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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by francineus on February 9, 2008, at 7:22:22
I started nardil on 2/1 at 45mg. not feeling much except I cry a little less and am a bit foggy and tired. Is this typical for early side effects or is this perhaps not the med for me? Seeing my pdoc on Tues. Should I recommend increase. Or do I just need to settle down and be more patient?
Mucho thanks
Posted by squatlover on February 9, 2008, at 8:47:49
In reply to Nardil since 2/1 at 45mg Waiting for effect ...., posted by francineus on February 9, 2008, at 7:22:22
starting 2nd of jan? How much do you weigh? I am not really getting much of an effect at 4 weeks but I am going to patient at 60mg (I weigh 73kg) and give it another 2 weeks before upping to 75.
Posted by bulldog2 on February 9, 2008, at 9:54:14
In reply to Re: Nardil since 2/1 at 45mg Waiting for effect ...., posted by squatlover on February 9, 2008, at 8:47:49
> starting 2nd of jan? How much do you weigh? I am not really getting much of an effect at 4 weeks but I am going to patient at 60mg (I weigh 73kg) and give it another 2 weeks before upping to 75.
I believe he said 2/1 and that is not long enough to evaluate.
Posted by Jedi on February 9, 2008, at 18:57:19
In reply to Nardil since 2/1 at 45mg Waiting for effect ...., posted by francineus on February 9, 2008, at 7:22:22
> I started nardil on 2/1 at 45mg. not feeling much except I cry a little less and am a bit foggy and tired. Is this typical for early side effects or is this perhaps not the med for me? Seeing my pdoc on Tues. Should I recommend increase. Or do I just need to settle down and be more patient?
> Mucho thanksHi,
The most quoted effective dose for Nardil is 1mg per kilogram of body weight. In other words, if you weigh 170 pounds; divide 170 by 2.2 (there are 2.2 pounds in a kilogram) and you come up with 77mg per day. This is roughly five 15mg pills per day. Of course everyone is different and the effective dose for you may be higher or lower. To avoid excessive side effects I would titrate up about one 15mg per week. Sometimes it takes four to six weeks after reaching the effective dose for the med to work. I hate trial and error. If it does work for you, this is one medication that will have clear results. When it works, it can be like turning on a switch. I have never had this kind of result from any other AD.
Good luck,
Jedi
Posted by tapiocamonk on February 10, 2008, at 6:50:10
In reply to Re: Nardil since 2/1 at 45mg Waiting for effect .... » francineus, posted by Jedi on February 9, 2008, at 18:57:19
> Hi,
> The most quoted effective dose for Nardil is 1mg per kilogram of body weight. In other words, if you weigh 170 pounds; divide 170 by 2.2 (there are 2.2 pounds in a kilogram) and you come up with 77mg per day. This is roughly five 15mg pills per day. Of course everyone is different and the effective dose for you may be higher or lower. To avoid excessive side effects I would titrate up about one 15mg per week. Sometimes it takes four to six weeks after reaching the effective dose for the med to work. I hate trial and error. If it does work for you, this is one medication that will have clear results. When it works, it can be like turning on a switch. I have never had this kind of result from any other AD.
> Good luck,
> Jedi
>Let me just emphasize everything that Jedi said. I would certainly take your time and titrate up to AT LEAST the 1mg/kg level, waiting a minimum of a week (preferably 2-3 if you have the patience) at each dose level, then at least 4-6 weeks once you get up to 75mg before you move up to 90mg.
Like everyone who takes Nardil, I have been on plenty of other meds before this (I'd say 15 different meds in dozens and dozens of different combinations over the past 14 years) and there is just nothing in the world like Nardil. There are few (none?) who this drug doesn't work for as long as they have given it an adequate trial. And when Nardil works, it works better than anything!!!!
Posted by francineus on February 12, 2008, at 17:30:35
In reply to Re: Nardil since 2/1 at 45mg Waiting for effect .... » francineus, posted by Jedi on February 9, 2008, at 18:57:19
Day 11 now....Noticed that I'm not as tearful and AM tired more (drinking diet coke to counteract)
But not feeling too much in the way of AD effect yet. Kind of irritable actually and "uppity!"
Do I just need to wait longer? Is it too early to tell...Phoenix maybe you can respond :)
Guess I just need reassurance and hand holding..what a wuss! Doc said stay at 45 mg for now...should I increase next week. I weigh 140 lbs, so according to Jedi's comment I should be taking about 60mg maybe?
Thanks all!
Posted by Phoenix1 on February 13, 2008, at 7:36:37
In reply to nardil day 11 -- phoenix are you there?, posted by francineus on February 12, 2008, at 17:30:35
> Day 11 now....Noticed that I'm not as tearful and AM tired more (drinking diet coke to counteract)
>
> But not feeling too much in the way of AD effect yet. Kind of irritable actually and "uppity!"
>
> Do I just need to wait longer? Is it too early to tell...Phoenix maybe you can respond :)
>
> Guess I just need reassurance and hand holding..what a wuss! Doc said stay at 45 mg for now...should I increase next week. I weigh 140 lbs, so according to Jedi's comment I should be taking about 60mg maybe?
>
> Thanks all!
>
>Hi Francineus,
Day 11 is still too early to make a decision on how effective you think Nardil is. You need to give it a full 2-3 months to be fair. As for dose increases, if you are handling the side-effects OK, you should aim for the magic goal of 1mg/kg. This amount is not right for everyone, but it has been reviewed in literature a few times as a maximally safe and effective dose. Yes, for you that would be 60mg. Again, if you can handle another increase in terms of side effect levels at 45mg, I think you should try it. But there's no harm at staying at 45mg for a while longer. That dose may work for you, but you just have to give it time 11 days isn't long enough. I really hope Nardil works as well for you as it has for others on this board. Best of luck to you. Feel free to post more questions or to Babblemail me directly if you'd like to talk more.
Phoenix1
Posted by francineus on February 13, 2008, at 9:35:12
In reply to Re: nardil day 11 -- phoenix are you there? » francineus, posted by Phoenix1 on February 13, 2008, at 7:36:37
Thank you phoenix. Was what I needed to hear.:)
Will be patient and then call doc to increase in a couple of weeks.
Posted by Phoenix1 on February 14, 2008, at 7:50:49
In reply to Re: nardil day 11 -- phoenix are you there?, posted by francineus on February 13, 2008, at 9:35:12
> Thank you phoenix. Was what I needed to hear.:)
> Will be patient and then call doc to increase in a couple of weeks.Good for you francineus. Just be patient and don't give up too quickly. It's been a wonderful life-saving med for myself, and for many others on this board, so give Nardil a good long trial to see how much potential it has for you.
Good luck!
Phoenix1
Posted by 4WD on February 20, 2008, at 21:10:58
In reply to Re: nardil day 11 -- phoenix are you there? » francineus, posted by Phoenix1 on February 14, 2008, at 7:50:49
I think Phoenix had good advice. I am planning to start Nardil myself (I will have to go though the 2 week washout period from Celexa first).
But it good to have someone tell you to be patient and let the medicine work. I have always been the type that if I don't feel any better in a week or two, then I want to give up. I will keep Phoenix's post in mind when I start feeling that way if the Nardil doesn't help as quickly as I think it "ought" to.
But I thought I read somewhere that some people experience a kind of immediate effect the first week- almost a euphoric hypomanic effect. I sure hope that happens for me. It would give me somehting to hang on to while waiting for it to work.
Marsha
Posted by Jedi on February 21, 2008, at 0:52:42
In reply to Re: nardil day 11 -- phoenix are you there?, posted by 4WD on February 20, 2008, at 21:10:58
Marsha,
I had a feeling of euphoria when Nardil first started working. I would call it a hypomanic state. It took over a month to get to this point, don't be upset if all you get is side effects the first week.I used about 4mg of clonazepam to get me through the anxiety and depression until the Nardil kicked in. When it did work it was like overnight. One day I felt terrible, the next day I felt great. The hypomanic feeling is not the true antidepressant affect of Nardil, but a lot of people get it when they are first starting out. Don't let your MD talk you out of Nardil because of the hypomania. This side effect will pass, and you'll probably wish it would come back.
More than likely you will need something for sleep. Seems like insomnia is almost a universal side effect of Nardil. Plan for this. At first I took trazodone, but I didn't like the really drugged out feeling, even in the morning. Ask your doctor. The best for me has been 2mg of clonazepam (which also helps with my general and social anxiety) plus 25mg of Seroquel (which is a very small dose). Everyone is different, but I sleep well every night on this combination.
Be Well,
Jedi
_____________________________________________________________________> I think Phoenix had good advice. I am planning to start Nardil myself (I will have to go though the 2 week washout period from Celexa first).
>
> But it good to have someone tell you to be patient and let the medicine work. I have always been the type that if I don't feel any better in a week or two, then I want to give up. I will keep Phoenix's post in mind when I start feeling that way if the Nardil doesn't help as quickly as I think it "ought" to.
>
> But I thought I read somewhere that some people experience a kind of immediate effect the first week- almost a euphoric hypomanic effect. I sure hope that happens for me. It would give me somehting to hang on to while waiting for it to work.
>
> Marsha
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