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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by stargazer2 on August 15, 2007, at 13:37:38
After reading Michael's inspirational post about Nardil, I think I will give it a bit longer. I have been feeling quite useless and depressed ever since I had the hypertensive reaction about two weeks ago. It made me so scared I was convinced to go off it and try Celexa, Wellbutrin and Adderall again.
Now, I think I will try and add other medications to it. I know SLS has used Nortripyline, along with other meds. I have never tried Nortrip or any of the tricyclics so I'm tempted to do so. Also, I'm thinking about adding Lithium for some unknown reason, but alot has to do with other posts I have read recently.
Can Lithium be added to Nardil??? Anyone know????
Over the last week, I have only been on 30 Nardil and I have gotten more depressed. So on my own I added Lamictal, which caused me much cognitive decline at amounts above 100 mg, so I'm only taking 25 mg twice a day.
Can you tell I'm very desperate for finding something that can help me get out of where I am.
I'm waiting on endocrine labs that were drawn last week and I'm waiting for the nurse to follow up with me since she was away this week.
I see my pdoc on Friday and will have to tell him I've been experimenting on my own since waiting and doing nothing was excruciatingly difficult. (He has been away for 2 weeks)
I see no reason for being, no goals, no interest, no job, no friends, just my beloved pets who keep me company daily, but that isn't enough for me to say I am really living any worthwhile or meaningful life.
Why am I still here I often think, is there something that I'm supposed to be here for? I'm not sure but unless my husband reaches the breaking point with me, I will be OK with all this trial and error stuff. If I don't get well pretty soon, I will not be sure what I will do.
It's impossible to predict the future but there has to be more than what I have been going through the last 2-3 years.
I'm not sure what to do next...go back and try Celexa, stay with Nardil and add things to it, not sure at all, it is really not within my ability to sort this all out. I used to think I could understand what was going on with my meds and knowing what might work, but not anymore. I am stumped. That is what is really depressing. At least many other illnesses really have validated treatments but with depression there is only more wasted time. After so many years (20+), you have to start to lose hope. I don't have much time left to turn this around, I'm lost (sorry Michael) but that is my "uncensored" view of this situation.
Should I stay with Nardil(since 5/15, 3 mos exactly) and add to it? I'm so unsure of what to try next...Major symptoms are low self esteem, negativity, social anxiety, major anhedonia, inability to leave the house (3 or 4 days now). I don't know what to do anymore...
Can anyone tell me what I should do other than be patient and keep trying? I'm losing what little faith I have left, it is so debilitating and demeaning.
Stargazer
Posted by Phillipa on August 15, 2007, at 13:46:44
In reply to Nardil and what? Best add-ons for TRD?, posted by stargazer2 on August 15, 2007, at 13:37:38
Did the pdoc have any other suggestions? Could you be misdiagnosed as I think you once thought you could be ADD or was it the meds you wanted to augment with? So many combos out there. I am confident you will find a solution you have a lot of spunk. Love Phillipa
Posted by Jedi on August 16, 2007, at 12:59:20
In reply to Nardil and what? Best add-ons for TRD?, posted by stargazer2 on August 15, 2007, at 13:37:38
Stargazer,
Nortriptyline and other tricyclics that have very little effect on serotonin can be combined safely with Nardil. Caution is required. There is even some evidence that certain tricyclics can reduce the chance of a tyramine reaction.Gardenergirl has added lithium to Nardil with some success.
Take care,
JediHere are some references:
http://www.dr-bob.org/babble/20070604/msgs/761653.htmlA 3-year follow-up of a group of treatment-resistant depressed patients with a MAOI/tricyclic combination.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=7560546&ordinalpos=38&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSumTreatment response of depressed outpatients unresponsive to both a tricyclic and a monoamine oxidase inhibitor antidepressant.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8071301&ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSumThe combined use of MAOIs and tricyclics.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pubmed&LinkReadableName=Related%20Articles&IdsFromResult=6376486&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus> After reading Michael's inspirational post about Nardil, I think I will give it a bit longer. I have been feeling quite useless and depressed ever since I had the hypertensive reaction about two weeks ago. It made me so scared I was convinced to go off it and try Celexa, Wellbutrin and Adderall again.
>
> Now, I think I will try and add other medications to it. I know SLS has used Nortripyline, along with other meds. I have never tried Nortrip or any of the tricyclics so I'm tempted to do so. Also, I'm thinking about adding Lithium for some unknown reason, but alot has to do with other posts I have read recently.
>
> Can Lithium be added to Nardil??? Anyone know????
>
> Over the last week, I have only been on 30 Nardil and I have gotten more depressed. So on my own I added Lamictal, which caused me much cognitive decline at amounts above 100 mg, so I'm only taking 25 mg twice a day.
>
> Can you tell I'm very desperate for finding something that can help me get out of where I am.
>
> I'm waiting on endocrine labs that were drawn last week and I'm waiting for the nurse to follow up with me since she was away this week.
>
> I see my pdoc on Friday and will have to tell him I've been experimenting on my own since waiting and doing nothing was excruciatingly difficult. (He has been away for 2 weeks)
>
> I see no reason for being, no goals, no interest, no job, no friends, just my beloved pets who keep me company daily, but that isn't enough for me to say I am really living any worthwhile or meaningful life.
>
> Why am I still here I often think, is there something that I'm supposed to be here for? I'm not sure but unless my husband reaches the breaking point with me, I will be OK with all this trial and error stuff. If I don't get well pretty soon, I will not be sure what I will do.
>
> It's impossible to predict the future but there has to be more than what I have been going through the last 2-3 years.
>
> I'm not sure what to do next...go back and try Celexa, stay with Nardil and add things to it, not sure at all, it is really not within my ability to sort this all out. I used to think I could understand what was going on with my meds and knowing what might work, but not anymore. I am stumped. That is what is really depressing. At least many other illnesses really have validated treatments but with depression there is only more wasted time. After so many years (20+), you have to start to lose hope. I don't have much time left to turn this around, I'm lost (sorry Michael) but that is my "uncensored" view of this situation.
>
> Should I stay with Nardil(since 5/15, 3 mos exactly) and add to it? I'm so unsure of what to try next...Major symptoms are low self esteem, negativity, social anxiety, major anhedonia, inability to leave the house (3 or 4 days now). I don't know what to do anymore...
>
> Can anyone tell me what I should do other than be patient and keep trying? I'm losing what little faith I have left, it is so debilitating and demeaning.
>
> Stargazer
Posted by stargazer2 on August 17, 2007, at 8:57:45
In reply to Re: Nardil and what? Best add-ons for TRD? » stargazer2, posted by Jedi on August 16, 2007, at 12:59:20
I have heard that tricyclics were added to Nardil to help with insomnia. Since this has not been an issue for me, is there any other benefit that would come from adding a tricyclic, Nortriptyline, in particular, to Nardil. Is there a direct Ad effect as well as one for insomnia?
My thinking is that i do not need something to help with sleep so I do not want to take something that may make me feel any more letharic than I already do...
Thanks for any advice, sugestions on adding a tricylcic.......
Posted by stargazer2 on August 17, 2007, at 9:08:11
In reply to Re: Nardil and tricyclics? Anyone?, posted by stargazer2 on August 17, 2007, at 8:57:45
I have taken Lithium many years ago without any significant effect in supplementing the AD effect of a given AD.
So now being on Nardil for 3 months, I have reached a max effect of it's efficacy.
What could Lithium do to effect the less than satisfactory response to Nardil?
I am not bipolar but I have had no acceptable response to Ad's in many years.
My fear is that since I have never been able to get the depression into any, long term remission,it has become so recalcitrant that there are no meds that can alleviate the depressive symptoms at this time.
Short of ECT, which I would rather die than undergo, I can't figure out why nothing is working and no pdoc can help me anymore. Just more wasted time and life lost to this elusive illness.
Anyone have luck with lithium and Nardil? What benefits could I expect that nardil alone is not capable of on it's own?
Desperately seeking solutions.
Posted by UgottaHaveHope on August 18, 2007, at 4:52:29
In reply to Re: Nardil and tricyclics? Anyone?, posted by stargazer2 on August 17, 2007, at 8:57:45
SLS is the expert.
Here is one of his past posts on the subject:
Posted by blueboy on August 18, 2007, at 9:42:11
In reply to Nardil and what? Best add-ons for TRD?, posted by stargazer2 on August 15, 2007, at 13:37:38
How much Nardil?
If you feel lethargic, you might consider a higher dose. Most reports I have seen seem to consider it activating, and that was my personal experience with it.
I'd personally be unwilling to add any AD to Nardil. Any medical researcher who thinks he "understands" the mechanism of AD's (much less possible interaction of multiple AD's) is deluded. A huge amount of received knowledge in the area is not properly validated at best, and outright guesswork at worst. What solid knowledge does exist is (again IMHO) rather haphazard.
I will also say, I would rather try ECT than die, LOL. I'm sympathetic to your desire to avoid it, though. I'm in the same boat. My pdoc is big on it, but the medical establishment's record concerning integrity, transparency, and methodological soundness for ECT research/reporting is abysmal.
On that topic, I just don't understand how any doctor cannot express some degree of professional embarrassment concerning ECT. I wish that med schools would require completion of an hour course in hermeneutics, practical statistics, and decision-making.
But on the other hand, competent and honest psychiatrists often vouch for ECT from their personal experiences.
Posted by stargazer2 on August 21, 2007, at 12:07:53
In reply to Re: Nardil and tricyclics? Anyone?, posted by UgottaHaveHope on August 18, 2007, at 4:52:29
Well I saw my pdoc on Friday and we decided to try
Nortripyline and Nardil alone together. This has been considered a safe combination and so far, no troubles.I'm starting to worry about my lack of response to all meds lately and I am trying everything I can to get beyond this dull and unmotivated state.
Has anyone really doubted their diagnosis when all attempts to find a medication fails. I'm starting to think that the way I feel must be my normal state and I'm trying to achieve a state that does not exist for me. Else why have no meds worked very well.
Is this possible even though I have felt better for brief periods over the years? I'm running out of ideas and I've convinced myself that it's the depression that is making me like this. Maybe this is who I am, insecure, uninspired,and unmotivated. Maybe I'm looking for solutions that don't exist and I should be focusing on other things than meds? Who knows...
Stargazer
This is the end of the thread.
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