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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by craig allen on September 6, 2003, at 22:58:53
i started nardil 3 1/2 weeks ago. one week at 30mg. two weeks at
45mg. this is my third day at 60mg and my doc told me to push it up
to 75 asap. results to this point have been marginal. maybe some
improvement but nothing dramatic. my questions: 1) what dose are
people having good results with? 2) how long did it take to work?
3) is it best to split the dose throughout the day and if so, how
many times - i've read a few different opinions.
thanks for your feedback in advance.
Posted by Questionmark on September 7, 2003, at 23:07:33
In reply to NARDIL DOSAGE QUESTIONS , posted by craig allen on September 6, 2003, at 22:58:53
> i started nardil 3 1/2 weeks ago. one week at 30mg. two weeks at
> 45mg. this is my third day at 60mg and my doc told me to push it up
> to 75 asap. results to this point have been marginal. maybe some
> improvement but nothing dramatic. my questions: 1) what dose are
> people having good results with? 2) how long did it take to work?
> 3) is it best to split the dose throughout the day and if so, how
> many times - i've read a few different opinions.
> thanks for your feedback in advance.1) So far i'm having good results with 45mg/day-- it's been about 3 weeks. My anxiety is sigNIFicantly decreased, and the severity of depression is cut out, but the depression is still very much alive. i didn't want to but i'm gonna try 60mg for awhile.
2) Like 3 days-- BUT, i was doing weird things med-wise before this... like taking very low dose Paxil every 3 days (which i quit doing about a week before starting the Nardil) and taking 10 or 20mg Parnate several days before starting the Nardil... for a # of diff reasons i won't get into but NOT things i would necessarily suggest doing of course. i was just mentioning because this may be why the Nardil started working so quickly for me. Generally i think it takes about 4 to 6 weeks to start being effective. Don't quit before then.
3) This was a good question & something i've really been wondering about myself for awhile. i've noticed that the more Nardil i take at once the worse the anticholinergic side effects often are for awhile (like dry eyes and nose & what not). i'd like to hear more on this too. (right now been doing 3x/day but would like to just do morning and night or even one or the other if possible).
Posted by timidly on September 7, 2003, at 23:14:05
In reply to NARDIL DOSAGE QUESTIONS , posted by craig allen on September 6, 2003, at 22:58:53
Don't give up yet. It can take up to 2 months for Nardil to become effective. My experience is that is that a dosage change takes between 3 days and 4 weeks to take effect. I've been on Nardil for almost 30 years, and am currently taking 120 mg a day. The split that works best for me is half first thing in the morning and the other half at noon. I have tried one pill at a time equally spaced out over the day, all in the morning, all at noon, all at night, three times a day, all variations of twice a day, and more. Both the effective dose and the way the dosage is split over the day vary enormously from one person to the next. You will have to experiment to find what works best for you ane how to split the dose over the day.
> i started nardil 3 1/2 weeks ago. one week at 30mg. two weeks at
> 45mg. this is my third day at 60mg and my doc told me to push it up
> to 75 asap. results to this point have been marginal. maybe some
> improvement but nothing dramatic. my questions: 1) what dose are
> people having good results with? 2) how long did it take to work?
> 3) is it best to split the dose throughout the day and if so, how
> many times - i've read a few different opinions.
> thanks for your feedback in advance.
Posted by Tepiaca on September 8, 2003, at 13:35:58
In reply to Re: NARDIL DOSAGE QUESTIONS , posted by timidly on September 7, 2003, at 23:14:05
30 years on nardil ???
wow that´s a lot of time ,is higher than my age.Why have you been so much time on NArdil ???
I know it must really works very well for you , but , have you tried any other medicine in your life ?After 30 years , what have been the worst thing that you have experimented with Nardil ???
wich have been your worst side effects??Im a rookie on this drug ,Ive been only 3 weeks and a half , and I has help me alot.
Hope you can help me , with any advice
Tep
Posted by craig allen on September 8, 2003, at 16:36:07
In reply to Re: Nardil Qs, posted by Questionmark on September 7, 2003, at 23:07:33
thanks for the posts. i'm getting some ugly headaches that seem to be at their worst right after i take my dose of nardil. anyone else have this? my concern is that it is a symptom of a blood pressure change which the medication can cause, but i don't know if it's related to that. maybe just a side effect of the medication that's unrelated to blood pressure. i'm also feeling more irritable even than normal, and i have to stand up and sit down gingerly due to slight dizziness. i am adhering to the dietary restrictions, so this shouldn't be due to a food interaction. any info/experience would be appreciated.
Posted by timidly on September 8, 2003, at 22:30:13
In reply to Re: NARDIL DOSAGE QUESTIONS » timidly, posted by Tepiaca on September 8, 2003, at 13:35:58
> 30 years on nardil ???
> wow that´s a lot of time ,is higher than my age.
> Why have you been so much time on NArdil ???
> I know it must really works very well for you , but , have you tried any other medicine in your life ?
> After 30 years , what have been the worst thing that you have experimented with Nardil ???
> wich have been your worst side effects??
> Im a rookie on this drug ,Ive been only 3 weeks and a half , and I has help me alot.
> Hope you can help me , with any advice
>
> Tep
Tep,I've been on Nardil so long because nothing else has worked for me.
I have tried every anti-depressant and mood stabilizer on the market,
ECT, and more. Just two years ago I tried Effexor and Celexa. The
only other anti-depressant that seemed to work well was Meritol, but
that was taken off the market because it was killing people.
For more details of my experiences refer to my posts 122488,
122723, 122706, 122458, 137711, 137718, 137702, 137692, and 137707.
Find the posts by using the PsychoBabble SEARCH, or
the URL http://www.dr-bob.org/babble/20020930/msgs/<post#>.html
Posted by timidly on September 8, 2003, at 22:49:47
In reply to SOME NEW NARDIL QUESTIONS, posted by craig allen on September 8, 2003, at 16:36:07
> thanks for the posts. i'm getting some ugly headaches that seem to be at their worst right after i take my dose of nardil. anyone else have this? my concern is that it is a symptom of a blood pressure change which the medication can cause, but i don't know if it's related to that. maybe just a side effect of the medication that's unrelated to blood pressure. i'm also feeling more irritable even than normal, and i have to stand up and sit down gingerly due to slight dizziness. i am adhering to the dietary restrictions, so this shouldn't be due to a food interaction. any info/experience would be appreciated.
Relax. I experience the same thing. Those are common transitional side effects that go away after you have been taking it a while. High Blood pressure has no symptoms, unless it is extremely high. The headaches are unlikely to be blood pressure related, especially since you are having postural hypotension (low blood pressure when changing from laying down to sitting or standing, or sitting to standing, or getting back up after bending over, etc.) That is a very common side effect of Nardil. When changing positions, do it slowly. It's the worst when first starting the Nardil or increasing the dose.
It becomes much less severe after several weeks. As you browse around PsycoBabble you will find a lot of varying opinions about the dietary restrictions. I adhere to the dietary restrictions very rigidly. I am not willing to play "russian roulette" with my life by deviating from it. As you review the posts of those who do, keep in mind that "getting away with it once" does not mean "you can get away with it again".
Hang in there. It gets better.
Posted by Questionmark on September 9, 2003, at 20:41:16
In reply to SOME NEW NARDIL QUESTIONS, posted by craig allen on September 8, 2003, at 16:36:07
Timidly's right that these side effects you mentioned should go away after a few weeks, more or less. From what you said about the dizziness and following the diet restrictions, it's possible the headaches might be associated with low blood pressure, which is most likely not a bid deal. Hypertensive headaches, on the other hand, could be dangerous, but these have their own characteristic signs (such as bad occipital/ back-of-the-head pain).
> thanks for the posts. i'm getting some ugly headaches that seem to be at their worst right after i take my dose of nardil. anyone else have this? my concern is that it is a symptom of a blood pressure change which the medication can cause, but i don't know if it's related to that. maybe just a side effect of the medication that's unrelated to blood pressure. i'm also feeling more irritable even than normal, and i have to stand up and sit down gingerly due to slight dizziness. i am adhering to the dietary restrictions, so this shouldn't be due to a food interaction. any info/experience would be appreciated.
Posted by craig allen on September 9, 2003, at 21:08:05
In reply to Re: Nardil Qs » craig allen, posted by Questionmark on September 9, 2003, at 20:41:16
better today as far as the headaches go. the irritability is another story. bad again today. anyone else get this when starting on nardil? need some relief already!
Posted by Questionmark on September 10, 2003, at 22:07:17
In reply to Re: Nardil Qs, posted by craig allen on September 9, 2003, at 21:08:05
> better today as far as the headaches go. the irritability is another story. bad again today. anyone else get this when starting on nardil? need some relief already!
Yes i had that to some extent (though not nearly as bad as Wellbutrin or Remeron). It's gotten much better. If anything now i'm less irritable. So worry not, eet gets bettah.
Posted by cee on September 17, 2007, at 21:03:58
In reply to Re: NARDIL DOSAGE QUESTIONS, posted by timidly on September 8, 2003, at 22:30:13
> > 30 years on nardil ???
> > wow that´s a lot of time ,is higher than my age.
> > Why have you been so much time on NArdil ???
> > I know it must really works very well for you , but , have you tried any other medicine in your life ?
> > After 30 years , what have been the worst thing that you have experimented with Nardil ???
> > wich have been your worst side effects??
> > Im a rookie on this drug ,Ive been only 3 weeks and a half , and I has help me alot.
> > Hope you can help me , with any advice
> >
> > Tep
>
> Tep,
>
> I've been on Nardil so long because nothing else has worked for me.
> I have tried every anti-depressant and mood stabilizer on the market,
> ECT, and more. Just two years ago I tried Effexor and Celexa. The
> only other anti-depressant that seemed to work well was Meritol, but
> that was taken off the market because it was killing people.
> For more details of my experiences refer to my posts 122488,
> 122723, 122706, 122458, 137711, 137718, 137702, 137692, and 137707.
> Find the posts by using the PsychoBabble SEARCH, or
> the URL .html" target="_blank">http://www.dr-bob.org/babble/20020930/msgs/<post#>.html
> hello nardil veteran
i was wondering if the side effects like weight gain go away over timecheers cee
Posted by Jedi on September 21, 2007, at 23:49:38
In reply to NARDIL DOSAGE QUESTIONS , posted by craig allen on September 6, 2003, at 22:58:53
> i started nardil 3 1/2 weeks ago. one week at 30mg. two weeks at
> 45mg. this is my third day at 60mg and my doc told me to push it up
> to 75 asap. results to this point have been marginal. maybe some
> improvement but nothing dramatic. my questions: 1) what dose are
> people having good results with? 2) how long did it take to work?
> 3) is it best to split the dose throughout the day and if so, how
> many times - i've read a few different opinions.
> thanks for your feedback in advance.Hi craig,
I take 90mg which works for me, but I'm big. The standard effective dose for Nardil is 1mg/kg of body weight. So take your weight in pounds and divide by 2.2, this should be the dosage to shoot for. When I first took Nardil, it was about six weeks before it really kicked in. When it did it was like no other med I had ever tried. One day I was seriously depressed and hopeless. The next day all of the answers were there and quite simple. I also had a period of hypomania when Nardil first kicked in. After being depressed for so long, this actually felt really good. But watch out for it, it is not the true antidepressant effect of Nardil. The effect will soon go away and a lot of people mistake this for poop out.I take my medication 45mg in the AM and 45mg at bedtime. I've tried just about every dosing schedule, including taking all 90mg at once. It doesn't seem to make any difference for me. My main side effects of carb cravings and insomnia are still there. I'm currently taking 25 to 50mg of Seroquel for the insomnia. Once in a while I will mix in a little diphenhydramine(Benadryl). I am really sensitive to these medications, as they both really hit the histamine receptors hard for me.
Good luck,
Jedi
Posted by Jedi on September 22, 2007, at 0:55:07
In reply to Re: NARDIL DOSAGE QUESTIONS, posted by cee on September 17, 2007, at 21:03:58
> i was wondering if the side effects like weight gain go away over time
>
> cheers ceeHi cee,
In my experience on carb cravings and associated weight gain:
1. They do not go away without strenuous exercise.
2. Perhaps Topamax, Provigil, Concerta or Ritilan-SR would help, I haven't tried them.Daytime somnolence does go away over time.
I've always had to treat the insomnia, first with trazodone, clonazepam, Seroquel, and diphenhydramine.
The orthostatic hypotension goes away with time.
Orgasmic delay lessens over time but does not go away.
Euphoria goes away after several weeks(regrettably).
Increase in presbyopia(far sightedness) does not decrease.
These are just my experiences and other people wil have different side effects.
Take care,
Jedi
Posted by UGottaHaveHOPE on September 26, 2007, at 12:33:28
In reply to Re: NARDIL DOSAGE QUESTIONS, posted by Jedi on September 22, 2007, at 0:55:07
Daytime sedation has been the most challenging sympton for me to erase.
Posted by Jedi on September 26, 2007, at 20:38:50
In reply to Re: NARDIL DOSAGE QUESTIONS, posted by UGottaHaveHOPE on September 26, 2007, at 12:33:28
> Daytime sedation has been the most challenging sympton for me to erase.
Hi,
What else are you taking besides the Nardil. I noticed when I cut my dosage of clonazepam in half, it took care of a lot of the daytime somnolence. I went from 2mg while on my trial of Parnate to 1mg when I went back on Nardil. To 1mg every other day now. It does seem to be helping.
Be Well,
Jedi
Posted by UGottaHaveHOPE on September 27, 2007, at 11:20:37
In reply to Re: NARDIL DOSAGE QUESTIONS » UGottaHaveHOPE, posted by Jedi on September 26, 2007, at 20:38:50
Jedi: I am taking 2-3mg of Klonopin, along with 50-100mg of Seroquel. I am thinking Seroquel is the biggest cause for the sedation. The pdoc said he wanted to wean me off it, but right now getting a good night's sleep (helped a lot by Seroquel) is more important than feeling a little bit groggy. I appreciate your input, Michael
> > Daytime sedation has been the most challenging sympton for me to erase.
>
> Hi,
> What else are you taking besides the Nardil. I noticed when I cut my dosage of clonazepam in half, it took care of a lot of the daytime somnolence. I went from 2mg while on my trial of Parnate to 1mg when I went back on Nardil. To 1mg every other day now. It does seem to be helping.
> Be Well,
> Jedi
>
Posted by Jedi on September 27, 2007, at 22:35:56
In reply to Re: NARDIL DOSAGE QUESTIONS » Jedi, posted by UGottaHaveHOPE on September 27, 2007, at 11:20:37
> Jedi: I am taking 2-3mg of Klonopin, along with 50-100mg of Seroquel. I am thinking Seroquel is the biggest cause for the sedation. The pdoc said he wanted to wean me off it, but right now getting a good night's sleep (helped a lot by Seroquel) is more important than feeling a little bit groggy. I appreciate your input, Michael
Hi Michael,
Yes you are taking a lot of very sedating medications besides Nardil. When I was on Parnate and taking 2mg of clonazepam, I could not get through the day without a two hour nap. I also take Seroquel for the Nardil induced insomnia. It really works well for me, but I only take 50mg. Sometimes I will add 25mg of diphenhydramine if I just can't get to sleep. When I first started Seroquel a few months ago, I would wake up really tired and groggy. That side effect seems to have worn off. Maybe if you can limit your dosage to 50mg, it would not be such a problem. I agree with you, a good night's sleep is very important when recovering from depression.3mg of clonazepam is a pretty hefty dose. According to the equivalence table at benzo.org.uk it is like 60mg of valium. If your social or generalized anxiety is being controlled mostly by the Nardil, maybe you could get the dosage down to 1mg. If you attempt this, do it slowly to avoid rebound anxiety.
Maybe, by reducing some of the sedating meds you could up your dosage of Nardil. It affects GABA like clonazepam, which helps with the generalized and social anxiety. I need 90mg daily. I could probably go to 105mg if my MD would give me permission.
Best of Luck,
Jedi
Posted by UgottaHaveHope on September 30, 2007, at 22:52:44
In reply to Re: NARDIL DOSAGE QUESTIONS » UGottaHaveHOPE, posted by Jedi on September 27, 2007, at 22:35:56
Jedi: What was the difference in Nardil from when you took 45mg or whatever to the 90 you take now? What difference did it make? How long did it take you to notice it? What did you notice? Are side effects any different at 90? Thanks.
Posted by Jedi on October 1, 2007, at 13:17:39
In reply to Re: Nardil Q for Jedi » Jedi, posted by UgottaHaveHope on September 30, 2007, at 22:52:44
> Jedi: What was the difference in Nardil from when you took 45mg or whatever to the 90 you take now? What difference did it make? How long did it take you to notice it? What did you notice? Are side effects any different at 90? Thanks.
Michael,
I believe that when I first started Nardil that 60mg was my target dose, but that was eleven years ago. As I remember as I raised the dosage to 90mg the side effects increased for a time and then subsided. I've been off Nardil four times in this eleven year period, and have had to go back on each time because of the return of chronic atypical depression.Each time it would take a while to get used to the side effects again. I have not had the hypomania and associated euphoria since the first couple of times I started Nardil. The delayed ejaculation has returned each time I have stopped and restarted. It never completely goes away but does get better with time. The orthostatic hypertension that I had eleven years ago, when I first started the medication, has not returned.
The carb cravings and associated weight gain have been and probably always will be a struggle for me. At one point I had gained over 100 pounds from the Nardil and atypical depression. I went from doing ironman events at about 205 to being sick with pneumonia at 310. At this point I started strenuous exercise and dropped to about 235. I have gained some of that back and am about 265 now. This is the reason for my relatively high dosage of Nardil. I hope to get back to the gym this winter to drop some of that weight. I could probably be at 105 or 120mg of Nardil with no problem. 265 lbs. divided by 2.2 equals 120mg, using the formula for finding the Nardil affective dose.
At my weight I am considered morbidly obese by my BMI numbers. But actually for a fat guy, I'm in pretty good physical shape. Nardil helps lower my borderline high BP, I'm the only one in my family that is not on medication for hypertension (father, mother, two sisters, and a brother). My lipids are low. I take 1080mg of EPA and 720mg of DHA on a daily basis. The data for the benefit of these fatty acids on cardiovascular health is becoming overwhelming.
Like I've written in other posts, I would rather be fat and free of major depression than thin and sick. There is nothing worse than being depressed for months or years on end; lying on the floor in a fetal position with no hope and wanting to die.
The other side effect from Nardil is the insomnia, which I control with 50mg of Seroquel and sometimes 25mg of diphenhydramine(Benadryl).
The Seroquel made me really groggy in the morning at first, but this has passed.My daytime tiredness has greatly decreased since cutting my dosage of clonazepam from 2mg to .5mg daily. I eventually want to cut the benzos out completely. I hope that this will help my memory loss also. Seems to be mostly short term memory that is the problem. I can remember things I learned in school 30 years ago, but finding my keys that I put down 5 minutes ago is a problem.
Sorry for rambling.
Be well,
Jedi
Posted by UGottaHaveHOPE on October 1, 2007, at 22:01:54
In reply to Re: Nardil Q for Jedi » UgottaHaveHope, posted by Jedi on October 1, 2007, at 13:17:39
Jedi:
No, youre not rambling at all. You are sharing very valuable info for me and many others either taking or considering taking Nardil. On behalf of all, I appreciate it.
Im taking 50-100mg of Seroquel and 2-3mg of Klonopin. Whats interesting about the Seroquel is that the less I take, the more I feel it.
Right now, however, I am still peaking with anxiety so nothing is really working. As I may have mentioned I dropped from 45 to 15mg for most of the summer without telling my pdoc, just not a good decision by me.
I have gone from 15 to 45mg for the last two weeks and am wondering how long it will take it kick in? I weigh around 210 lbs. and have asked my pdoc if I should be taking more, but he's staying at 45 for the time being.
Yes, that's what I was wondering. How long did it take for the doses to kick for you each time? Thanks, Michael @ sportscarvell@yahoo.com
> Michael,
> I believe that when I first started Nardil that 60mg was my target dose, but that was eleven years ago. As I remember as I raised the dosage to 90mg the side effects increased for a time and then subsided. I've been off Nardil four times in this eleven year period, and have had to go back on each time because of the return of chronic atypical depression.
>
> Each time it would take a while to get used to the side effects again. I have not had the hypomania and associated euphoria since the first couple of times I started Nardil. The delayed ejaculation has returned each time I have stopped and restarted. It never completely goes away but does get better with time. The orthostatic hypertension that I had eleven years ago, when I first started the medication, has not returned.
>
> The carb cravings and associated weight gain have been and probably always will be a struggle for me. At one point I had gained over 100 pounds from the Nardil and atypical depression. I went from doing ironman events at about 205 to being sick with pneumonia at 310. At this point I started strenuous exercise and dropped to about 235. I have gained some of that back and am about 265 now. This is the reason for my relatively high dosage of Nardil. I hope to get back to the gym this winter to drop some of that weight. I could probably be at 105 or 120mg of Nardil with no problem. 265 lbs. divided by 2.2 equals 120mg, using the formula for finding the Nardil affective dose.
>
> At my weight I am considered morbidly obese by my BMI numbers. But actually for a fat guy, I'm in pretty good physical shape. Nardil helps lower my borderline high BP, I'm the only one in my family that is not on medication for hypertension (father, mother, two sisters, and a brother). My lipids are low. I take 1080mg of EPA and 720mg of DHA on a daily basis. The data for the benefit of these fatty acids on cardiovascular health is becoming overwhelming.
>
> Like I've written in other posts, I would rather be fat and free of major depression than thin and sick. There is nothing worse than being depressed for months or years on end; lying on the floor in a fetal position with no hope and wanting to die.
>
> The other side effect from Nardil is the insomnia, which I control with 50mg of Seroquel and sometimes 25mg of diphenhydramine(Benadryl).
> The Seroquel made me really groggy in the morning at first, but this has passed.
>
> My daytime tiredness has greatly decreased since cutting my dosage of clonazepam from 2mg to .5mg daily. I eventually want to cut the benzos out completely. I hope that this will help my memory loss also. Seems to be mostly short term memory that is the problem. I can remember things I learned in school 30 years ago, but finding my keys that I put down 5 minutes ago is a problem.
>
> Sorry for rambling.
> Be well,
> Jedi
>
Posted by Jedi on October 2, 2007, at 2:06:46
In reply to Re: More Nardil Qs for Jedi » Jedi, posted by UGottaHaveHOPE on October 1, 2007, at 22:01:54
...
> Yes, that's what I was wondering. How long did it take for the doses to kick for you each time? Thanks, Michael@sportscarvell@yahoo.com
>
>Michael,
For me, the full effect of Nardil didn't kick in until after about six weeks. This can be a really tough time in a med trial, when the side effects are at their worst, and the antidepressant effect has yet to kick in. In later trials the Nardil seemed to kick in somewhat faster, I don't know the reason for this.
Take care,
Jedi
Posted by FredPotter on October 3, 2007, at 15:44:20
In reply to Re: Nardil Qs, posted by craig allen on September 9, 2003, at 21:08:05
soon you should get to the euphoria side-effect. Sadly it only lasts a few weeks and is replaced with normality. I am cutting back from 75mg to 60mg in the hope that a smaller maintenance dose might work, as was stated by some Dr. The side effect of weight gain is troublesome, despite what I thought. It's all on my stomach. I feel inflated and can't cut my toenails without suffocating. Also lack of sexual feeling or ability is a drag, especially as it's spring here and in a sense I can feel the sap rising. Nothing else rises though Fred
Posted by FredPotter on October 3, 2007, at 16:02:57
In reply to Re: More Nardil Qs for Jedi » Jedi, posted by UGottaHaveHOPE on October 1, 2007, at 22:01:54
As body weight is used as a guide to dosage and the higher the dose the more you weigh, we have a classic functional relationship. There should be an optimum dose and an optimum weight
This is the end of the thread.
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