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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 Atalanta on April 21, 2010, at 12:50:14
I have a patient with severe, treatment-resistant depression. She states that she has only been successfully treated with Nardil prior to a formulation change which was, I believe, an excipient change? Does anyone have experience with this? Has anyone been able to achieve similar anti-depressant success with the Nardil but at a higher dosage?
Posted by Phillipa on April 21, 2010, at 13:17:05
In reply to old versus new Nardil formulation, posted by Atalanta on April 21, 2010, at 12:50:14
Are you a doctor? Goggle archieves yes others have in a variety of way and the phenomenum from what I read is true. Phillipa
Posted by Atalanta on April 21, 2010, at 14:03:09
In reply to Re: old versus new Nardil formulation » Atalanta, posted by Phillipa on April 21, 2010, at 13:17:05
No, I am not an MD. I am a grad student in clinical psychology doing an internship. I wasn't quite sure what your answer said.
Posted by ed_uk2010 on April 21, 2010, at 14:36:06
In reply to Re: old versus new Nardil formulation, posted by Atalanta on April 21, 2010, at 14:03:09
> No, I am not an MD. I am a grad student in clinical psychology doing an internship. I wasn't quite sure what your answer said.
I think Phillipa was suggesting that you use the Google search box at the bottom of the page. This way, you can search the psycho-babble archives for patients' experiences of the 'new' versus the 'old' Nardil.
Posted by europerep on April 21, 2010, at 14:41:21
In reply to Re: old versus new Nardil formulation, posted by Atalanta on April 21, 2010, at 14:03:09
it looks like there was a formulation made by warner lambert, and then pfizer bought the company and after some time changed the formulation.. that's what I understood..
if you tell me the exact ingredients of nardil I can check if the local version of phenelzine is different, although that probably wouldn't help much since that would be in europe..
Posted by bulldog2 on April 21, 2010, at 15:16:41
In reply to old versus new Nardil formulation, posted by Atalanta on April 21, 2010, at 12:50:14
> I have a patient with severe, treatment-resistant depression. She states that she has only been successfully treated with Nardil prior to a formulation change which was, I believe, an excipient change? Does anyone have experience with this? Has anyone been able to achieve similar anti-depressant success with the Nardil but at a higher dosage?
The impression I have is that the new formulation works well for some people but at higher doses. I believe the original formulation was enteric coated for release in the intestines. That has been replaced with a cheaper non-enteric coating that releases in the stomach.
Posted by stargazer2 on April 21, 2010, at 17:06:31
In reply to old versus new Nardil formulation, posted by Atalanta on April 21, 2010, at 12:50:14
Yes, I took Nardil at 15 mg BID back in the late 80's with good success, until a doc treating me stopped the Nardil (standard of care then)and I got all of my symptoms back without being able to successfully treat it again.
The new formulation just works differntly all together. Many here say that a higher dose is required but I took 30 mg with fair relief as higher doses caused too many SE's. I had a variety of SE's with the newer version beginning with weight gain, hypotension, severe GI symptoms including gas pain and constipation, along with pedal edema. Most of the SE's resolved over time.
I have not felt that great on the newer version of Nardil and Marplan (also reformulated). I think there were more changes than the enteric coating with Nardil, although this has been denied. I think it is made somewhere out of the US, so who knows anything about the quality standards of foreign production of meds, including generics. Many generic do not work the same as the brand name (i.e Synthroid).
You can Google 'Nardil reformulation', there is a website of many whom petitioned Pfizer to make the original formula without success.
Posted by bulldog2 on April 24, 2010, at 14:05:24
In reply to Re: old versus new Nardil formulation, posted by stargazer2 on April 21, 2010, at 17:06:31
> Yes, I took Nardil at 15 mg BID back in the late 80's with good success, until a doc treating me stopped the Nardil (standard of care then)and I got all of my symptoms back without being able to successfully treat it again.
>
> The new formulation just works differntly all together. Many here say that a higher dose is required but I took 30 mg with fair relief as higher doses caused too many SE's. I had a variety of SE's with the newer version beginning with weight gain, hypotension, severe GI symptoms including gas pain and constipation, along with pedal edema. Most of the SE's resolved over time.
>
> I have not felt that great on the newer version of Nardil and Marplan (also reformulated). I think there were more changes than the enteric coating with Nardil, although this has been denied. I think it is made somewhere out of the US, so who knows anything about the quality standards of foreign production of meds, including generics. Many generic do not work the same as the brand name (i.e Synthroid).
>
> You can Google 'Nardil reformulation', there is a website of many whom petitioned Pfizer to make the original formula without success.Do you have any theories for the excessive sides? Would the med coming apart in the stomach instead of the intestines possibly be the cause of some of the sides?
Posted by Atalanta on April 26, 2010, at 8:07:55
In reply to Re: old versus new Nardil formulation » stargazer2, posted by bulldog2 on April 24, 2010, at 14:05:24
> > Yes, I took Nardil at 15 mg BID back in the late 80's with good success, until a doc treating me stopped the Nardil (standard of care then)and I got all of my symptoms back without being able to successfully treat it again.
> >
> > The new formulation just works differntly all together. Many here say that a higher dose is required but I took 30 mg with fair relief as higher doses caused too many SE's. I had a variety of SE's with the newer version beginning with weight gain, hypotension, severe GI symptoms including gas pain and constipation, along with pedal edema. Most of the SE's resolved over time.
> >
> > I have not felt that great on the newer version of Nardil and Marplan (also reformulated). I think there were more changes than the enteric coating with Nardil, although this has been denied. I think it is made somewhere out of the US, so who knows anything about the quality standards of foreign production of meds, including generics. Many generic do not work the same as the brand name (i.e Synthroid).
> >
> > You can Google 'Nardil reformulation', there is a website of many whom petitioned Pfizer to make the original formula without success.
>
> Do you have any theories for the excessive sides? Would the med coming apart in the stomach instead of the intestines possibly be the cause of some of the sides?I suppose breaking down higher up in the digestive tract could cause these additional side effects. It's the seeming lack of efficacy that flummoxes me. I do not know what to do for this patient!
Posted by stargazer2 on April 28, 2010, at 20:00:59
In reply to Re: old versus new Nardil formulation, posted by Atalanta on April 26, 2010, at 8:07:55
I ended up taking Wellbutrin with Nardil and this improved my response. Before I did that I saw an endo and now take Synthroid for essentially a normal TSH level(5-ish) but it has been found that even so called normal levels can be the cause of depression so treating for hypothyroid can help with TRD, like I have.
The side effcts with Nardil do eventually subside, even the severe constipation did and the intestinal gas.
Posted by FredPotter on April 29, 2010, at 21:26:11
In reply to Re: old versus new Nardil formulation, posted by Atalanta on April 26, 2010, at 8:07:55
> I think it is made somewhere out of the US
Oh dear it must be poison then. OTOH why would I trust anything made IN the US? The US health system is world-famous for being lousy and inequitable
The new formulation works fine for me
Posted by Phillipa on April 29, 2010, at 21:48:53
In reply to Re: old versus new Nardil formulation » Atalanta, posted by FredPotter on April 29, 2010, at 21:26:11
Hi Fred how's it going? You sound good. Love Phillipa
This is the end of the thread.
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