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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Fruitcup on September 11, 2009, at 21:55:19
I have been taking Nardil for 25 years, with a few trials of different meds (Prozac, Parnate) within the first five years. Always put back on Nardil, I tolerate the side effects, but many have disappeared over the years. Originally, I was very constipated, but when I started drinking lots of water and eating more fiber, it went away. At the beginning, my psychopharmacologist prescribed lactulose, a liquid that is used in hospitals a lot. It was always pretty harmless and one tablespoon used to do the trick.
The most difficult thing to deal with was my hypotension. My doc always said that it was very "labile" (subject to ups and down), and after trying salt tablets and a few years on Florinef, I was finally put on Yohimbine HCL, 5.4 mg twice daily. If you look it up, you'll see it's primarily for erectile dysfunction...and I'm a female with no worries about that -- but it hadn't been studied in women of reproductive age and was a gamble. Frankly, I was more concerned with losing my horrible depression which has affected most of my adult life.
(Don't go looking for Yohimbine HCL and DEFINITELY DO NOT go online to find it. There's an herb with the same name that men sometimes use to deal with ED, and it can be dangerous (unregulated by the FDA--though I think they make mistakes, too). It's now "extremely back-ordered," which makes me think that it's going to come off the market, and in a month I'll be out of it, so if anyone knows of anything besides Florinef that helps with low blood pressure from Nardil (I take 90 mg/daily), please post immediately. I can't function with my BP going down to 75/50. I'm almost unconscious without Yohimbine HCL.
Other side effects: Extremely dry mouth (I try to chew gum or carry Tic-Tacs, and drink lots of liquids), some muscle twitching of the face -- but I wonder how much of that I feel but no one sees -- and definitely insomnia. I've been on so many different drugs to sleep that it's still a puzzle.
BTW, does anyone else dream on Nardil? I had heard that it suppresses REM sleep, but I dream like crazy and remember my dreams.
I feel like an expert on Nardil, so if Dr. Bob doesn't object, feel free to ask me whatever you want. My depression IS refractory because even Nardil doesn't do the trick more than about 63%, and if any of you also know that in 2003 Pfizer changed the coating and somehow that changed the chemistry of the drug, making it less effective, I'd like to hear about it. Pfizer knows that lots of people report this. I ADVOCATE LETTING PFIZER KNOW OF SIDE EFFECTS YOU HAVE THAT ARE NOT LISTED, OR COMPLAING ABOUT ITS LOSING EFFICACY SINCE 2003 -- Oh, and weight gain. I gained about 30% of my original body weight, and it's a BEAST to try to take off. I crave carbs like crazy and feel exhausted most of the time. For the daytime somnolence, I take Provigil as needed.
I'm going broke, even with insurance. Out of work for 5 months with no unemployment benefits because I've been an independent contractor. I guess you folks go through that too. Nardil costs me $55 a month, and that's only one drug that I take. Yikes!
Posted by desolationrower on September 12, 2009, at 0:25:12
In reply to Nardil and Side Effects, including Hypotension, posted by Fruitcup on September 11, 2009, at 21:55:19
hey, i agree yohimbe is a bit more of a gamble in terms of trusting the manufacturer that is really has the amount listed, but the active molecule is yohimbine just like the pharmaceutical preparation. the main implication of 'unregulated' is just that you don't know that the chemical is useful instead of harmful. but that isn't relevant re: yohimbine.
so i'd suggest using that. mirtazipine is also an alpha2 agonist like yohimbine, you'd probably need a higher dose. maybe adderall to increase bp or desipramine
how did you find parnate vs the nardil, especially on anxiety/energy (if those are noticable issues for you)
-d/r
Posted by Phillipa on September 12, 2009, at 1:09:05
In reply to Re: Nardil and Side Effects, including Hypotension, posted by desolationrower on September 12, 2009, at 0:25:12
25 years is a long time that sure makes you an expert on the med in my opinion. Phillipa
Posted by Fruitcup on September 12, 2009, at 7:53:42
In reply to Re: Nardil and Side Effects, including Hypotension, posted by desolationrower on September 12, 2009, at 0:25:12
Parnate had the worst, scariest effect on me. I felt like I had ants crawling under my skin. Seriously, I went to my pdoc five times the week it finally kicked in because I thought I was going to lose my mind. I really wanted to get out of my own body. Fortunately, I had a great doc then who found the time to see me (really for emotional support), and kept reminding me that it would take time to metabolize out of my system. It finally did, but all along he apologized for it having "backfired" when there didn't seem to be any reason it should have. However, I personally know of a friend of a friend who has been on Parnate for years, and does well with it. Go figure.
I'm still not convinced about the Yohimbine, and wouldn't risk it when I've been on the pharma drug for so many years without a problem. However, as i said...the drug is likely going to be off the market. Thanks for your suggestions. I'll look into them and speak with my doc.
Does anyone else find it really difficult to find a doc who treats with MAOIs anymore?
> hey, i agree yohimbe is a bit more of a gamble in terms of trusting the manufacturer that is really has the amount listed, but the active molecule is yohimbine just like the pharmaceutical preparation. the main implication of 'unregulated' is just that you don't know that the chemical is useful instead of harmful. but that isn't relevant re: yohimbine.
>
> so i'd suggest using that. mirtazipine is also an alpha2 agonist like yohimbine, you'd probably need a higher dose. maybe adderall to increase bp or desipramine
>
> how did you find parnate vs the nardil, especially on anxiety/energy (if those are noticable issues for you)
>
> -d/r
This is the end of the thread.
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