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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 tepi on May 4, 2009, at 23:05:21
This has happened me all the times during all the years I have been on med.
It happened again today , Im on 45mg of Nardil
increasing gradually to 60. I took for the first time the 60mg like this -
6 AM - 15mg
10 AM - 30 mg
3 PM - 15 mgI felt a very good effect on my fear to people after 2 hrs of taking 30 mg . I was very sociable and talking wiht selfconfindence.
This has happened to me in the past. The problem is that this good effect only last during the first day. This happen wiht most of the drugs I have takne but I feel a better effect with Nardil
What is this ? Im gonna have to make a plan to be decreasing - increasing the dose to have at leats some good days
Anybody has any idea why this happen? I would do or give anythng to have this effect all the time.
All my problems, All my life will be fixed feeling this way.
Tepi
Posted by Phillipa on May 4, 2009, at 23:35:17
In reply to Why after increasing the dose? SLS-Anybody pls, posted by tepi on May 4, 2009, at 23:05:21
Tepi wierd as not on what you are but one day feel good then bad. Can't figure it out either? Strange and not good. Love Phillipa
Posted by jedi on May 5, 2009, at 3:45:56
In reply to Why after increasing the dose? SLS-Anybody pls, posted by tepi on May 4, 2009, at 23:05:21
> I felt a very good effect on my fear to people after 2 hrs of taking 30 mg . I was very sociable and talking wiht selfconfindence.
>
> This has happened to me in the past. The problem is that this good effect only last during the first day. This happen wiht most of the drugs I have takne but I feel a better effect with Nardil
>
> What is this ?Tepi,
IMHO any benefit from any mainstream antidepressant during the first day is a placebo effect. These medications just take much longer than a day to work. With Nardil, first you have to taper up to a level that will inhibit MAO, then you will generally have to wait for weeks for the medication to work. Sometimes you can get short term relief with a benzo while you are waiting for the med to kick in. The benzo probably won't help the depression, but sometimes they can just help you through the day.I qualified my last statement with "mainstream" because sometimes the stimulants and other medications that affect dopamine can give almost immediate relief. I really have never seen these medications work long term for a person. Also, some of the narcotic medications can give very quick relief. Again, I suspect that very few people have been given long term relief from depression with narcotics. And do not mix stimulants or narcotics with Nardil; unless you know exactly and precisely what you are doing.
Wishing you the Best,
Jedi
Posted by SLS on May 5, 2009, at 5:45:09
In reply to Why after increasing the dose? SLS-Anybody pls, posted by tepi on May 4, 2009, at 23:05:21
> This has happened me all the times during all the years I have been on med.
> It happened again today , Im on 45mg of Nardil
> increasing gradually to 60. I took for the first time the 60mg like this -
> 6 AM - 15mg
> 10 AM - 30 mg
> 3 PM - 15 mg
>
> I felt a very good effect on my fear to people after 2 hrs of taking 30 mg . I was very sociable and talking wiht selfconfindence.
>
> This has happened to me in the past. The problem is that this good effect only last during the first day. This happen wiht most of the drugs I have takne but I feel a better effect with Nardil
>
> What is this ? Im gonna have to make a plan to be decreasing - increasing the dose to have at leats some good days
>
> Anybody has any idea why this happen? I would do or give anythng to have this effect all the time.
> All my problems, All my life will be fixed feeling this way.
> TepiI do believe that you had a "blip" improvement that was acute to the dosage increases. I am certain that such things can happen biologically and it not need be a placebo effect. The pro-social effects of Nardil might come earlier than the antidepressant effects because of the way Nardil increases the activity of GABA neurons, which are calming. You don't need MAOI inhibition for this to occur. In addition, I used to experience an energy rush right after each dosage of Nardil. I think there is something pro-dopaminergic going on there, but I can't prove it.
My advice to you is to continue increasing the dosage of Nardil at a normal pace. There is no advantage for going backwards. Never, never, judge a drug as a failure if you feel better during the first week and have this improvement disappear. This improvement blip is sometimes an indicator that an antidepressant will ultimately prove therapeutic after the passage of time and making dosage adjustments. This is how the research clinicians at the NIMH interpret this blip phenomenon.
- Scott
Posted by SLS on May 5, 2009, at 5:56:35
In reply to Re: Why after increasing the dose? SLS-Anybody pls » tepi, posted by jedi on May 5, 2009, at 3:45:56
> IMHO any benefit from any mainstream antidepressant during the first day is a placebo effect.
You would think so, but these drugs are extremely powerful, and strange things can occur upon the initial exposure to them or upon dosage adjustments.
You are right that the true antidepressant response occurs latent to the initiation of treatment. It is hypothesized that it is not the acute effects of the drug that is the response, but, rather, the changes that occur in the brain as a reaction to chronic exposure. It just so happens that the turnover rate for receptors is about two weeks. If you figure in the delay that probably exists for changes in gene activity, you might be looking at three weeks.
I can attest personally to the biological origin of the type of blip response that Tepi experienced. It has happened with me with several drugs, including Effexor. The improvement I experienced after taking my very first dose of Effexor lasted for several hours. After that, I did not see an improvement for another 2-3 weeks. I believe that Nardil can produce a similar acute reaction for exactly those reasons you cite below:
- Scott> I qualified my last statement with "mainstream" because sometimes the stimulants and other medications that affect dopamine can give almost immediate relief. I really have never seen these medications work long term for a person. Also, some of the narcotic medications can give very quick relief. Again, I suspect that very few people have been given long term relief from depression with narcotics. And do not mix stimulants or narcotics with Nardil; unless you know exactly and precisely what you are doing.
> Wishing you the Best,
> Jedi
>
>
Posted by jedi on May 6, 2009, at 2:34:30
In reply to Re: Why after increasing the dose? SLS-Anybody pls » jedi, posted by SLS on May 5, 2009, at 5:56:35
Thanks for the info Scott. I am always amazed with your insight into these medications.
Be Well,
Jedi
Posted by tepi on May 6, 2009, at 22:05:05
In reply to Re: Why after increasing the dose? SLS-Anybody pls, posted by SLS on May 5, 2009, at 5:45:09
>
> I do believe that you had a "blip" improvement that was acute to the dosage increases. I am certain that such things can happen biologically and it not need be a placebo effect.
>
Great , that was something that the "best doctors " used to tell me ,its a placebo effect.
I used to tell them that this is something strong than a placebo effect , its an abnormal feeling that makes me feel good for a time.
Today I was again like nothing , everything return to be dark .I wanted to leave job
>
> My advice to you is to continue increasing the dosage of Nardil at a normal pace. There is no advantage for going backwards. Never, never, judge a drug as a failure if you feel better during the first week and have this improvement disappear. This improvement blip is sometimes an indicator that an antidepressant will ultimately prove therapeutic after the passage of time and making dosage adjustments. This is how the research clinicians at the NIMH interpret this blip phenomenon.
>
That sounds great Scott ,Im gonna keep forward
with the increasing.
I really appreciate your wise adviceTepi
Posted by tepi on May 6, 2009, at 23:24:25
In reply to Re: Why after increasing the dose? SLS-Anybody pls » SLS, posted by jedi on May 6, 2009, at 2:34:30
Thanks for your opinion Jedi
God bless you
This is the end of the thread.
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