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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Phoenix1 on January 29, 2008, at 16:06:14
Hi All,
Now that I'm at 75mg of Nardil, I'm noticing a new set of side effects. Specifically, very frequent uncontrollable yawning (without sleepiness) and jaw muscle tightness and clenching. I remember this as a side effect I had with most of the SSRI's, even at lower doses. Is this an indication of too much serotonin, or mild serotonin syndrome? It has been persistent for a week.
Is it a reason to stop at 75mg and not increase to 90mg? I'd like to go to 90 mg if possible. I'm a little afraid to talk much to my pdoc about side effects (especially if I feel they are minor) because he is only reluctantly prescribing the Nardil. I always feel that he is looking for a reason to stop it or lower the dosage. But it is working SO well for me.
This side effect isn't too bothersome, and I'm not really experiencing any other bothersome side effects except for insomnia. What do you think I should do?
Thanks
Phoenix
Posted by Bob on January 29, 2008, at 16:30:09
In reply to Nardil - Side Effects, posted by Phoenix1 on January 29, 2008, at 16:06:14
> Hi All,
>
> Now that I'm at 75mg of Nardil, I'm noticing a new set of side effects. Specifically, very frequent uncontrollable yawning (without sleepiness) and jaw muscle tightness and clenching. I remember this as a side effect I had with most of the SSRI's, even at lower doses. Is this an indication of too much serotonin, or mild serotonin syndrome? It has been persistent for a week.
>
> Is it a reason to stop at 75mg and not increase to 90mg? I'd like to go to 90 mg if possible. I'm a little afraid to talk much to my pdoc about side effects (especially if I feel they are minor) because he is only reluctantly prescribing the Nardil. I always feel that he is looking for a reason to stop it or lower the dosage. But it is working SO well for me.
>
> This side effect isn't too bothersome, and I'm not really experiencing any other bothersome side effects except for insomnia. What do you think I should do?
>
> Thanks
>
> Phoenix
I get the jaw and yawning thing on basically every single drug I've ever taken involving some sort of serotonin reuptake. The worst was on higher doses of Effexor, where I was clamping my jaw almost constantly and had to visit the dentist for a mouth guard since I was afraid I was going to crack my teeth. I'm not at all suprised that you are getting that side effect.
Posted by bleauberry on January 29, 2008, at 16:43:42
In reply to Nardil - Side Effects, posted by Phoenix1 on January 29, 2008, at 16:06:14
Since you say you are doing so well on it, I don't quite understand the need or the desire to keep increasing dose. Just because instructions say to reach this or that dose, or just because other people say a certain dose is better, is no reason for you to chase that. You go with what works and ignore everything else. And be glad for it. Maybe go back down to your previous dose and stay there a couple months to give the med more time, give your body more time to adjust, and then re-evaluate at that time.
Posted by Phoenix1 on January 29, 2008, at 17:01:05
In reply to Re: Nardil - Side Effects » Phoenix1, posted by Bob on January 29, 2008, at 16:30:09
> > Hi All,
> >
> > Now that I'm at 75mg of Nardil, I'm noticing a new set of side effects. Specifically, very frequent uncontrollable yawning (without sleepiness) and jaw muscle tightness and clenching. I remember this as a side effect I had with most of the SSRI's, even at lower doses. Is this an indication of too much serotonin, or mild serotonin syndrome? It has been persistent for a week.
> >
> > Is it a reason to stop at 75mg and not increase to 90mg? I'd like to go to 90 mg if possible. I'm a little afraid to talk much to my pdoc about side effects (especially if I feel they are minor) because he is only reluctantly prescribing the Nardil. I always feel that he is looking for a reason to stop it or lower the dosage. But it is working SO well for me.
> >
> > This side effect isn't too bothersome, and I'm not really experiencing any other bothersome side effects except for insomnia. What do you think I should do?
> >
> > Thanks
> >
> > Phoenix
>
>
> I get the jaw and yawning thing on basically every single drug I've ever taken involving some sort of serotonin reuptake. The worst was on higher doses of Effexor, where I was clamping my jaw almost constantly and had to visit the dentist for a mouth guard since I was afraid I was going to crack my teeth. I'm not at all suprised that you are getting that side effect.
>Yes, I also remember it being terrible on Effexor. That was probably the worst for yawning and jaw tightness.
Posted by Phoenix1 on January 29, 2008, at 17:17:02
In reply to Re: Nardil - Side Effects, posted by bleauberry on January 29, 2008, at 16:43:42
> Since you say you are doing so well on it, I don't quite understand the need or the desire to keep increasing dose. Just because instructions say to reach this or that dose, or just because other people say a certain dose is better, is no reason for you to chase that. You go with what works and ignore everything else. And be glad for it. Maybe go back down to your previous dose and stay there a couple months to give the med more time, give your body more time to adjust, and then re-evaluate at that time.
OK, I'm doing well on it but still have some bad days. For example last week, it was like someone turned the light off, and I woke up one day feeling very depressed and anxious. That lasted for 4 days and then on the 5th day I woke up feeling somewhat better, and by day 6 I was fine again. I thought I was relapsing or the nardil had pooped out for a few days.
So I'm not arbitrarily going to 90mg, but hoping that it will even things out and prevent the "down swings". I would like to find a dose that balances side-effects with benefits. If I don't see any benefits at the higher dose, then I'll go back down to 60 or 75mg. And it is widely recommended to reach the "maximum tolerable dose" of ADs for the best results. Also there is research that shows that 1mg/kg of Nardil may be needed for full effect, and that many patients are under-dosed. Not sure if that is always the correct strategy, but that's what I want to do.
Phoenix1
Posted by bulldog2 on January 29, 2008, at 17:23:00
In reply to Nardil - Side Effects, posted by Phoenix1 on January 29, 2008, at 16:06:14
> Hi All,
>
> Now that I'm at 75mg of Nardil, I'm noticing a new set of side effects. Specifically, very frequent uncontrollable yawning (without sleepiness) and jaw muscle tightness and clenching. I remember this as a side effect I had with most of the SSRI's, even at lower doses. Is this an indication of too much serotonin, or mild serotonin syndrome? It has been persistent for a week.
>
> Is it a reason to stop at 75mg and not increase to 90mg? I'd like to go to 90 mg if possible. I'm a little afraid to talk much to my pdoc about side effects (especially if I feel they are minor) because he is only reluctantly prescribing the Nardil. I always feel that he is looking for a reason to stop it or lower the dosage. But it is working SO well for me.
>
> This side effect isn't too bothersome, and I'm not really experiencing any other bothersome side effects except for insomnia. What do you think I should do?
>
> Thanks
>
> PhoenixI had that side effect on zoloft which can develope into TMJ. The use of one of the benzos (which have muscle relaxing properties) may be of great benefit. I also use a night guard when I can during the day which reminds me when I'm clenching and helps me relax the jaw.
Posted by Justherself54 on January 29, 2008, at 21:07:31
In reply to Nardil - Side Effects, posted by Phoenix1 on January 29, 2008, at 16:06:14
I posted but it didn't show up..must not have hit the confirm button..
I haven't experienced the yawning, but my jaw clenching is getting worse (I've been a clencher for years)..I broke a tooth (the filling was weak)..I'm a tooth grinder from childhood, so I'd better go find my mouth guard..
It may be something for you to consider..wear it at home and when you sleep..it should give you some relief..and prevent any damage to your teeth, especially if you have fillings that have been in for a long time..dang it..now I have to go to the dentist..glad to hear you're still doing well on Nardil..
Posted by Jedi on January 29, 2008, at 22:40:29
In reply to Nardil - Side Effects, posted by Phoenix1 on January 29, 2008, at 16:06:14
Hi,
The jaw clinching will lessen over time. I take 2mg of clonazepam, which lessens this symptom among other things; helps with social and generalized anxiety, helps with insomnia when combined with 25mg of Seroquel.I've read that some use Buspar for the condition. I have no personal experience with this medication.
Good Luck,
Jedi___________________________________________________________________
> Hi All,
>
> Now that I'm at 75mg of Nardil, I'm noticing a new set of side effects. Specifically, very frequent uncontrollable yawning (without sleepiness) and jaw muscle tightness and clenching. I remember this as a side effect I had with most of the SSRI's, even at lower doses. Is this an indication of too much serotonin, or mild serotonin syndrome? It has been persistent for a week.
>
> Is it a reason to stop at 75mg and not increase to 90mg? I'd like to go to 90 mg if possible. I'm a little afraid to talk much to my pdoc about side effects (especially if I feel they are minor) because he is only reluctantly prescribing the Nardil. I always feel that he is looking for a reason to stop it or lower the dosage. But it is working SO well for me.
>
> This side effect isn't too bothersome, and I'm not really experiencing any other bothersome side effects except for insomnia. What do you think I should do?
>
> Thanks
>
> Phoenix
Posted by Justherself54 on January 31, 2008, at 23:14:27
In reply to Re: Nardil - Side Effects » Phoenix1, posted by Jedi on January 29, 2008, at 22:40:29
I'm finding my balance is getting worse..I'm a good two-stepper but at a dance recently, I couldn't keep time at all..and I find that I have to catch myself at times as I feel I'm going to fall sideways..
Does this go away in time?
Posted by Phoenix1 on February 1, 2008, at 8:47:58
In reply to Re: Nardil - Side Effects, posted by Justherself54 on January 31, 2008, at 23:14:27
> I'm finding my balance is getting worse..I'm a good two-stepper but at a dance recently, I couldn't keep time at all..and I find that I have to catch myself at times as I feel I'm going to fall sideways..
>
> Does this go away in time?Agreed, my balance is off. It was never great before, but now I regularly run into things like door frames. It's not like I feel drunk or anything, the Nardil is just subtly effecting my balance. I sure hope it resolves over time.
Oh, and on the mouth guard thing, I have one and use it at night for the Nardil jaw clenching. It helps, but I bit a hole through it last night. So back to the dentist for a new one, maybe made from harder material. Thanks for the suggestions everyone.
Phoenix
This is the end of the thread.
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