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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by 4WD on May 3, 2008, at 19:01:59
Hi all,
Just wanted to update my Nardil experience. I've not had a great day today so it's maybe not the best day to post but I feel okay right now.
I am still having days where I am depressed. I sometimes have spells of depression which last a few hours. But I hope that after I've been on Nardil for a full 12 weeks, that will stop. When I have those bad days or spells, I drink caffeine and that seems to help my motivation and lessens the depression.
Trouble is my anxiety level is through the roof. I have had days where I have had to take 30 mg of Valium in addition to my 1mg of Klonopin. This all started about a week ago. Before that I was fine on 15mg of Valium and 1.5 mg Klonopin. I know it's not the lowering of the Klonopin dose that is doing it because it started before I lowered the dose. When I have those depressed spells, I drink caffeine to feel better and then I get even more anxious so I have to take more benzos. It's a fine line.
I am trying to treat the increased anxiety by lowering my Geodon dosage. I'm going from 80mg a day to 60. It's the only thing I can think of to do. I am also going to ask my pdoc on Thursday if I can try a short trial of Xanax instead of Valium to see if it works better. I already have some Xanax and I find that it does take care of the anxiety better but it doesn't last very long.
Can anybody figure out why I am suddenly more anxious? I have tried skipping caffeine entirely one day and I was still scared all day, although not quite as bad. It sometimes doesn't matter how much benzos I take, I am still scared. The day I took 30 mg of Valium I was still scared all day. I don't know what's going on.
The other problem is my blood pressure. It is fluctuating a lot. Occasionally it is roughly normal but usually it is either too high (160/110) or too low (55/40). When I first get up in the morning, I feel very faint and lightheaded and have to keep my head between my legs a lot. This usually lasts about an hour. Then I have spells during the day where it feels like it has dropped really low because I feel so faint. When I measure it, sometimes it is normal and sometimes it is remarkable low.
I bought a blood pressure monitor and starting using it. I had thought my BP was low all the time and that was causing the faintness. So I had been drinking salt water every day (about 2 pints with a teaspoon of salt in each pint). Imagine my surprise when I first measured my BP and it was 180 over something. So I quit drinking the salt water. I don't know if it's better for it to be too high or too low. In any case, there is nothing I can do about it so I have turned it over to God to handle. He'll work something out. My hope is that as I get more used to the Nardil the BP will stabilize more.
But the increased anxiety is what's driving me crazy. I don't WANT to take 30mg of Valium a day. It's too much. But sometimes it's that or be very very scared all day. Any suggestions?
In general, though I am feeling so much better than before I went on the Nardil. I have my life back now. I can clean the house and clean out closets and accomplish stuff. I have more energy and motivation and except for the days or spells of depression, I am not depressed anymore.
Nardil is a wonder drug. I wish I had had the courage to try it years ago instead of staying on the SSRI/SNRI merry-go-round so long. It's the first AD that has worked since I got so sick four years ago. The dietary restrictions don't bother me much. I just miss Chinese food and I don't like having to check the ingredients on everything I buy. I don't eat out so that's not a problem.
Please, someone, tell me what to do about the extremely increased anxiety/scaredness. Or at least tell me what could be causing it.
Marsha
Posted by bulldog2 on May 3, 2008, at 19:22:59
In reply to 8 weeks on Nardil, posted by 4WD on May 3, 2008, at 19:01:59
Cut out the caffeine or lower the amount to one cup a day. I've found that my anxiety is higher after a cup of coffee and bp also. There also may be an interaction between caffeine and nardil.
Posted by 4WD on May 3, 2008, at 19:29:00
In reply to 8 weeks on Nardil, posted by 4WD on May 3, 2008, at 19:01:59
I forgot to say about the anxiety and scaredness - it's not typical anxiety. It is a feeling of physical fear. I'm not afraid of anything; there is nothing worrying me that I'm anxious about. I am just phsycially scared. It mostly resides in my stomach and chest. It's not related to anything - it's just physical fear.
Marsha
Posted by fayeroe on May 3, 2008, at 19:31:00
In reply to p.s. about the anxiety, posted by 4WD on May 3, 2008, at 19:29:00
> I forgot to say about the anxiety and scaredness - it's not typical anxiety. It is a feeling of physical fear. I'm not afraid of anything; there is nothing worrying me that I'm anxious about. I am just phsycially scared. It mostly resides in my stomach and chest. It's not related to anything - it's just physical fear.
>
> Marsha
Marsha, I also experience that. I' m not scared but I am. I even wake up, with a start, feeling it. I have a large dog inside and one outside, it isn't like I am afraid here at home. I don't know what the deal is.
Posted by Phillipa on May 3, 2008, at 20:03:38
In reply to Re: p.s. about the anxiety » 4WD, posted by fayeroe on May 3, 2008, at 19:31:00
Marsha have you done the tilt test yet at the docs? Also was thinking are you positive the monitor you bought is accurate? No caffeine either. I will do a search later and see if I can find any corrolation. Thyroid is fine right? Love Phillipa
Posted by 4WD on May 3, 2008, at 20:38:10
In reply to Re: 8 weeks on Nardil, posted by bulldog2 on May 3, 2008, at 19:22:59
> Cut out the caffeine or lower the amount to one cup a day. I've found that my anxiety is higher after a cup of coffee and bp also. There also may be an interaction between caffeine and nardil.
But what do I do on the days or during the spells where I feel depressed and caffeine is the only thing that will pick me back up? It's like a decision between depression (no caffeine) and anxiety (caffeine). And I can treat the anxiety with meds.
Also, this only started, as I said, about a week ago. Before that, I was drinking a lot (relatively) of caffeine and it wasn't making me scared.
Marsha
Posted by 4WD on May 3, 2008, at 20:39:38
In reply to Re: p.s. about the anxiety » 4WD, posted by fayeroe on May 3, 2008, at 19:31:00
> > I forgot to say about the anxiety and scaredness - it's not typical anxiety. It is a feeling of physical fear. I'm not afraid of anything; there is nothing worrying me that I'm anxious about. I am just phsycially scared. It mostly resides in my stomach and chest. It's not related to anything - it's just physical fear.
> >
> > Marsha
>
>
> Marsha, I also experience that. I' m not scared but I am. I even wake up, with a start, feeling it. I have a large dog inside and one outside, it isn't like I am afraid here at home. I don't know what the deal is.How do you treat it? Benzos? Or do you just endure it. I don't know what is causing it but it sure sucks.
marsha
>
Posted by 4WD on May 3, 2008, at 20:45:12
In reply to Re: p.s. about the anxiety, posted by Phillipa on May 3, 2008, at 20:03:38
> Marsha have you done the tilt test yet at the docs? Also was thinking are you positive the monitor you bought is accurate? No caffeine either. I will do a search later and see if I can find any corrolation. Thyroid is fine right? Love Phillipa
I don't think I'm going to do the tilt table test. AFter all, I know it's from the Nardil. So why test it? If the BP fluctuations were happening on their own, I'd have the test but I know it's from Nardil since it only started after I'd been on Nardil a few weeks.
Yes, I think the monitor is relatively accurate. It might be off a few points but I went to the fire dept. and had them check my blood pressure then I immediately checked it again with my monitor and it was very close to the same.
Yes, I know I need to give up the caffeine. But I'm scared whether I drink caffeine or not. ANd the caffeine treats the spells of depression. I guess I need to learn to accept that I am not completely well yet and will have spells of depression and just accept them and not try to treat them. But it's so hard, when I know I can feel better in 15 minutes or so if I drink a cup of coffee. And the anxiety doesn't come till later.
ANd my thyroid is fine. Just had it checked a couple of weeks ago.
Marsha
Posted by Phillipa on May 3, 2008, at 21:01:13
In reply to Re: p.s. about the anxiety » Phillipa, posted by 4WD on May 3, 2008, at 20:45:12
Good bases are covered. I don't know what to make of the caffeine and anxiety and depression. Hold on could it be the lowering of geodon as you once posted that it kept you from being scared in the am. Why are you decreasing it anyway? Thought it was the klonopin? Love Phillipa
Posted by SLS on May 4, 2008, at 5:01:47
In reply to 8 weeks on Nardil, posted by 4WD on May 3, 2008, at 19:01:59
From my experience with Deplin, I think it is worth a try at a dosage of 1/2 pill. You can start with a whole pill if you want, but if you get diminishing returns after a period of robust response, you should try to lower the dosage. One indicator of this would be excessive daytime sleepiness and vivid dreams or fitful sleep. The interesting thing about Deplin is that it can take 2-3 months to work. However, you might experience a short "blip" improvement in the first week that lasts a day or so. You might get some insomnia or choppy sleep early on. My guess is that this, along with the blip, is a good sign.
Since it takes Deplin so long to work, you might as well add it in now and keep it onboard for further drug trials if necessary. I bet it won't be though.
- Scott
Posted by octothorpe on May 4, 2008, at 7:42:01
In reply to 8 weeks on Nardil, posted by 4WD on May 3, 2008, at 19:01:59
Are you on 30 mg now or 45? I find Nardil to have good anti-anxiety/fear properties, but I am at 90 mg. I was taking 2 mg Klonopin for over 10 years, and was able to quit rather quickly after starting Nardil.
Do you smoke? That really increased my anxiety and gave me palpitations after I started Nardil (it didn't before). Within about 2 weeks, I was able to quit and that helped.
Odd, I know.
Hope this gets evened out for you. If not, why not give some thought to Parnate? It is another proven MAOI with perhaps fewer side effects and slightly different action.
Posted by 4WD on May 5, 2008, at 12:16:15
In reply to 8 weeks on Nardil, posted by 4WD on May 3, 2008, at 19:01:59
Hi all,
Just realized a couple of days ago that I mostly posted negative stuff. There's a lot of good that's happening in spite of the horrible scaredness.
Side effects I don't have: insomnia. I was told by my family doctor not to take my last dose after 3 pm. It really makes a difference. Most nights i sleep a full 8 hours. I still occasionally wake up at 3 or 4 but it's rare.
Constipation: I eat prunes at night. Works much better than Miralax.
Food cravings: Not having any of those at all.
Diet: Having no problem following the diet.
Weight gain: None.
So all I'm really having trouble with is the spells of faintness especially in the mornings and the liver enzyme issue. But I have started taking milk thistle. If that doesn't work I will switch to methionine.
I also have depressed spells in the afternoon sometimes. Don't know what that's about. Some days I have depression all day but I think that's a function of the scaredness.
I think if I didn't have the scaredness issue, I would be doing great on Nardil. As it is, I am still doing very well on Nardil. It beats any AD I;ve ever taken overall. And I did tell my pdoc I was willing to endure any side effect if Nardil gave me my life back. And it has certainly done that.
Anyway hated to leave you with such a negative post earlier.
Marsha
This is the end of the thread.
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