Vale of Bardsley, Ashton-under-Lyne
Lancashire OL7 9RR (United Kingdom)It's great your pharmacist is helping you out so nicely with contacting the different pharma firms, distributors, etc. Personally, I have difficulty understanding why a drug whose active ingredient is not sensitive to higher temperatures has to be kept in the fridge, but I'm neither a pharmacist nor a chemist, so I'll defer to others regarding that question.
Anyhow, my Nardelzine tablets are still as glowing red and still smell the same way when I opened it first. Man these pills look awesome. ;) Just kidding...
I'm keeping my Nardelzines because I hope one day to get ahold of other phenelzine preparations, then I can make a photo for Wikipedia comparing the different Nardil products.
Anyhow, gotta watch the news now..
Bye!ER
Posted by Mark25 on November 10, 2011, at 10:09:55
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » ger man, posted by europerep on October 6, 2011, at 14:09:37
How did Nardil work out for you after Parnate / Jatrosom failed? Could you please tell me how the import procedure works? Thanks!
- Mark
Posted by Mark25 on November 10, 2011, at 10:11:38
In reply to Re: Questions on phenelzine/Nardil (@jedi and others) » ger man, posted by europerep on October 6, 2011, at 14:09:37
How did Nardil work out for you after Parnate / Jatrosom failed? Could you please tell me how the import procedure works? Thanks!
- Mark
Posted by Mark25 on November 12, 2011, at 12:12:21
In reply to Re: Questions on phenelzine/Nardil (@jedi and others), posted by Mark25 on November 10, 2011, at 10:11:38
Is it worth to give Nardil a shot altough Parnate didn't help me and caused really troublesome hypotension / dizziness? My major problem is social anxiety disorder, so the +GABAergic / calming action of Nardil could be better suited for that.
At the moment I take 8mg Klonopin a day as prescribed, but it doesn't make me want to socialize at all, just helps with the anxiety and in the end I'll have to taper down that stuff.
Nardil / Phenelzine isn't even available in my country, but as I live in the EU I should be able to import it from e.g. the UK with a valid (private) prescription I guess?
Posted by jedi on November 12, 2011, at 12:22:43
In reply to 2nd MAOI after the first one failed?, posted by Mark25 on November 12, 2011, at 12:12:21
> Is it worth to give Nardil a shot altough Parnate didn't help me and caused really troublesome hypotension / dizziness? My major problem is social anxiety disorder, so the +GABAergic / calming action of Nardil could be better suited for that.
>
> At the moment I take 8mg Klonopin a day as prescribed, but it doesn't make me want to socialize at all, just helps with the anxiety and in the end I'll have to taper down that stuff.
>
> Nardil / Phenelzine isn't even available in my country, but as I live in the EU I should be able to import it from e.g. the UK with a valid (private) prescription I guess?
Mark,
Nardil can and does work where Parnate fails. That is a S**tload of clonazepam! I used up to 5mg while I was waiting for Nardil to kick in the first time. Phenelzine is the "BOMB" for social anxiety and atypical depression. In my opinion it should be 2nd tier and not last resort for this diagnosis. It is a bloody crime that it is not available in your country. The stuff saved my life more than once! You can probably get all of the worthless SSRIs you want! Sorry! The MAOIs work where all others fail. I have been preaching about it on here for years. I did have 2 failed Parnate trials. Google some of my posts. This S**T works!
Good Luck,
Jedi
Posted by Mark25 on November 12, 2011, at 13:18:34
In reply to Re: 2nd MAOI after the first one failed? » Mark25, posted by jedi on November 12, 2011, at 12:22:43
> Mark,
> Nardil can and does work where Parnate fails. That is a S**tload of clonazepam! I used up to 5mg while I was waiting for Nardil to kick in the first time. Phenelzine is the "BOMB" for social anxiety and atypical depression. In my opinion it should be 2nd tier and not last resort for this diagnosis. It is a bloody crime that it is not available in your country. The stuff saved my life more than once! You can probably get all of the worthless SSRIs you want! Sorry! The MAOIs work where all others fail. I have been preaching about it on here for years. I did have 2 failed Parnate trials. Google some of my posts. This S**T works!
> Good Luck,
> JediThanks for you encouraging post! I know that's really much clonazepam, but less wouldn't do anything for me. Haven't taken it for too long without breaks (5 weeks).
I also have atypical depression since like 10+ years. Tried about 30 meds / combos, but to no avail.
My psychiatrist is cool and old-school, so getting a script for Nardil / phenelzine shouldn't be a problem. I don't know about import regulations, but guess - as the drug is approved in another EU country (UK) - it shouldn't be a problem. Other users from above were also able to get it. Insurance will very likely not pay for it, but that's OK.
PS: What's your Nardil dose?
- Mark
Posted by europerep on November 12, 2011, at 15:50:38
In reply to Re: 2nd MAOI after the first one failed?, posted by Mark25 on November 12, 2011, at 13:18:34
Hello there,
jedi knows more about that particular drug than I do, but it is generally accepted that, while tranylcypromine and phenelzine are both irreversible MAOIs, they do have their own pharmacological profile, so it's probably worth a try...
I was just going to say that, as a EU citizen, you shouldn't have too much trouble getting the drug even if it's not marketed in your particular country. There are two possiblities: what definitely works is take a prescription from your doctor to a pharmacy in a country where phenelzine is sold (UK, Belgium, Netherlands, Luxemburg, maybe others...). Per EU law, your prescription is valid in all 27 member countries.
In at least some countries, such as Germany, you can also have the drug imported by your pharmacy. I'm not familiar with how (and if) that procedure works in other member states though.
If you have more questions on that subject, let me know...
ER
Posted by Mark25 on November 12, 2011, at 16:34:05
In reply to Re: 2nd MAOI after the first one failed? » Mark25, posted by europerep on November 12, 2011, at 15:50:38
Thanks! Some bigger pharmacies here do import drugs from other EU countries.
I know that Parnate is considered more stimulating (altough I never felt that effect). And one metabolite of Nardil / Phenenlzine raises brain GABA levels which should make it more calming in general.
Could you please answer those short questions:
1) What shall my doctor write on the prescription (except the usual stuff)? The generic (english?) drug name or brand name?
Phenelzin(e) or Nardil or Nardelzine? I see Nardelzine is 15mg Phenelzine a 100 tablets, right? How much does it cost / did you pay?
Thanks in advance.
Posted by europerep on November 13, 2011, at 6:05:35
In reply to Re: 2nd MAOI after the first one failed?, posted by Mark25 on November 12, 2011, at 16:34:05
> Could you please answer those short questions:
>
> 1) What shall my doctor write on the prescription (except the usual stuff)? The generic (english?) drug name or brand name?
>
> Phenelzin(e) or Nardil or Nardelzine? I see Nardelzine is 15mg Phenelzine a 100 tablets, right? How much does it cost / did you pay?
>Hey there,
what your doctor should write on the prescription depends on what he wants to prescribe you. In the UK and the Netherlands, phenelzine is available as Nardil. In Belgium and Luxemburg it's Nardelzine.
I went to a Belgian pharmacy with my script that said "Nardelzine 100 tbl." and it worked fine. I'm not sure what the script has to say if you want to import a medicine, but I would assume that similar rules apply. If you want to be sure, go to a pharmacy near you and ask them about what your script must say in order to be valid.
When bought locally, Nardelzine costs around 34 per 100 tablets. When importing it, the price may be somewhat higher. I'm not sure about the price of Dutch or British Nardil. They all shouldn't be really expensive though, because phenelzine has been off-patent for a long, long time.
I hope that helps...
ER
Posted by jedi on November 13, 2011, at 8:01:07
In reply to Re: 2nd MAOI after the first one failed?, posted by Mark25 on November 12, 2011, at 13:18:34
> PS: What's your Nardil dose?
>Mark,
I'm currently off phenelzine. I've been off several times in the 13 years I have been taking the medication. This time I tapered down very slowly from 60mg. Took over 3 months. Right now, I'm only taking .5mg of clonazepam daily, on the way to zero.I'm a large male and the lowest effective dose for me is 60mg. 45mg does not provide the degree of MAO inhibition to knock back a major depression. I have been on 90mg for long periods. Even up to 120mg for a month or so. The side effects at 90mg are so much worse for me. I gained a lot of weight at first, but have taken most of that off. Watch for the hypomania when the med first kicks in. It hit me and many others on this board. It is not the true antidepressant effect, but it is very intoxicating, especially if you have been depressed for a long time. Don't chase the dragon!
I used to quote the 1mg/kg effective dosage that is published. If this was accurate, I would have to be on 120mg for the med to work. That is not the case for me. Everybody reacts to these medications differently. There are blood tests for MAO inhibition, but trial and error seems to be the way to judge. I have been on phenelzine enough that I can tell the dosage I need. I can feel the level of MAO inhibition in my body. It does take time to get there, but this drug is very predictable for me.
For me, there is also a synergism with phenelzine and clonazepam. They both effect GABA and this transmitter seems to be involved, to a high degree,in social anxiety and atypical depression.
Good luck my friend. Sounds like your symptoms and diagnosis are very similar to mine. I have been on 45+ different combinations of ADs and augmenters that did not work. Phenelzine can work when all others fail.
Jedi
Posted by ed_uk2010 on November 13, 2011, at 11:27:56
In reply to Re: 2nd MAOI after the first one failed? » Mark25, posted by europerep on November 13, 2011, at 6:05:35
>When bought locally, Nardelzine costs around 34 per 100 tablets. When importing it, the price may be somewhat higher. I'm not sure about the price of Dutch or British Nardil. They all shouldn't be really expensive though, because phenelzine has been off-patent for a long, long time.
If you had a private prescription for 100 Nardil tablets in the UK, it would cost about £25. This is about 30 euros.
If you were trying to import it from the UK it would probably be dramatically more expensive, especially since it is a fridge line.
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