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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by akston on March 1, 2007, at 7:39:41
I read this on a post from 2003:
"The alcohol got me out of the house and stopped the phobic anxiety, also helped the depression (only for as long as I was drunk)...I was drinking far too much. When I started Nardil I stopped."
My question is this:
Is it safe for me to start Nardil 12 hours after my last beer? Say I have my last beer at 7PM. Is it safe to begin my first Nardil (I havn't started the regimen yet) at 7 AM, or a little later, the next day? I have been driking like the one who posted the above for two months.
Posted by Ken Blades on March 1, 2007, at 20:16:19
In reply to How soon to start Nardil after last beer?, posted by akston on March 1, 2007, at 7:39:41
If it was regular bottled beer, not
microbrewery, tap or non-alcoholic beer,
starting Nardil after letting 12 hours
go by is ok.Since you haven't as yet started Nardil,
the monoamine oxidase in your body will
inactivate any tyramine you have ingested
in any case.I drink beer in moderation and have been
on Parnate for nine years and never had
a hypertensive episode.After you have gotten to your maintenance
dose of Nardil and have adjusted to it,
you can carefully start drinking beer,
but drink less than a full can and check your
blood pressure as you go so you can see how
your own system responds. We're all different.
Posted by akston on March 2, 2007, at 1:01:42
In reply to Re: How soon to start Nardil after last beer? » akston, posted by Ken Blades on March 1, 2007, at 20:16:19
> If it was regular bottled beer, not
> microbrewery, tap or non-alcoholic beer,
> starting Nardil after letting 12 hours
> go by is ok.
>
> Since you haven't as yet started Nardil,
> the monoamine oxidase in your body will
> inactivate any tyramine you have ingested
> in any case.
>
> I drink beer in moderation and have been
> on Parnate for nine years and never had
> a hypertensive episode.
>
> After you have gotten to your maintenance
> dose of Nardil and have adjusted to it,
> you can carefully start drinking beer,
> but drink less than a full can and check your
> blood pressure as you go so you can see how
> your own system responds. We're all different.It's been only canned beer (Bud Light). Should have mentioned the dosage of Nardil the doc has given me is 15MG in the morning. He knows I've been drinking for so long. Does this low dose as a starting point make it even safer? He does say that as time goes by and if things go well he'll increase it gradually up to 45 or even 60MG. Once Nardil becomes effective, I have no intention of drinking at all ever again. I can say that, but the proof will have to wait.
Thanks for your reply.
Posted by akston on March 2, 2007, at 1:24:44
In reply to Re: How soon to start Nardil after last beer? » Ken Blades, posted by akston on March 2, 2007, at 1:01:42
> > If it was regular bottled beer, not
> > microbrewery, tap or non-alcoholic beer,
> > starting Nardil after letting 12 hours
> > go by is ok.
> >
> > Since you haven't as yet started Nardil,
> > the monoamine oxidase in your body will
> > inactivate any tyramine you have ingested
> > in any case.
> >
> > I drink beer in moderation and have been
> > on Parnate for nine years and never had
> > a hypertensive episode.
> >
> > After you have gotten to your maintenance
> > dose of Nardil and have adjusted to it,
> > you can carefully start drinking beer,
> > but drink less than a full can and check your
> > blood pressure as you go so you can see how
> > your own system responds. We're all different.
>
> It's been only canned beer (Bud Light). Should have mentioned the dosage of Nardil the doc has given me is 15MG in the morning. He knows I've been drinking for so long. Does this low dose as a starting point make it even safer? He does say that as time goes by and if things go well he'll increase it gradually up to 45 or even 60MG. Once Nardil becomes effective, I have no intention of drinking at all ever again. I can say that, but the proof will have to wait.
>
> Thanks for your reply.Addendum:
I'm not positive that the doc knows I've been drinking every day for 2 months, but he knows me well enough to suppose that's the case.
He also prescribed Clonidine 0.1MG and I've been on Xanax 2MG/day for a week leading up to this. I plan to start on Sun. March 4.
I've been told by a friend who is a nurse to expect "vomiting and such" that first day since I'm not giving 72 hours for the alcohol to clear.
Posted by akston on March 2, 2007, at 2:18:30
In reply to Re: How soon to start Nardil after last beer? » akston, posted by Ken Blades on March 1, 2007, at 20:16:19
> If it was regular bottled beer, not
> microbrewery, tap or non-alcoholic beer,
> starting Nardil after letting 12 hours
> go by is ok.
>
> Since you haven't as yet started Nardil,
> the monoamine oxidase in your body will
> inactivate any tyramine you have ingested
> in any case.
>
> I drink beer in moderation and have been
> on Parnate for nine years and never had
> a hypertensive episode.
>
> After you have gotten to your maintenance
> dose of Nardil and have adjusted to it,
> you can carefully start drinking beer,
> but drink less than a full can and check your
> blood pressure as you go so you can see how
> your own system responds. We're all different.And more:
It's been 8 to 16 beers/day since Dec.21, 06. A few tries to stop and never got more than 36 hours free from the beer.
Been this way since 1990. Two or three months of daily drinking; then two or three months sober. Twice over these years I quit drinking for a year to the day, once from June 1, 1995 to June 1, 1996 and then again from January 1, 1997 to January 1, 1998.
Now all this time I've taken Thiamine 100MG every four beers.
When I became a professional drunk in 1990, I researched the best I could to minimize the damage.
Now I'm 58 and scared to go forward with Nardil. Hate the thought of sickness the first day after only 12 hours free of beer. But this drinking can't go on I'm so depressed. I stopped Prozac on December 1, 2006. I'm guessing that's why I'm finding it hard to get the 72 hours sober.
All these years I've never vomited from drinking. Once I drank 30 beers, and the next day quit for 5 days. The hangovers are mild.
I'm just throwing in everything I can think of that anyone might notice, and offer advise for.
I'm desperate to start Nardil on Sunday after only 12 hours after my last beer. But scared.
Posted by Crazy Horse on March 2, 2007, at 9:17:24
In reply to Re: How soon to start Nardil after last beer? » akston, posted by Ken Blades on March 1, 2007, at 20:16:19
Hey Ken, i just started Parnate (this is my 3rd time on Parnate in the past 10 years). I love Parnates affect on my depression and anxiety, the reason i have had to quit in the past was due to the severe insomnia and afternoon fatigue i got from it. The 2 previous times i was on a very high dose (150-160 mgs) my goal this time is to keep the dose at or below 100 mgs. in hope of reducing the side effects.
My questions for you: Do the side effects reduce in severity with time? Do you think going with a lower dose, maybe as low as 60 to 80 mgs. will reduce the severity of the side effects? And if you suffer from insomnia and afternoon fatigue, what do you do to combact these side effects?
I appreciate anything you can offer to help me Ken, i'd love nothing more than to be able to stay on Parnate for 9 years. Thank you.
-Monte
Posted by Ken Blades on March 2, 2007, at 9:48:09
In reply to Re: How soon to start Nardil after last beer?, posted by akston on March 2, 2007, at 2:18:30
akston~
You've got a complicated situation there
my man!Since there isn't much tyramine in beer, you're
probably ok unless you drank let's say 12 beers
or more yesterday. The low dose of Nardil would
make any reaction unlikely as well. It takes
more than one first dose of Nardil to inhibit your
monoamine oxidase; it's not the ingestion of the drug itself that's the point, but the MAO inhibition. You should check with your
doctor and tell him how many beers you had 12
hours ago and go with his recommendation.Did your doctor say why he prescribed the
clonidine? It is sometimes used for withdrawal
from alcohol and drugs, but is mainly used
to lower blood pressure. Since you will be
taking Nardil, you may have hypotension[low
blood pressure] and feel woozy or unsteady.
The clonidine may add to this, so let your
doctor know so you won't be falling and
injuring yourself. You can take the Xanax
but you might want to withdraw from it
after you've been on Nardil awhile and have
gotten closer to your effective dose so you
can see how you feel with just the Nardil;
hopefully your depression as well as your
anxiety will improve. This would also apply
to alcohol; if you're drinking you can't
accurately judge whatever improvement you
may be experiencing on Nardil.Maybe your nurse friend thought you would
be vomiting from withdrawing from alchol
'cold-turkey', not necessarily from starting
Nardil 12 hours after drinking. Maybe you
should get her to clarify that.You're going to have to monitor your blood
pressure if you cannot give up beer just
to be safe. Hopefully you will eventually feel
little need for alcohol when the Nardil kicks
in.Amazing that you couldf drink 30 beers and not
vomit..I sure would...I'd never get close to that number before I barfed.Do you think you could make it allowing 24 hours
from your last beer to the first dose of Nardil,
especially if you have had a large amount of beer?58 eh? I'm four days shy of 56....wonder how many
old f*rts are on this board?I hope the Nardil helps you.
Posted by akston on March 2, 2007, at 10:13:14
In reply to Re: How soon to start Nardil after last beer? » akston, posted by Ken Blades on March 2, 2007, at 9:48:09
It'll be 11 or 12 beers the day before I start Nardil.
The doc gave me clonidine just in case I had a rise in blood pressure. I haven't taken it yet. He said take it the night before, and one in the morning.
I'm starting on Sunday because my wife will be off work and ready for the 911 call if necessary.
I won't be drinking anything (I never did drink wine or hard liquor) once I start Nardil.
Vomiting from withdrawal from alcohol? I've never vomited, or even passed out from drinking. I think the clonidine and xanax are "just in case".
I can't wait much more than 12 hours. When on Prozac I could get through the 72 hours, each day getting better feeling. But I had to clear the system of Prozac on Dec. 1. That's why I think it's hard now to get the 72 hours in. Deeply depressed.
Old? You're only coming on 56.
2 years and 40 days in Vietnam with the Marines will get me through. I'm still tough and want to do it my way.
Posted by Ken Blades on March 2, 2007, at 10:20:19
In reply to Re: On Parnate for nine years, Ken. » Ken Blades, posted by Crazy Horse on March 2, 2007, at 9:17:24
Hi Monte~When I started Parnate, I had a fast
heartbeat that seemed like it was
pounding; it would keep me awake
or wake me up. This has basically
disappeared. I've never been on
the high doses you've had, though
I'd love to try it just to see how
I felt.I did have some insomnia at first
that eventually improved to just
light sleep and eventually my sleep
normalized.The afternoon fatigue....THE bugaboo
that never seems to disappear and
seems to exist at most dose levels.
I think this is one of the side
effects that leads people to quit
Parnate.The only things I can do to 'work
through' the afternoon fatigue is
to have two cups of coffee and
be more active than sitting at
the desk. It's not a perfect
solution because I still feel
less than totally alert, but
it does help.I've been at 70mg/day for
nine years, so I can't say
for sure whether your reducing
your daily dose to 60-80mg. will
lessen the insomnia and afternoon
fatigue. It might lessen the
severity of the afternoon fatigue,
being able to fight it a bit whereas
the higher dose afternoon fatigue may
not be in your power to do anything
about. And then there is theThere isn't anything else that has
helped me other than the unavailable
trial drug I had years ago, so I
don't have any choice; either put up
with the negative aspects of Parnate
or quit it. If I quit it I don't want
to think of what would happen... :>{Let's hope that someday soon 'they'
come up with something just as effective
as Parnate for us MAOI types minus the
afternoon fatigue and sleep effects.Sorry I didn't have much to suggest Monte...
you have a lot of company though.
Posted by Ken Blades on March 2, 2007, at 10:49:05
In reply to Re: How soon to start Nardil after last beer?, posted by akston on March 2, 2007, at 10:13:14
akston~
>>>>The doc gave me clonidine just in case I had a rise in blood pressure. I haven't taken it yet. He said take it the night before, and one in the morning.<<<<<<Good idea if you are having 12 beers the day
before....>>>>>I'm starting on Sunday because my wife will be off work and ready for the 911 call if necessary.<<<<<
VERY good idea! Hopefully that won't be necessary.
>>>>I won't be drinking anything (I never did drink wine or hard liquor) once I start Nardil.<<<<
Are you having the 12 beers the day before you
start Nardil as a sort of 'farewell to beer' party? If not, are you sure you won't have
trouble resisting beer once you start Nardil?
>>>>> Vomiting from withdrawal from alcohol? I've never vomited, or even passed out from drinking.<<<<I'm not a mind reader; I was just wondering if
THE NURSE friend thought that withdrawal from alcohol might make you vomit. Never passed out
from drinking? Lucky you...I've done it more times
than I can remember. That was before the MAOI I'm on helped me. Now I never drink to excess or even
want to.>>>>Old? You're only coming on 56.<<<<
Just HALF kidding...this bod has a lot of
problems so it feels older than it is...>>>>2 years and 40 days in Vietnam with the Marines will get me through. I'm still tough and want to do it my way.<<<<<
One of those tough Gyreens, eh? I know one
'Nam Marine who recently turned 70, and two
of his sons who were in the Marines during
the 1980's.Vietnam....those bad old days.
Posted by akston on March 2, 2007, at 11:11:28
In reply to Re: How soon to start Nardil after last beer? » akston, posted by Ken Blades on March 2, 2007, at 10:49:05
Yep, a goodbye to all alcohol. I can only promise myself I won't have a problem resisting beer once on nardil. It's like Antabuse--I call a "magic pill"--I know the consequences and never tested it. Had to clear that out of the system too before starting Nardil.
Sorry for your "old bod". I'm feeling older than 58, but still look younger so I'm told by my tolerant wife of going on 38 years of marriage. She doesn't drink, never has.
Semper Fi! to your Marine friends.
Yeh, this heavy drinking started in 1990, and then a total VA disability for PTSD. Didn't believe in it. I do now. Still I wouldn't trade my VN experience for anything. Don't know if allowed, but if you want to see my huge Marine Corps site--it's a very sober looking site--I'll send it along.
Thanks for all.
Posted by bulldog2 on March 2, 2007, at 15:09:00
In reply to Re: How soon to start Nardil after last beer?, posted by akston on March 2, 2007, at 11:11:28
I'm 59 going on 60. I sure remember those turbulent years in the US. It's a shame what happened to the vets back than. I mean how they were treated by the anti-war movement. In my mind they were always heros and still are.
There was a hedonistic movement (drugs sex), women's movement, anti-war, black power ETC. Those were some crazy times.
Been depressed on and off most of my adult life.When I was younger self medicated with drugs.Doc willing to try parnate. I have hypertension and a fear of the dietary restrictions. So I've been unable to make up my mind yet. Would love to feel some joy and excitement again in my life. Seems like parnate and nardil are the best meds for some but also carry that hypertensive risk. Everytime I would go to someone's house to eat I would have to interogate them about what's in the food.Wonder if taking .1 ml of clonidine before a meal would cut down on the risk.
Posted by Ken Blades on March 2, 2007, at 15:56:02
In reply to Re: How soon to start Nardil after last beer?, posted by akston on March 2, 2007, at 11:11:28
akston~
Good luck with your farewell to alcohol...your
wife will be happy to have you with her longer
and in better shape too.I look younger than my 56 but feel a lot
older; everything's on the inside so people
think I'm just complaining for complaining's
sake arrgh.>>>>Semper Fi! to your Marine friends.<<<<<
Will relay that!
>>>Yeh, this heavy drinking started in 1990, and then a total VA disability for PTSD. Didn't believe in it. I do now. Still I wouldn't trade my VN experience for anything.<<<<
It's like a lot of things...hard to believe
or wrap your brain around because it's not
familiar. Once it hits you THEN it all
becomes clear. Remembering just the TV
coverage of Vietnam is awful; being there
would be a nightmare.>>>>>Don't know if allowed, but if you want to see my huge Marine Corps site--it's a very sober looking site--I'll send it along.<<<<<
If you'd rather, you send it to me through
Babblemail where it will reach my registered
email address and not show up on the board.http://www.dr-bob.org/cgi-bin/pb/babblemail.pl
Regards~
Posted by Ken Blades on March 2, 2007, at 16:26:20
In reply to Re: How soon to start Nardil after last beer?, posted by bulldog2 on March 2, 2007, at 15:09:00
Lots of baby boomers here it seems!
Yup..those years were a real shakeup...
assasinations, riots, protests, 'Flower Power'...Woodstock...
and of course Vietnam.I ended up being antiwar after leaving my
parents sheltered world...but I never thought
ill of the vets..they didn't start the war
and it was shameful how many were treated
when they came home. I'm sure that reception
added to many of their psychiatric problems.Depressed just like you....started when I
got to college and the s^^t hit the fan
so to speak. My social phobia went into
overdrive but there was no such diagnosis
in the late 60's. Benzos and hypnotics
eventually, and TCA antidepressants that
didn't do much. I also self-medicated
with things you drink and things you
smoke in the past.Fast forward to the 90's...Parnate has
been the only thing that has helped. I
was hesitant because of the dietary
thing, but it really is not as bad
as it looks. I have hypertension partly
because of the Parnate[not from any food/tyramine
reaction...it just has that effect] but the greater responsibility goes to the weight I've
gained over the years. I take 40mg.
lisinopril daily and it keeps my BP
down to a nice number.When you're out to dinner, don't feel bad
about interrogating the preparer as to
the ingredients; you have a legitimate
reason..you're not doing it just to be
fussy. It's better than taking anything
beforehand to handle any reactions. You'll
become adept at selecting things you know
are safe; it's just the 'mixtures' you
really have to ask about or steer clear
because they might have those dreaded
aged cheeses melted in
them and you might not be able to tell
by looking.The chance that you'll feel better is
worth the hypertensive risk which is
small if you are just a bit careful.
This is the end of the thread.
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