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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by ace on March 23, 2003, at 19:56:28
I'm getting the 'zaps' in the head (mainly) and the body (a little). It's like standing on an electicity box for a millisecond and being zapped. My muscles tense up a little, and there is sometimes vertigo.
This is pissing me off. It only started when I began fooling around with my Nardil dose.
1. I went up to 105 (2 days) - no zaps
2. Went up to 120 around 6 days - no zaps
3. Went down to 105 (around 4 days)4. Back to 90mg - the zaps begin and have been happening for 7-9 days. 6 days ago added Lithium.
What the heck is causing these shitty 'zaps'
They annoy me I would like to zap those zaps in their fat ass!
Ace.Whose Zapping.
Posted by missliz on March 24, 2003, at 0:40:43
In reply to Those friggin' ZAPS - NARDIL or LITHIUM?, posted by ace on March 23, 2003, at 19:56:28
Dude- Do Not Screw With An MAOI Dose Like That EVER! You're already up at the top end of the dose scale. This isn't some candy assed SSRI, and you can screw yourself up. If anything, the dose should come down as the lithium works. It takes time to get well.
The zaps are a common side effect of MAOIs, and messing around the dose makes them worse. Get some vitamin B-6, that should make it stop. Nardil can cause deficiency of B-6 and take the dose on the bottle, not a "more must be better" approach. It may take a couple of days to work.missliz
Posted by mattdds on March 24, 2003, at 9:37:12
In reply to Those friggin' ZAPS - NARDIL or LITHIUM?, posted by ace on March 23, 2003, at 19:56:28
Ace,
This sounds like coming off an SSRI! When I went off Paxil, Celexa and Zoloft (after unsuccessful trials) they all gave me the zaps. These are annoying but they do go away in about a month.
Here's my hypothesis. I bet this has something to do with downregulation of serotonin receptors, which happens when you are exposed to drug-induced increased serotonin levels over a long period of time. So now there are fewer serotonin receptors, and when the drug is reduced or withdrawn too abruptly, serotonergic transmission is inadequate. It might be something like a shorted circuit in the brain, hence the zaps. That is what it felt like to me, like my brain was shorting out briefly. Again, this is just my hypothesis as to what is happening.
The good news is this is all reversible once you stabilize your dose. The brain is very plastic. I have never heard of "zaps" that persist forever.
Best,
Matt
Posted by jaby on March 24, 2003, at 12:59:31
In reply to Those friggin' ZAPS - NARDIL or LITHIUM?, posted by ace on March 23, 2003, at 19:56:28
Ace,
Most likely the Nardil-sounds like a serotonin thing.
Posted by djmmm on March 24, 2003, at 15:13:24
In reply to Re: Those friggin' ZAPS - NARDIL or LITHIUM?, posted by missliz on March 24, 2003, at 0:40:43
Huh?...please stop perpetuating misinformation about MAOIs... "zaps" are common with any antidepressant when the dose is lowered or discontinued.
The myth that SSRIs ("candy assed SSRI") are safe, is wrong...manipulation of a SSRI dose (=/-) is not safe. SSRIs are safer in overdose situations than other AD's, but that's about it.
The "zaps" are caused by manipulation of the serotonin system via up/downregulation, and the brains constant need for homeostasis.
Vit B supplements should be taken with all antidepressants, they will not stop the "zaps"...only time, or going back on a serotonin acting antidepressant will.
Posted by ace on March 24, 2003, at 19:31:53
In reply to Re: Those friggin' ZAPS - NARDIL or LITHIUM?, posted by djmmm on March 24, 2003, at 15:13:24
MissLiz, sure I was screwing with my dose. In retrospect I shouldn't have, but I wanted to try and conk out OCD with only Nardil. But I changed my mind - I don't want to be on 120mg or 105mg just because these are extremely high doses, and further increase my chance of physiological damage. I have been on 90mg over a week now - I am adapting as the dose levels out and the zaps are petering out. BTW MissLiz, my Dr. had no hesitations to try this high dose route first for OCD. I now believe the zaps are not Lithium related but soley Nardil related.
BTW, EXTREMELY good explanation Djmmm. I have to question whether you are a psychomarmacologist. I have studied chemistry extensively and am soon to embark on a psychopharmacology unit at uni. My psychopharmacological knowledge at the moment is dubious, but in 6-12 months will be extensive.
Ace.
Posted by missliz on March 25, 2003, at 3:49:18
In reply to They have all but stopped now. Attn MissLiz, Djmmm, posted by ace on March 24, 2003, at 19:31:53
Well I'm glad for you Ace,, and sorry to offend you djmmm, I thought the guys at Johns Hopkins had a clue about psychopharm. The fact that B6 works so well to stop "zaps" must have been a complete delusion on the part of somebody who actually went to med school and psych residency. I guess I was just plain wrong about it working so well for me over the six years I took Nardil and had this problem. I guess you were absent the day they had that lecture in med school on the symptoms and history of vitamin deficiencys and related diseases.
And I must profoundly apologize for offering a simple, easy solution to a common problem instead of ranting on about brain chemistries that don't apply. I personally prefer to have a highly trained proffessional psychopharmacologist sweat things like downregulation of seratonin recepters because I'm interested in living my life and pursuing my own work, not obssessing over post graduate level biochemistry I'm not really qualified for. But I guess everybody needs a hobby. You might try finding out how MAOIs actually work and what the common side effects are next.
And by the way, you might go look up the term "sarcasm", since you completely missed the context of the phrase "candy assed SSRIs".missliz
Posted by djmmm on March 25, 2003, at 9:50:11
In reply to Didn't realize simple solutions would jerk chains, posted by missliz on March 25, 2003, at 3:49:18
> Well I'm glad for you Ace,, and sorry to offend you djmmm, I thought the guys at Johns Hopkins had a clue about psychopharm. The fact that B6 works so well to stop "zaps" must have been a complete delusion on the part of somebody who actually went to med school and psych residency.
I would like to see some sort of evidence of this...I am completely aware of decreased plasma levels vitamin B6 in realtion to Phenelzine treatment
>I guess I was just plain wrong about it working so well for me over the six years I took Nardil and had this problem.
Im very happy B6 works well for you. My response to your post was simply out of disgust that many people continue to perpetuate the idea that MAOIs are excessivly dangerous, especially when most research shows that following appropriate diet restrictions MAOIs are as safe and often safer that many ADs.
>I guess you were absent the day they had that lecture in med school on the symptoms and history of vitamin deficiencys and related diseases.
I think I took a class like that as part of a health requirement in my undergraduate studies..I think it was offered in the nursing and Biology programs(?)..Other than that, I did catch a class or two on the effects of antidepressant dicontinuation and the effects on indolamines and catecholamine synthesis...as well as post synaptic response to chronic antidepressant treatment, in addition to the role of autoreceptors and heteroreceptors in contemporary psychopharmacology (graduate studies)
I am aware connection between vitamin B and monoamines and its effects on L-tryptophan transport ...and several Vit B studies on serotonin and migraine, PMS, melatonin, depression, bulimia, .etc
> And I must profoundly apologize for offering a simple, easy solution to a common problem instead of ranting on about brain chemistries that don't apply.
If taking a vitamin B supplement was an easy solution to a common problem, we wouldn't have this problem.
>Maybe you were absent for the lecture on the effects of chronic antidepressant treatment on the serotonin system and the the ramifications of abrupt discontinuation
>I personally prefer to have a highly trained proffessional psychopharmacologist sweat things like downregulation of seratonin recepters because I'm interested in living my life and pursuing my own work, not obssessing over post graduate level biochemistry I'm not really qualified for. But I guess everybody needs a hobby. You might try finding out how MAOIs actually work and what the common side effects are next.
My hobbies include Yoga and gardening
In short..MAO's are mitochondrial proteins. Conventional MAOIs , unlike reversible MAOIs, form a permanent covalent bond with monoamine oxidase. MAO activity returns when new MAO is resynthesized and supported by existing catechol-O-Methyl transferase, another degradative enzyme. Just like SSRIs, TCA's, and second generation atypicals, the side-effects vary, and are expressed in virtually every part of the body. Common side-effects include, constipation dry mouth, orthostatic hypotension, insomnia, nausea, and anorexia.
> And by the way, you might go look up the term "sarcasm", since you completely missed the context of the phrase "candy assed SSRIs".
sarcasm: a sharp and often satirical or ironic utterance designed to cut or give pain.
A mode of satirical wit depending for its effect on bitter, caustic, and often ironic language that is usually directed against an individual.The context...your words, not mine..."Dude, Do Not Screw with and MAOI dose like that ever! You're already at the end of the dose scale. This isn's some candy assed SSRI...you can screw yourself up."
so, by your definition of sarcasm, I could theoretically (and hypothetically) take 300mg of Zoloft, in place of the usual 75mg and this would be less harmfull that manipulating a MAOi dose =/- 15mg?
I am a bit skeptical of your credentials, "dude."
>
> missliz
Posted by agent killer on March 25, 2003, at 10:20:41
In reply to Re: Didn't realize simple solutions would jerk chains, posted by djmmm on March 25, 2003, at 9:50:11
i enjoyed reading that!
agent
Posted by ace on March 25, 2003, at 18:26:57
In reply to Re: Didn't realize simple solutions would jerk chains » djmmm, posted by agent killer on March 25, 2003, at 10:20:41
Posted by Dr. Bob on March 25, 2003, at 22:01:31
In reply to Didn't realize simple solutions would jerk chains, posted by missliz on March 25, 2003, at 3:49:18
> The fact that B6 works so well to stop "zaps" must have been a complete delusion on the part of somebody who actually went to med school and psych residency. I guess I was just plain wrong about it working so well for me over the six years I took Nardil and had this problem. I guess you were absent the day they had that lecture in med school on the symptoms and history of vitamin deficiencys and related diseases.
> And I must profoundly apologize for offering a simple, easy solution to a common problem instead of ranting on about brain chemistries that don't apply.Please be sensitive to the feelings of others and don't be sarcastic or post anything that could lead them to feel accused or put down, thanks.
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
Posted by justyourlaugh on March 25, 2003, at 22:38:24
In reply to Miss Liz - there was no need to be so vitriolic (nm), posted by ace on March 25, 2003, at 18:26:57
never was my intent to harm you..
iwanted some of that "high too..."
was feeling so bad,,,,,,
mabe wanted to .....touch someone happy..mabe was callingout for you help...you are very well versed on your meds......
just wanted.....happy you?
shannonjyl
Posted by cybercafe on March 26, 2003, at 23:48:01
In reply to Re: Those friggin' ZAPS - NARDIL or LITHIUM?, posted by djmmm on March 24, 2003, at 15:13:24
> Vit B supplements should be taken with all antidepressants, they will not stop the "zaps"...only time, or going back on a serotonin acting antidepressant will.this is something i have not heard before... could i ask you to elaborate?
This is the end of the thread.
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