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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Girlnterrupted78 on May 27, 2008, at 18:40:09
I know there's many people on this site who are or have been on Nardil at some point in their lives.
Well, this question is for anyone who has stopped Nardil.
I was wondering if you could please tell me what is the fastest way you can safely stop Nardil? I know I need to wean myself off, but I want to do it in the fastest possible way without going insane.
Unfortunately, I have gained more weight than I can handle and it's hurting my self-esteem really bad. I'm taking 60mgs daily.
Could someone please help me? How do I stop Nardil fast? And what's the worst case scenario in the event I go a bit too fast?
I decided (on my own) to reduce 1/4 every 3 days. So I'm thinking of going: (A) 45mg for 3 days, (B) 30mg for 3 days, (C)15mgs for 3 days, and then ZERO.
This means I'd be getting off 60mgs in about 10 days.
After that I would wait 15 days to start another antidepressant.
I did not ask my doctor about this because he's made too many mistakes for me to trust him. If anyone remembers, this is the same doctor who sent me to the ER due to an overdose of Nardil (90mg.) He started me off on 45mgs, and when that didn't work, he put me on 90mgs right away. This caused me the worst headache I've had in my life. No food interaction--it was just the overdose. The minute I lowered the amount the headaches stopped.
So apparently he's not the best person to ask.Any advice from someone knowledgeable or experienced on this would be GREATLY appreciated.
Thank you in advance,
GI78
Posted by stargazer2 on May 27, 2008, at 20:35:34
In reply to Advice needed: Fastest way to wean off Nardil?, posted by Girlnterrupted78 on May 27, 2008, at 18:40:09
sorry about weight gain, I'm in the same boat as you but I can't stop Nardil since nothing else has ever worked for me except marplan but not the last time I tried it. It is too risky for me to stop and I just have to be fat and live with it or die and be thin or even just normal for now. I have tried to lose weight but I can't stay with anything long enough to lose. In some ways I blame myself for not being able to lose the weight on my own. I have never been overweight by more than 10 lbs or so in my life and now I have gained around 30#. You the same?
As far as stopping it, with Marplan I went cold turkey once since the drug was discontinued and I wasn't able to taper down. I would try to cut back 15 mg every 2 or 3 days as a guide line.
Sorry I don't have any documentation of how to reduce dosage. Have you tried to google this?
SG
Posted by Girlnterrupted78 on May 27, 2008, at 21:51:08
In reply to Re: Advice needed: Fastest way to wean off Nardil?, posted by stargazer2 on May 27, 2008, at 20:35:34
Thank you stargazer, it's been a long time!
Nardil is finally working for you? What did you do?Last time I heard from you, you were on 30-45mg and it wasn't working. You were augmenting without results.. right? So what combo did it for you?
Well, Nardil never worked for me. I was also waiting to get a new pdoc in order to augment, and the appointment is within the next 2 weeks, but I simply cannot wait any longer. I haven't gained as much as you seem to have, but about 15-20lbs. So you gained 30lbs?? How long did it take you to gain those pounds? For me it's been going very slow but nonstop. Probably 1-3lbs per month in the last 8 months. The first 3 or 4 months on Nardil I didn't gain, or at least I didn't think I did.
But now I can see a big gain, and this is simply more than I can handle. And now with the summer coming I can't see myself trying to cover up the extra weight. I've never been fat, and the only time I was slightly overweight (when I was 15) I remember being so miserable. Now it's all coming back..!!
I also have been trying to lose weight, have been trying to cut back on food and to exercise a lot, and still I won't lose a single pound. Especially that, like you, I also find it hard to stick with anything. After the 3rd day or so, I feel very hungry and I just blow it and start eating like a madwoman. It's just like your worst nightmare! You can't stop eating, and you can't stop gaining!
Anyway, I hope something will work out for you. How uncomfortable do you feel with those extra 30lbs? Is it causing you a lot of stress, or it's not that bad?
Have you asked your doctor if there's a way to counter this weight gain? So sorry to hear this. I am almost grateful that it's not working, because then I'd be in such a hard situation. I'd be trying to choose between my outer well-being vs my inner one, and it's not easy to give one up!
Let me know about my q's above please, and hope things get better.
Best,
GI78
(ONCE AGAIN: Sorry about the reposts. I don't know what's causing them, but it was certainly not me, maybe some connection error.)
> sorry about weight gain, I'm in the same boat as you but I can't stop Nardil since nothing else has ever worked for me except marplan but not the last time I tried it. It is too risky for me to stop and I just have to be fat and live with it or die and be thin or even just normal for now. I have tried to lose weight but I can't stay with anything long enough to lose. In some ways I blame myself for not being able to lose the weight on my own. I have never been overweight by more than 10 lbs or so in my life and now I have gained around 30#. You the same?
>
> As far as stopping it, with Marplan I went cold turkey once since the drug was discontinued and I wasn't able to taper down. I would try to cut back 15 mg every 2 or 3 days as a guide line.
>
> Sorry I don't have any documentation of how to reduce dosage. Have you tried to google this?
>
> SG
Posted by Justherself54 on May 28, 2008, at 0:17:48
In reply to Re: Advice needed: Fastest way to wean off Nardil? » stargazer2, posted by Girlnterrupted78 on May 27, 2008, at 21:51:08
I went off it by 15 mg per week..even at that I had constant brain zaps after reducing the first pill...I gained 30 pounds in 6 months...and I was overweight to begin with...plus other side effects that I couldn't tolerate. The brain zaps were the only thing I experienced and they continued for a couple of weeks afterwards. I don't think I could have done it faster...
Posted by Girlnterrupted78 on May 28, 2008, at 1:42:33
In reply to Re: Advice needed: Fastest way to wean off Nardil?, posted by Justherself54 on May 28, 2008, at 0:17:48
Thank you Justherself54. Were the brain zaps intolerable? Did they last the whole day? I've had them before (when discontinuing an SSRI), and I found them annoying, but I'd probably put up with them if I were able to recover my previous weight faster.
What are the other side effects that you couldn't tolerate? What happened to you weight once the Nardil washed out completely? Did you lose the weight?
I am on my 4th day of tapering off. First 3 days I reduced 1 pill (I was on 60mgs, so I went down to 45mg) Today's my first day on 30mgs. Nothing yet. I will continue this way.. until I'm off completely.
Did Nardil work out for you at all, Justherself54? Why did you decide to quit it? Did you augment it?
Thanks in advance for any info,
Girl78
> I went off it by 15 mg per week..even at that I had constant brain zaps after reducing the first pill...I gained 30 pounds in 6 months...and I was overweight to begin with...plus other side effects that I couldn't tolerate. The brain zaps were the only thing I experienced and they continued for a couple of weeks afterwards. I don't think I could have done it faster...
Posted by blueboy on May 28, 2008, at 9:43:23
In reply to Advice needed: Fastest way to wean off Nardil?, posted by Girlnterrupted78 on May 27, 2008, at 18:40:09
I stopped 60mg/day cold turkey after nearly 2 years. I had absolutely no withdrawal symptoms.
Posted by Justherself54 on May 28, 2008, at 11:31:50
In reply to Re: Advice needed: Fastest way to wean off Nardil? » Justherself54, posted by Girlnterrupted78 on May 28, 2008, at 1:42:33
> Thank you Justherself54. Were the brain zaps intolerable? Did they last the whole day? I've had them before (when discontinuing an SSRI), and I found them annoying, but I'd probably put up with them if I were able to recover my previous weight faster.
The brain zaps weren't intolerable..they just wore me out as they lasted througout the whole titration and the following two week washout..
>
> What are the other side effects that you couldn't tolerate? What happened to you weight once the Nardil washed out completely? Did you lose the weight?I had some urinary issues and the one side effect that caused to to come off Nardil was spontaneous vomiting in my sleep. My pdoc (and I) felt there was too much risk for asphixiation on it, so that's where my Nardil trial ended. The "Nardil weight" is almost completely gone (except for 2 pounds.
>
Did Nardil work out for you at all, Justherself54? Why did you decide to quit it? Did you augment it?Yes, it is a great AD...the weight gain was bad enough, but the barfing thing was the deal breaker!
Parnate, on the other hand, killed my appetite...go figure!
>
> Thanks in advance for any info,
> Girl78I hope you have a successful titration! I hope the brain zaps don't happen, but if they do I hope they are minor and short-lived!
Posted by SLS on May 28, 2008, at 14:16:46
In reply to Re: Advice needed: Fastest way to wean off Nardil?, posted by blueboy on May 28, 2008, at 9:43:23
> I stopped 60mg/day cold turkey after nearly 2 years. I had absolutely no withdrawal symptoms.
Wow. I experienced "brain zaps" and severe REM rebound with the abrupt discontinuation of Nardil. It is possible that being on it for 2 years produced changes in the brain that mitigated against withdrawal symptoms. My sensitivity to Nardil discontinuation syndrome has waned over the years, though.
- Scott
Posted by stargazer2 on May 28, 2008, at 21:10:30
In reply to Re: Advice needed: Fastest way to wean off Nardil? » stargazer2, posted by Girlnterrupted78 on May 27, 2008, at 21:51:08
Hi again GI, I wasn't sure if you remembered me but we talked a few times perhaps a year or so ago. I have been off PB more than on, I sometimes just read for old times sake.
I'm on so many meds right now (Synthroid, an antibiotic, meds for pain, Vitamins) but Nardil at 60 is the mainstay for my depression. Occasionally I add a small amount of Seroquel for anxiety, but the Nortriptylline and other meds I added didn't do much. It's such a fine line sometimes with knowing what is working or just holding you steady.
I too gained weight slowly and wasn't even aware of the weight gain until around October and I had statred Nardil around April or May. I'm not using my notes just trying to remember things off the top of my head which is very difficult when it comes to what meds I was on, what dosage and for how long. I consulted a high level researcher at Yale who wasn't all that helpful since at the time, Nardil was starting to do something.
I did see a very progressive endocrinologist and I was started on Synthroid, which may have boosted my thyroid and thusly my mood. He called me borderline hypothyroid and felt that a lower TSH was something that should be evaluated in depressives, especially someone like me who over time never had good results with meds. I'm sorry I didn't push for this sooner. That may have made a difference in my response. Have you seen an endo yourself? It may be beneficial since even a "normal" level of TSH can be beneficial when it's reduced to 1 or 2.
The weight gain is troubling of course since all my size 12 pants are too tight so I had to buy a larger size, ughhh...but I have to bear with it since I am functional now. I'm not feeling happy but mostly balanced I guess I would term it.
I would love to try another med, but what one(s), every med I've tried was useless or harmful, and I was losing out on life big time. At my age, a year is a major loss of life and I couldn't risk being housebound and purposeless for any longer. I wanted to work again since I had no self esteem left from doing nothing. So despite the negative side effects, I do have most of my life back, at least enough to get out and work and make some money which seriously helps ones life as long as the job doesn't cause you to crash and burn. I do fear that I will wake up one day and not be able to function again. It's only been 3 months since I started to work. When I feel good I am a highly functional person and it surprises me how far I fall when depression takes over. I become a crying, hateful sack of negativity and doubt I'll ever be helped again. This last time I thought I would have to give up.
Keep in touch and write me through babble any time. I hope you find a drug that can help you too. Is there a particular med you you think you should try next????
SG
Posted by Phillipa on May 29, 2008, at 0:01:27
In reply to Re: Advice needed: Fastest way to wean off Nardil?, posted by stargazer2 on May 28, 2008, at 21:10:30
Stargazer read my thread on hasimotos thyroiditis and prozac and amphetamines it's an eye opening at least it was to me as I had seen that trend for years of people coming into psych with thyroid problems and see the synthroid helped you too. Miss you write when you can. Love Phillipa
Posted by Girlnterrupted78 on May 29, 2008, at 16:06:37
In reply to Re: Advice needed: Fastest way to wean off Nardil?, posted by stargazer2 on May 28, 2008, at 21:10:30
Hi Stargazer, I'm glad to hear you're feeling that well on 60mgs of Nardil. I recall that you didn't want to go beyond 45mgs for some reason.. but I can't remember the reason.
I haven't seen an endo, but I'm switching pdocs, so I will probably suggest seeing one.I also didn't realize the weight gain until about November! One woman at work told me I was gaining a bit of weight and I remember trying to lose, losing 4 pounds, and gaining them back right away. It was frustrating--I could not keep the weight off.
I'm not sure what medication to take next. I was thinking of maybe going back to Celexa and adding lithium. But that's just my opinion, I will see a new doctor and see what he recommends. Maybe he comes up with something better. At some point I was interested in trying Remeron, but I've heard it also causes weight gain! so I'm reluctant. I always thought that since I go to the gym and take care of myself, I would probably not gain. But Nardil proved me wrong. No matter how hard I tried, I felt starved and my metabolism slowed down a LOT. I could feel myself losing weight in a week, but the starvation of the next week would make me gain immediately what I had lost. So no, I cannot do it with diet and exercise. Your metabolism slows to a point where you really can't lose.
Anyway, I'm on my 6th day of tapering off Nardil. I did 3 days on 3 pills, and this is my 3rd day on 2 pills. Now I only have 3 days on one pill and then zero!! So far I haven't felt any brain zaps or any other side-effects. The only thing I'm starting to feel is less hungry.. I hope I'm not having the placebo effect just because I know this is supposed to happen, but somehow I don't feel starved like I felt on the full dosage of Nardil.
Anyway, I'd be interested in finding out how you were able to go up to 60mgs when you were having trouble at 45mgs and even had to go down to 30mgs at some point. How did you manage to do that?
Best of luck,
GI
Posted by Justherself54 on May 29, 2008, at 17:53:23
In reply to Re: Advice needed: Fastest way to wean off Nardil? » stargazer2, posted by Girlnterrupted78 on May 29, 2008, at 16:06:37
So glad to hear you're having success in weaning off Nardil with no brain zaps. I've just restarted Parnate. It has been the only AD where I've actually lost weight. I hope you are able to find something that really works well for you.
Posted by Crotale on June 2, 2008, at 16:23:26
In reply to Re: Advice needed: Fastest way to wean off Nardil? » stargazer2, posted by Girlnterrupted78 on May 29, 2008, at 16:06:37
Good luck with this. Tapering like you are doing sounds like a good idea. I had a doctor make me go off Nardil cold turkey and I had horrible REM rebound, depression, and panic attacks.
On the bright side, I was able to lose the weight quite rapidly once I was off the stuff. (Something to do with the return of my depression, no doubt!)
Crotale
Posted by Girlnterrupted78 on June 2, 2008, at 21:56:35
In reply to Re: Advice needed: Fastest way to wean off Nardil? » Girlnterrupted78, posted by Crotale on June 2, 2008, at 16:23:26
Thanks for the comments.
I'm on day #10 of tapering off Nardil. Today I stop taking Nardil completely.I did have some slight brain zaps today, but they came only in certain situations--i.e. when I was falling asleep and my eyes were closing, then the brain zap would come, but much milder than what I had experienced on SSRI's.
I also don't feel as obsessed with food. I hope I can rid myself of the weight soon. Thanks again. Keep posting if you have any experience on this please. I'm out of this, but still interested in hearing about other cases.
Posted by Justherself54 on June 2, 2008, at 23:38:31
In reply to Re: Advice needed: Fastest way to wean off Nardil? » Crotale, posted by Girlnterrupted78 on June 2, 2008, at 21:56:35
> Thanks for the comments.
> I'm on day #10 of tapering off Nardil. Today I stop taking Nardil completely.
>
> I did have some slight brain zaps today, but they came only in certain situations--i.e. when I was falling asleep and my eyes were closing, then the brain zap would come, but much milder than what I had experienced on SSRI's.
>
> I also don't feel as obsessed with food. I hope I can rid myself of the weight soon. Thanks again. Keep posting if you have any experience on this please. I'm out of this, but still interested in hearing about other cases.I'm glad to hear you didn't have too many brain zaps. My Nardil weight dropped off fairly quickly (thank goodness)..hope it does for you too!
>
>
Posted by Girlnterrupted78 on June 3, 2008, at 23:41:09
In reply to Re: Advice needed: Fastest way to wean off Nardil?, posted by Justherself54 on June 2, 2008, at 23:38:31
Thanks justherself54,
How long did it take you to lose those 30lbs?So far, I'm on my 2nd day on zero Nardil. I'm not having full brain zaps, but only the feeling of discomfort that accompanies the brain zaps. But it's not too bad thank god.
The thing I've noticed so far is that my appetite has changed dramatically. While on Nardil, I was obsessed with anything that had carbs and was sweet. Right now I can't think too much of those things and feel more like having something sour, like limes, and something fresh like strawberries! I wouldn't have my usual peanut butter & honey sandwich that became the staple of my diet while on Nardil. I would simply crave those sandwiches, and would eat bananas like a maniac.Anyway, what medication did you take after Nardil, and did it work? Thanks!
Posted by Justherself54 on June 4, 2008, at 0:33:37
In reply to Re: Advice needed: Fastest way to wean off Nardil? » Justherself54, posted by Girlnterrupted78 on June 3, 2008, at 23:41:09
>
> How long did it take you to lose those 30lbs?Very quickly..about 1 1/2 months.
>
> So far, I'm on my 2nd day on zero Nardil. I'm not having full brain zaps, but only the feeling of discomfort that accompanies the brain zaps. But it's not too bad thank god.I'm so glad to hear that coming off it was easy for you. That's great!
> The thing I've noticed so far is that my appetite has changed dramatically. While on Nardil, I was obsessed with anything that had carbs and was sweet. Right now I can't think too much of those things and feel more like having something sour, like limes, and something fresh like strawberries! I wouldn't have my usual peanut butter & honey sandwich that became the staple of my diet while on Nardil. I would simply crave those sandwiches, and would eat bananas like a maniac.It was like that for me too...had no interest in eating a pound of chocolate at night or whatever I could get my hands on. I take 25 mg of seroquel at bed and I have to watch the sweet cravings with that. If I stay up after I take it I get the extreme munchies.
> Anyway, what medication did you take after Nardil, and did it work? Thanks!
I've just started Parnate...so far, so good. Parnate doesn't make me crave carbs or sweets. Good side effect!
Posted by Girlnterrupted78 on June 6, 2008, at 4:22:44
In reply to Re: Advice needed: Fastest way to wean off Nardil?, posted by Justherself54 on June 4, 2008, at 0:33:37
This is an update. I have been 4 days on zero Nardil after tapering 60mgs every 3 days: 3daysx45mgs, 3daysx30mgs, 3daysx15mgs, then zero.
Everything was fine, but the last 3 days I've had a headache and it doesn't go away. I guess it all seemed to good to be true.
What should I do now? Is this going to go away? I recall someone mentioned that some withdrawal symptoms were permanent! I hope this is not the case, but is it possible?
If somebody knows what happens when quitting Nardil the way I did, I'd appreciate any info/advice on the matter.
Thanks,
Girl78
This is the end of the thread.
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