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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by JohnM on June 23, 2001, at 22:42:02
Thought I would post this good news. I had fallen back in a depression when I came off my Nardil back in 1992. Tried to go back on it and it didn't work. Tried 8 other antidepressants to no avail over a three year time period. Tried to go back on Nardil at a higher dose and got a minimal response. I stayed there for a few years. The Nardil was making me groggy and I found I regained some cognitive benefits from slowly tapering down with the dose (from 4 pills to eventually 1.5 -- over a 2 year time period). At this point my mood was just functional--I could hold a job and socialize to a minimal degree, but I was still in a low grade depression.
I had been taking Klonopin, which basically reduced the amount of stimulus that I was taking in and thus kept work stress at bay and allowed me to get out of the house and socialize somewhat (it didn't work as well as the other traquilizers I've tried, but I stayed with it because of the long lasting effect--it got me away from the "pill-popping" phenomena and rebound anxiety that bothered me with xanax, etc.)
I did not like the emotional blunting and cognitive reducing effects of Klonopin so I eventually made up my mind to reduce my dose VERY slowly and gradually. Those that have read my other posts know that over nine months I actually reduced my doses to 1/32 of a 0.5 tablet!!--so as not to trigger a rebound/dizziness attack. Klonopin 0.5 (lowest dose tablet) is much more potent than any other tranquilizer's lowest dose tablet. This is because it was marketed orignially as a anti-convulsant, not a anti-anxiety med. 0.5 is equivalent to a 1mg tablet of Xanax or 2mg tablet of Ativan! You have to go slow and gradual to get off it. But I digress....
Anyway, this summer I got of the Klonopin and decided to increase the Nardil up again. My doctor agreed that it would be worth a try. I increased the dose very fast (up to 60mg) within one week [from 1.5 tablets (22.5mg)], and I was prepared to go higher if I didn't feel some response after 10-14 days. Well, I did get a bit more energy and seemed to smile a bit more...but I felt a little edgy and foggy (but I hear this is common in the early stages of antidepressant therapy).
Well, its been 3 weeks and the edginess and fogginess are subsiding and I'm feeling really good (confidence and energy)! I'd say I'm functioning at about 90-95%, verses about 60% before. I'll take it! It has been so long since I've felt well.... :) I'm feeling really good--mentally healthy.
I tried to describe my experiences so maybe someone else can possibly benefit. These are some insights that I can pass on:
1. If you have a medicine that had worked for you in the past or that reasonably agrees with you, try it again and when you do, bring the dose up FAST. There is a theory that getting an antidepressant effect from medications is more than just increasing chemical levels--the "shock" of the medicine is thought to trigger the antidepressant response. There is actually an antidepressant medicine (in France I believe) that *reduces* seratonin! Thus the "shock" theory.
2. I'm a school teacher and I'm getting to enjoy my summer off. I chose to try my Nardil experiment during this period where I could rest and have all my resources available for the medicine to take hold. I know this played a factor. Wait for your vacation or get hospitalized for your experiment.
3. Study up on Rational-emotive therapy or some other form of cognitive therapy. It basically made me more mature--dealing with people, anger, sadness, etc.
4. Try Nardil. I'm not just saying this because it worked for me. I've read more than one doctor say that NARDIL ALMOST ALWAYS WORKS or that it will work when other medicines don't. Take it up to 90mg if you can tolerate it. The only (common) food you have to avoid is cheddar cheese when you are taking it. It commonly causes orgasmic inhibition (it's hard to come--but I still enjoyed sex), but that side effect went away after about nine months for me (back when I took it originally in 1988)--I know that still stinks!!
5. My old psychiatrist had told me, you have to be careful when you decide to come off an antidepressant, because sometimes it won't work if you decide to go back on it later. In my case, he said once I get stabilized again, to STAY on the medicine the rest of my life and not try to be a hero!
GOOD LUCK and I hope this information is helpful. JOHN
Posted by Cece on June 24, 2001, at 4:34:04
In reply to I'm back on my feet and feeling great!, posted by JohnM on June 23, 2001, at 22:42:02
I just have to say that I thought that I held the record for klonopin-chopping, but I am humbled.
For years I have taken 1/4 of a .5mg tab of klonopin once a day- that tiny dose adds its own subtle steadiness to my complicated med mix. If I take twice that amount (1/2 tab), I am dulled and depressed for about 48 hours (doctors find it hard to believe that I am really so sensitive to it, but it's absolutely true).
A few months ago I decided to (very) slowly go off the klonopin and see if I really still needed it, and also to check out if it was causing any cognitive dulling. I got down to 1/16 of a tab as my final dose, and it was almost impossible to do that. How you could possibly have chopped it any smaller is beyond me!
After a couple of months off, I found that I missed my sliver of klonopin and have added it back in (1/4 tab).
Cece
> I did not like the emotional blunting and cognitive reducing effects of Klonopin so I eventually made up my mind to reduce my dose VERY slowly and gradually. Those that have read my other posts know that over nine months I actually reduced my doses to 1/32 of a 0.5 tablet!!--so as not to trigger a rebound/dizziness attack. Klonopin 0.5 (lowest dose tablet) is much more potent than any other tranquilizer's lowest dose tablet. This is because it was marketed orignially as a anti-convulsant, not a anti-anxiety med. 0.5 is equivalent to a 1mg tablet of Xanax or 2mg tablet of Ativan! You have to go slow and gradual to get off it. But I digress.... >
Posted by sweetmarie on June 24, 2001, at 14:37:09
In reply to I'm back on my feet and feeling great!, posted by JohnM on June 23, 2001, at 22:42:02
It has been so long since I've felt well.... :) I'm feeling really good--mentally healthy.
Nice one!
It`s always good to hear a `happy ending`, and it`s encouraging for those of us (like me) still stuck around 20%.
I wish you luck, and thanks for sharing your story.
All good things,
Anna.
Posted by Zo on June 24, 2001, at 15:16:30
In reply to I'm back on my feet and feeling great!, posted by JohnM on June 23, 2001, at 22:42:02
Thanks for the great advice!
And, that's been my experience with Effexor. . .I thought I'd be a hero and go off, several years back. . .You only need one big relapse to get right over the idea that heroic is going without meds!
My understanding is if a med once worked, it *will* work again. . .in my case, I'd usually titrated wrong, or needed augmentation.
So great to read a post with that headline!
Best,
Zo
Posted by Zo on June 24, 2001, at 15:26:10
In reply to Re: I'm back on my feet and feeling great! » JohnM, posted by Cece on June 24, 2001, at 4:34:04
> I just have to say that I thought that I held the record for klonopin-chopping, but I am humbled.
I know a guy who gets wonderful effect with one lorazepam every other day. . .!
Posted by JohnM on June 24, 2001, at 16:48:39
In reply to Re: I'm back on my feet and feeling great! » JohnM, posted by Cece on June 24, 2001, at 4:34:04
>How you could possibly have chopped it any smaller is beyond me!
FWIW: I used a pill splitter to chop the pill into 1/8ths (approx). Then I bit the edge off that piece, then bit *that* piece in half again!
Desperation is the mother of invention. ;)
This is the end of the thread.
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