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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 59. This is the beginning of the thread.
Posted by ed_uk on March 7, 2006, at 17:12:35
OK, here goes. Feel free to agree or disagree..........
I do not believe that the 'new' Nardil is any less effective than the 'old' Nardil.
Both formulations contain 15mg phenelzine sulfate. There are some differences in the excipients. I am not convinced that such differences are clinically important, at least not to most people.
It is my belief that people are being harmed by being told that the 'new' Nardil is ineffective. There is no scientific data to support this view. One would expect both formulations to be equally effective. Any minor differences in bioavailabily should be offset by appropriate adjustments in dose.
I am not posting this to 'get at' people who believe (or have been led to believe) that the 'new' Nardil is in some way significantly inferior to the 'old' Nardil. I am starting this thread because I believe that people are being harmed by the hoopla surrounding the change in Nardil's excipients. Many people may misunderstand the situation. Nardil contains exactly the same drug at exactly the same dose as it always did. There have been some changes to the excipients in the tablet. There is no evidence that such changes should be important.
The power of suggestion is strong.
Ed
Posted by Racer on March 7, 2006, at 18:53:59
In reply to The 'new' Nardil, posted by ed_uk on March 7, 2006, at 17:12:35
I have no expertise in this, but I agree with you -- especially about the power of suggestion. Yes, there are changes in the inert ingredients, and I suppose that could have some effect somewhere to some people, but it still doesn't mean that there's any change in the effectiveness of the drug.
OK. That's my opinion, and now everyone knows what it is.
Posted by forgetful mary on March 7, 2006, at 19:39:20
In reply to Re: The 'new' Nardil, posted by Racer on March 7, 2006, at 18:53:59
Heck what should I know --I only have taken it for over 20 years!!!
No one says Nardil is bad, and in fact it is better than most of the others-esp the SSRI's BUT it is inferior to the original Nardil which was far superior to this newer formula. And while we are on the subject -They don't make many things like they used to, As a manufactureres rep I personally know of products that are made of less quality for monetary reasons and yet claim to be the same.....That's just the way it is today as Big Business and mega corporations look to cut costs and keep those mega salaries coming.... Take a look around at the goods that China is replacing finely crafted materials with now, Get the picture? It is the same in health-care and it is going down the tubes!!!
> I have no expertise in this, but I agree with you -- especially about the power of suggestion. Yes, there are changes in the inert ingredients, and I suppose that could have some effect somewhere to some people, but it still doesn't mean that there's any change in the effectiveness of the drug.
>
> OK. That's my opinion, and now everyone knows what it is.
Posted by forgetful mary on March 7, 2006, at 19:41:18
In reply to Re: The 'new' Nardil, posted by Racer on March 7, 2006, at 18:53:59
And who "suggested" to you that this new formula even works for you??? Perhaps your Dr suggested it would be a good drug for you, Guess that suggestion proved to help you adjust to it yourself......LOL
> I have no expertise in this, but I agree with you -- especially about the power of suggestion. Yes, there are changes in the inert ingredients, and I suppose that could have some effect somewhere to some people, but it still doesn't mean that there's any change in the effectiveness of the drug.
>
> OK. That's my opinion, and now everyone knows what it is.
Posted by willyee on March 8, 2006, at 0:09:52
In reply to Re: The 'new' Nardil, posted by forgetful mary on March 7, 2006, at 19:41:18
I agree with mary,scieance can only go so far,ive read tha group a lot,and there are some very intelligent users,more important there are many many VETERAN users,i dont see power of suggestion bringing out a succesful user of the drug for over 20 years to become invovled in a lawsuit action.
Spending a few hours a week reading the post all scieance is put aside for me,its just too many people on it too long to come forward with such intensity,i mean u have veteran users who literaly switched to other drugs,after being on it 20 years,u have users attempting home scieance with no chemistry exper to making "liquid nardil" in hopes of the "same feel"
And in this specific case,unless im mistaken u have two definatly credable voices,but voices that if im not mistaken have never taken the OLD nardil and just using logic,i agree with the logic but the one person who was on it again you can read the most by mary and i presonaly feel the sincerity,i imagine personaly people being told its not changed must kinda feel like when folk tell us "oh just snap ot of it" its like why will u not listen to me,why do u suggest its in my imagination or whatver have u rather than go on a limb and although its hard to make sense of simply believe me when i tell u.
I definatly believe it,the posts from the users are powerful,and its the reason i consider i failed on nardil,i believe i prob would be on it today.Oh and just my view as well lol.
Posted by ed_uk on March 8, 2006, at 16:05:06
In reply to Re: The 'new' Nardil, posted by willyee on March 8, 2006, at 0:09:52
In order for the 'new' Nardil formulation to be approved, it would have had to have been shown to be bioequivalent to the 'old' formulation.
Excipients can affect the rate and extent of absorption of a drug. Two formulations are considered to be bioequivalent when their absorption parameters are the same.
Ed
Posted by forgetful mary on March 8, 2006, at 16:07:43
In reply to Re: The 'new' Nardil, posted by willyee on March 8, 2006, at 0:09:52
Thanks for the support Willyee....I wish you could have tried the old version as well, I also wish my brother had that chance too as he started it at my urging right around the tinme it changed. Although he says it's better than any of the SSRI's he'd been prescribed I know he would be better off with the old Nardil...More alarming than this one drug is the fact that the FDA pretty much allows these manufactureres to change a drug in any way and NOT TELL ANYONE, That is just unbelievable that they could get away with that. If they believe it would do no harm why not tell at least the Drs--Did they think the Drs couldn't "handle the truth" Hahhahahahha (They might be right about that!! LOL)
> I agree with mary,scieance can only go so far,ive read tha group a lot,and there are some very intelligent users,more important there are many many VETERAN users,i dont see power of suggestion bringing out a succesful user of the drug for over 20 years to become invovled in a lawsuit action.
>
> Spending a few hours a week reading the post all scieance is put aside for me,its just too many people on it too long to come forward with such intensity,i mean u have veteran users who literaly switched to other drugs,after being on it 20 years,u have users attempting home scieance with no chemistry exper to making "liquid nardil" in hopes of the "same feel"
>
> And in this specific case,unless im mistaken u have two definatly credable voices,but voices that if im not mistaken have never taken the OLD nardil and just using logic,i agree with the logic but the one person who was on it again you can read the most by mary and i presonaly feel the sincerity,i imagine personaly people being told its not changed must kinda feel like when folk tell us "oh just snap ot of it" its like why will u not listen to me,why do u suggest its in my imagination or whatver have u rather than go on a limb and although its hard to make sense of simply believe me when i tell u.
>
>
> I definatly believe it,the posts from the users are powerful,and its the reason i consider i failed on nardil,i believe i prob would be on it today.Oh and just my view as well lol.
Posted by ed_uk on March 8, 2006, at 16:09:44
In reply to Re: The 'new' Nardil, posted by forgetful mary on March 7, 2006, at 19:39:20
>the original Nardil which was far superior to this newer formula
The power of repetition is very strong. When a belief such as this has been repeated many times, it often ends up being regarded as self-evident truth, despite the lack of scientific data or even a logical explanation.
Ed
Posted by ed_uk on March 8, 2006, at 16:41:41
In reply to Re: The 'new' NardilThanks Willyee, posted by forgetful mary on March 8, 2006, at 16:07:43
Hi
>Thanks for the support.......
I'm not attacking you, I'm simply stating my views.
>I know he would be better off with the old Nardil
How can you possibly know that?
>More alarming than this one drug is the fact that the FDA pretty much allows these manufactureres to change a drug in any way and NOT TELL ANYONE
The manufacturer didn't change the drug. The drug is phenelzine sulfate, just as it always was. The manufacturer altered the excipients once they had gained FDA approval to do so. The approval was based on evidence that the new formulation was bioequivalent to the old one.
I am sorry that Nardil no longer relieves your symptoms in the way that it once did. It is a sad fact that psych meds frequently 'poop out' after prolonged use. Alternatively, people's underlying condition(s) can change, rendering their medication ineffective.
When I started this thread I was taking the risk that I would make myself unpopular. I did so because I believe that this thread will be a valuable source of information.
Regards
Ed
Posted by ed_uk on March 8, 2006, at 16:56:10
In reply to Re: The 'new' NardilThanks Willyee, posted by forgetful mary on March 8, 2006, at 16:07:43
In short, what I'm trying to say is that the reason people are blaming the 'new' Nardil for their increased depression/anxiety is that it is such an attractive (deceptively simple) explanation. The real reasons for their increased symptoms are likely much more complex, and unrelated to the altered formulation.
Ed
Posted by ed_uk on March 8, 2006, at 16:59:35
In reply to Re: The 'new' Nardil, posted by Racer on March 7, 2006, at 18:53:59
Hi Racer
It is my belief that the anti-new-Nardil hoopla is harmful to patients' wellbeing. It increases anxiety in people who are already very vulnerable.
Ed
Posted by forgetful mary on March 8, 2006, at 20:29:43
In reply to Re: The 'new' NardilThanks Willyee » forgetful mary, posted by ed_uk on March 8, 2006, at 16:41:41
And I just happened to have the drug poop out just when it was changed? As did others?? Just a curious coincidence ??
(You would make a lousy detective!!!)
And yes they DID change the ingredients of the pill I had been ingesting for many years....let's not use semantics to make your point shall we???
By the way if they had added peanut butter to it without notifying anyone they could well have killed someone...BTW- And just so you know I have considered other reasons for the change...try this one on for size...How do we know what these drugs do after long term use?? We don't...maybe these long term users are illustrating just what happens when you take a psychiatric drug for an extended period of time??....another possibility for the change is perhaps damage to long term users, which means we are all guinea pigs--BUT I knew the risk then and knew that without it I would not have lasted as long as I have...YOU don't know anymore than I do whether the changes made caused the CHANGE IN REACTION, and because they did change it we will never know , GENERICS are supposed to leave the original for those who don't respond well to the generic-Pfizer hasn't done that as peoples quality of life is just too costly for them to care.
> Hi
>
> >Thanks for the support.......
>
> I'm not attacking you, I'm simply stating my views.
>
> >I know he would be better off with the old Nardil
>
> How can you possibly know that?
>
> >More alarming than this one drug is the fact that the FDA pretty much allows these manufactureres to change a drug in any way and NOT TELL ANYONE
>
> The manufacturer didn't change the drug. The drug is phenelzine sulfate, just as it always was. The manufacturer altered the excipients once they had gained FDA approval to do so. The approval was based on evidence that the new formulation was bioequivalent to the old one.
>
> I am sorry that Nardil no longer relieves your symptoms in the way that it once did. It is a sad fact that psych meds frequently 'poop out' after prolonged use. Alternatively, people's underlying condition(s) can change, rendering their medication ineffective.
>
> When I started this thread I was taking the risk that I would make myself unpopular. I did so because I believe that this thread will be a valuable source of information.
>
> Regards
>
> Ed
Posted by forgetful mary on March 8, 2006, at 20:36:25
In reply to Re: The 'new' Nardil » forgetful mary, posted by ed_uk on March 8, 2006, at 16:56:10
Your reasoning is pprecisely the reason I had MRI's and brain scans and other tests...including hormone tests. None showed a problem. So you see, there is absolutely nothing "attractive" about blaming a powerful drug company whose main concern is making money....Used to be health care was about just that..Health "care"- now it's become -let's make money and if we happen to heal some people at the same time then we are justifying our existence. Do you not see what a horrendous mess the current business philosphy has done to health care in this country??? And I am not a liberal and believe in capitalism but the train is off the tracks and this is just one small component of that failing system.
And how long have you taken it? What makes you and your opinion right vs those who have relied on this drug for many years???
> In short, what I'm trying to say is that the reason people are blaming the 'new' Nardil for their increased depression/anxiety is that it is such an attractive (deceptively simple) explanation. The real reasons for their increased symptoms are likely much more complex, and unrelated to the altered formulation.
>
> Ed
Posted by forgetful mary on March 8, 2006, at 20:37:33
In reply to Re: The 'new' Nardil » Racer, posted by ed_uk on March 8, 2006, at 16:59:35
The change in the drug sure made me more vulnerable...thanks for your concern!!!
> Hi Racer
>
> It is my belief that the anti-new-Nardil hoopla is harmful to patients' wellbeing. It increases anxiety in people who are already very vulnerable.
>
> Ed
Posted by forgetful mary on March 8, 2006, at 20:39:32
In reply to Re: The 'new' Nardil » Racer, posted by ed_uk on March 8, 2006, at 16:59:35
Besides those people are crazy....who could believe them.??..they are psychiatric patients right?? That's what you sound like...I thought that attitude went out with Poodle skirts???
> Hi Racer
>
> It is my belief that the anti-new-Nardil hoopla is harmful to patients' wellbeing. It increases anxiety in people who are already very vulnerable.
>
> Ed
Posted by forgetful mary on March 8, 2006, at 20:40:43
In reply to Re: The 'new' Nardil » Racer, posted by ed_uk on March 8, 2006, at 16:59:35
NUFF said...let's agree to disagree......
from now on leave my brain out of it!!!!
> Hi Racer
>
> It is my belief that the anti-new-Nardil hoopla is harmful to patients' wellbeing. It increases anxiety in people who are already very vulnerable.
>
> Ed
Posted by Racer on March 8, 2006, at 22:17:11
In reply to Re: The 'new' Nardil, posted by forgetful mary on March 8, 2006, at 20:37:33
> The change in the drug sure made me more vulnerable...thanks for your concern!!!
>
>
> > Hi Racer
> >
> > It is my belief that the anti-new-Nardil hoopla is harmful to patients' wellbeing. It increases anxiety in people who are already very vulnerable.
> >
> > Ed
>
>
This is something that's come up here before, on this board. Sometimes, new people come here who have no experience with these drugs, and seeing so many negative posts about drugs can frighten them. I worry that there are people who read a board like this and are frightened away from medications which really would relieve their depression.And while I recognize that you believe the new formulation is why Nardil is no longer effective for you, I have experienced similar situations which I have attributed to medications that were later shown to be unrelated. It may be that you really and truly were responding only to the old formula. It may be that you're no longer responding for reasons unrelated to the change in formulation. It's probably true, though, that many people out there are continuing to respond to the new formulation, because the bioavailability is the same, and it would be a real shame if they were scared off a drug that is still helping them by reading so many negative reports on sites like this one. Suggestibility is a real effect, after all, and one's subjective response to these meds really is the most important measure.
And just to confuse myself more, I have experienced situations in which the inactive ingredients of a medication have had a significant effect on me. Lamictal, for instance, contains lactose as an inactive ingredient, and I needed to take lactase tablets with it. It is possible. Have you looked into the inactive ingredients in the new formulation, to see whether something in there has caused you reactions in the past?
Last thought -- ed_uk is just that: a guy named Ed, who lives in the UK. Just wanted to point that out, since you referenced the US as our collective point of reference.
Posted by ed_uk on March 9, 2006, at 13:05:14
In reply to Re: The 'new' NardilThanks Willyee, posted by forgetful mary on March 8, 2006, at 20:29:43
>And I just happened to have the drug poop out just when it was changed? As did others?? Just a curious coincidence??
People suffering from depression and anxiety frequently find that their symptoms fluctuate in severity over time. There are many reasons for this.
Ed
Posted by ed_uk on March 9, 2006, at 13:07:06
In reply to Re: The 'new' Nardil, posted by forgetful mary on March 8, 2006, at 20:36:25
>And how long have you taken it?
Citalopram? About 3 years.
Ed
Posted by ed_uk on March 9, 2006, at 13:08:11
In reply to Re: The 'new' Nardil, posted by forgetful mary on March 8, 2006, at 20:37:33
>MRI
What sort of symptoms led to the MRI and other tests?
Ed
Posted by ed_uk on March 9, 2006, at 13:14:48
In reply to Re: The 'new' Nardil, posted by forgetful mary on March 8, 2006, at 20:40:43
Let's take drug A. A person on drug A initially believes that drug A is a 'good' drug. The patient goes through good times and bad times while on drug A. Because the patient views drug A as 'good' - all the good times they have are attributed to the power of drug A. Drug A may or may not have been responsible for these good times.
A few years later, the same patient is told that drug A is 'bad'. The patient goes through good times and bad times. Due to the patient's belief that drug A is bad, the patient now attributes all their bad times to drug A. These bad times may or may not have anything to do with drug A.
How one views ones medication is very important. What if drug A was Nardil?
Ed
Posted by ed_uk on March 9, 2006, at 13:16:20
In reply to Re: The 'new' Nardil, posted by forgetful mary on March 8, 2006, at 20:39:32
>Besides those people are crazy....who could believe them.??..they are psychiatric patients right?? That's what you sound like...I thought that attitude went out with Poodle skirts???
I find your post offensive. I have been a psych patient myself.
Ed
Posted by ed_uk on March 9, 2006, at 13:20:36
In reply to I think there's another point, though, posted by Racer on March 8, 2006, at 22:17:11
Hi Racie
>......so many negative posts about drugs can frighten them. I worry that there are people who read a board like this and are frightened away from medications which really would relieve their depression.....
That's very true. Nardil is, as it always was, an effective medication for certain patients suffering from severe depression and/or anxiety. Various p-babblers have responded very well to the 'new' Nardil. People should not be dissuaded from trying it.
>It's probably true, though, that many people out there are continuing to respond to the new formulation, because the bioavailability is the same, and it would be a real shame if they were scared off a drug that is still helping them by reading so many negative reports on sites like this one.
That's one of the reasons I decided to start this thread.
Ed x
Posted by ed_uk on March 9, 2006, at 18:09:50
In reply to Re: I think there's another point, though » Racer, posted by ed_uk on March 9, 2006, at 13:20:36
In some cases, the excipients in a tablet can affect the bioavailability/absorption profile of a drug. The 'new' Nardil is alleged to be bioequivalent to the 'old' Nardil. It is, however, possible that its bioavailability may be slightly different. If so, it should be possible to re-establish efficacy by adjusting the dose.
Some of the symptoms people have reported when transitioning from the 'old' Nardil to the 'new' Nardil resemble withdrawal symptoms. It is possible that the new formulation may have resulted in slightly lower bioavailability. If this is true, increasing the dose or frequency of administration should help. Why is no one discussing this? The 'new' Nardil is all we have. We must learn to optimise its efficacy and usefulness, rather than dismissing it as useless. It might smell bad.........it might taste bad......but it's still phenelzine: a powerful antidepressant and anxiolytic.
Ed
Posted by forgetful mary on March 9, 2006, at 19:27:51
In reply to I think there's another point, though, posted by Racer on March 8, 2006, at 22:17:11
As far as scaring peopl away from a good drug...everyone should be leery of everydrug...No drug is a panacea to everyone.
When prozac first came out I bought the hoopla and although was using Nardil at the time I yearned to lose the weight. What worked extremely well for some caused me to be almost suicidal. That is the case with evevry drug, and every operson is different. What is more alarming to me is the many,many people still out there grappling with symptoms caused by the change in Nardils formula and still totally unaware that the drug they take each and every day is causing that reaction. They were never told, never warned and even there Drs still are not being told. I have told Drs myself even recently who had not a clue thAT PFIZER HAD DONE THIS...that IS SHAMEFUL AND FRIGHTENING THAT THE fda ALLOWED AND STILL ALLOWS THIS. That's what you should be afraid of...
> > The change in the drug sure made me more vulnerable...thanks for your concern!!!
> >
> >
> > > Hi Racer
> > >
> > > It is my belief that the anti-new-Nardil hoopla is harmful to patients' wellbeing. It increases anxiety in people who are already very vulnerable.
> > >
> > > Ed
> >
> >
>
>
> This is something that's come up here before, on this board. Sometimes, new people come here who have no experience with these drugs, and seeing so many negative posts about drugs can frighten them. I worry that there are people who read a board like this and are frightened away from medications which really would relieve their depression.
>
> And while I recognize that you believe the new formulation is why Nardil is no longer effective for you, I have experienced similar situations which I have attributed to medications that were later shown to be unrelated. It may be that you really and truly were responding only to the old formula. It may be that you're no longer responding for reasons unrelated to the change in formulation. It's probably true, though, that many people out there are continuing to respond to the new formulation, because the bioavailability is the same, and it would be a real shame if they were scared off a drug that is still helping them by reading so many negative reports on sites like this one. Suggestibility is a real effect, after all, and one's subjective response to these meds really is the most important measure.
>
> And just to confuse myself more, I have experienced situations in which the inactive ingredients of a medication have had a significant effect on me. Lamictal, for instance, contains lactose as an inactive ingredient, and I needed to take lactase tablets with it. It is possible. Have you looked into the inactive ingredients in the new formulation, to see whether something in there has caused you reactions in the past?
>
> Last thought -- ed_uk is just that: a guy named Ed, who lives in the UK. Just wanted to point that out, since you referenced the US as our collective point of reference.
>
>
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