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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Veronica on March 28, 2000, at 16:32:18
My husband started Nardil two weeks ago today. For the first week he was on 3 15mg pills a day. For the 2nd week he was one 4 15mg pills a day. He was on SSRI's previously & went through a 2 week washout period before starting Nardil.
Since he's started it, he's been having a lot of headaches, nasea, sore joints & a disconnected head feeling. We're aware of the dietary restrictions, however the pharmacist told him it was ok to eat processed American cheese & Velveeta.
Is it normal for these side effects to last for a couple of weeks? Are these side effects from the Nardil itself? Or should he not be eating the processed cheese?
We're not sure who to call regarding these questions--psychiatrist who wrote script, medical doctor or pharmacist. Thanks!
Veronica
Posted by Cam W. on March 29, 2000, at 19:48:29
In reply to New to Nardil, posted by Veronica on March 28, 2000, at 16:32:18
Veronica - Processed cheese does contain some tyramine and this may be causing some of the side effects your husband is experiencing. It is not as bad as the cheeses that are aged longer (eg blue, cheddar, camembert or Swiss). Is he drinking a beer every now and then? Even some non-alcoholic beers contain tyramine. He could also be inadvertently ingesting tyramine (eg meat tenderizer, yeast extracts, or soy sauce) in some of the prepared foods he is eating. Even some foods that contain vasopressors can cause problems (eg phenylephrine in chocolate; caffeine in coffee & colas; or even ginseng). You really have to pick apart your foods, especially in the beginning. Hope this helps. Some of the side effects could be his body adjusting to the MAOI. Give it another week or two. Hope this helps - Cam W.
Posted by MA on March 29, 2000, at 23:29:43
In reply to Re: New to Nardil, posted by Cam W. on March 29, 2000, at 19:48:29
When I took Nardil, the dose that worked for me was 15 mg twice a day (30 mg). Your husband started at a dose that was higher than that. The other thing that occurs to me is that some of the SSRI's can take longer than 2 weeks to clear your system, i.e. Prozac.
Even though many people may require doses up to 45-60 mg, I had success with 30 mg. It is now being proven that many medications, not just AD's, are NOT tolerated at the doses that are tested during the clinical trials. I am living proof of that. I have always had the best results with usually half of the so called normal dosage. And I am physicially tall and would not be considered of slight frame. Some of us are just more susceptible to medications.
You should definately call the physician who prescribed Nardil today. Unless you call, the assumption is that things are going well. This is the best way to help your husband feel better quickly.
I hope Nardil works for him. I found it very effective for a year or two.
MA
Posted by DC on March 30, 2000, at 1:10:59
In reply to Re: New to Nardil, posted by MA on March 29, 2000, at 23:29:43
I think your husband just needs to stick in there. I took Nardil for a long time. It worked best for me at 90mg. Don't give up too soon. Whenever you start a new AD there is this initial period of weirdness. I doubt the processed cheese is causing the problem. I never had any reactions to any foods, and from what I have heard this is the norm, especially for men. Nardil is also less likely to cause a hypertensive reaction than Parnate--I mean the dizziness when standing up.
Posted by Veronica on March 30, 2000, at 7:06:31
In reply to Re: New to Nardil, posted by Cam W. on March 29, 2000, at 19:48:29
Thanks for all the responses. He's still having the same side effects. The problem is that he's gotten his sleep schedule off track & so he's been sleeping during the day, which makes getting to the doctor difficult. Today he's determined to get up when I get home for lunch, so I will encourage him again to check with his pdoc.
He's cut caffeine out of his diet & only drinks caffeine free Pepsi on occasion. He doesn't drink beer or anything else alcoholic right now. He hasn't take any OTC products either. His pdoc's plan was to start him on the 45, then 60 a day then 6 15-mg pills a day, then taper him back down. I was under the impression that this was how they normally worked with MAOI's. Not true? Mentally he feels pretty good, so it's a bummer to have the physical problems.
Thanks a lot!
Posted by DC on March 30, 2000, at 17:23:41
In reply to Thanks, posted by Veronica on March 30, 2000, at 7:06:31
Veronic, I think the doctor's dosing plan is reasonable. He would get up to 90mg which is probably what you need to get the maximum response. Nardil is excellent for social phobia. If the drug works it will probably make your husband less inhibited and more talkative. One thing to keep in mind--it usually causes pretty severe insomnia. One way to deal with this is to take trazadone at night. That combo worked well for me.
Posted by Jeffrey Peikin on March 31, 2000, at 8:12:27
In reply to Re: Thanks, posted by DC on March 30, 2000, at 17:23:41
I took Nardil for OCD about 15 years ago when there wasn't anything else other than the trycyclics and stuff like Thorazine....but it sure did reduce social phobia. I had a girlfriend at a local University...was there just about all of the time, got a fistfull of parking tickets, could easily stay up all night (now I was 23, too)...the cigarettes and coffee added to it! A self-destructive lifestyle @ an MAO inhibitor (totally incompatible with many medications)...and the food restrictions, I think, make it not so great a medicine when there are so many options available these days. But it sure reduced my social phobia! (I need not go into that!!!). If you take Traz., it will put you to sleep, but then again, so will 25-50 mg. Benadryl (and I don't know if it's compatible with Nardil...try Luvox, Zoloft, and Behavioral Therapy? I'm not a Doctor, but my Dad was an Oral Surgeon...does that count?
Posted by will on March 31, 2000, at 17:27:27
In reply to Want to party hearty? Take Nardil!!!, posted by Jeffrey Peikin on March 31, 2000, at 8:12:27
> but I gained too much weight, so I had to stop taking it after a few years. It was nothing short of a miracle "cure" for me.
God bless.
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