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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by BlueM on May 3, 2010, at 15:58:42
I'm on day 5 of 45 mg of Nardil and I'm not noticing any side effects. When will I have them - I usually notice side effects pretty quickly - is it delayed with Nardil?
Posted by jedi on May 3, 2010, at 16:44:29
In reply to When do Nardil Side Effects start?, posted by BlueM on May 3, 2010, at 15:58:42
> I'm on day 5 of 45 mg of Nardil and I'm not noticing any side effects. When will I have them - I usually notice side effects pretty quickly - is it delayed with Nardil?
Hi,
I have been on and off Nardil for most of 12 years. For me, most of the side effects are related to the MAO inhibition, which also causes the positive effects of Nardil. Other people are different and have different types of side effects.The main ones for me are, weight gain due to carbohydrate cravings, insomnia at night, afternoon tiredness and delayed or absent orgasm. All of these are related in some way to the MAO inhibition caused by Nardil. Some people have orthostatic hypotension (low BP when standing up), which comes on right away. Some have gastrointestinal effects. Also, in many Nardil users (me included) there is a period of euphoria or hypomania just when the medication starts working. This is usually after 4 to 6 weeks on a dosage that works for you. My effective dosage ranges from 60 to 115 mg, but I am a very large male. Please do not mistake this euphoria as the antidepressant effect of Nardil. You will be disappointed when it goes away and think that the medication has pooped out. I only got this hypomania feeling the first time I started Nardil. On subsequent restarts, the hypomania never happened.
If you are a large person a higher dosage may be required as an effective dose. And, as always, everyone of us is different. For me, it has always taken 4 or 5 weeks for the MAO inhibition of Nardil to affect the neurotransmitters in my brain, and help with my atypical depression and social anxiety.
Be Well,
Jedi
Posted by angels78 on May 3, 2010, at 17:29:08
In reply to Re: When do Nardil Side Effects start? » BlueM, posted by jedi on May 3, 2010, at 16:44:29
Hey Jedi
What did you do for the afternoon tiredness?
And is it true to find the correct Nardil dosage you take your weight divided by 2.2?
Posted by jedi on May 3, 2010, at 19:29:20
In reply to Re: When do Nardil Side Effects start? » jedi, posted by angels78 on May 3, 2010, at 17:29:08
> Hey Jedi
> What did you do for the afternoon tiredness?
> And is it true to find the correct Nardil dosage you take your weight divided by 2.2?Hi,
The supposed effective dosage for phenelzine(Nardil) is 2.2mg per kilogram of body weight. I quit quoting that one because it is pretty much BS. Everyone is different when it comes to dosage on any of these medications. If the 2.2mg/kg was true, my effective dose now would be 115mg. I'm off Nardil after I had surgery 4 weeks ago, but 115mg is above the supposed highest allowed dosage of 90mg. I have taken up to 120mg before with no harm, but you won't find a doctor to prescribe it, unless they are smart enough to throw out the PDR.The afternoon tiredness seems to be very dose related for me. It also seems to be one of the side effects that goes away with time. Try not to fall victim to the late afternoon nap. This will compound the insomnia problem at night and start a nasty little circle of side effects. I have used a good cup of stiff coffee to fight it, but even that will give some people insomnia. Caffeine is a very strong and addictive stimulant. If you don't think so, try to cold turkey a five cup a day habit. On the 2nd day you will probably have the worst headache of your life. By the way, coffee has never been a problem for me with Nardil. On my Parnate trials, I could not even drink the stuff, I would be so wired!
Be well,
Jedi
Posted by BlueM on May 3, 2010, at 19:32:05
In reply to Re: When do Nardil Side Effects start? » BlueM, posted by jedi on May 3, 2010, at 16:44:29
Thanks for the info Jedi - so if I don't have insomnia or delayed or absent orgasm or afternoon tiredness and if 45 mg works - then I won't have any side effects? The side effects kick in at higher dosage or are you saying 45 mg is not likely high enough. I am 5'9" and 220 lbs - I think he said I'd likely go to 90 mg if necessary - so I might get side effects then? I have just never been an an AD with no side effects right at the beginning. I don't have the orthostatic hypotension - I've had that on imipramine. God I hope this works and really is that simple.
Thanks,
M
Posted by jedi on May 3, 2010, at 19:45:52
In reply to Re: When do Nardil Side Effects start?, posted by BlueM on May 3, 2010, at 19:32:05
At 220, you will probably end up at between 60 and 90 for an effective dose. Just a dumb guess. Is your depression atypical with social anxiety. If so, you are probably on the right track. Nardil can be a wonder drug, even when many others have failed. Some will argue with me, but phenelzine combined with clonazepam is just the GOLD standard for atypical depression and social anxiety. The side effects are really time and dose related. My side effects at 60mg are one tenth of what they are at 90mg. I can judge my level of MAO inhibition by ease of ejaculation; they are so related.
Good Luck,
Jedi
> Thanks for the info Jedi - so if I don't have insomnia or delayed or absent orgasm or afternoon tiredness and if 45 mg works - then I won't have any side effects? The side effects kick in at higher dosage or are you saying 45 mg is not likely high enough. I am 5'9" and 220 lbs - I think he said I'd likely go to 90 mg if necessary - so I might get side effects then? I have just never been an an AD with no side effects right at the beginning. I don't have the orthostatic hypotension - I've had that on imipramine. God I hope this works and really is that simple.
>
> Thanks,
> M
Posted by BlueM on May 3, 2010, at 20:18:54
In reply to Re: When do Nardil Side Effects start? » BlueM, posted by jedi on May 3, 2010, at 19:45:52
Hi Jedi - I do consider myself to have atypical depression, and while I never thought of my self as having social anxiety - I've been told that I do - but I'm comparing myself to someone with extreme social anxiety. I have to take 0.25 to 0.5 mg of Xanax to be able to sleep - are you saying clonazepam might be a better drug? I do know that ativan does nothing for me. Good to know about the difference between dose related side effects - I won't push for more if I'm getting a response with less. Thanks again.
M
Posted by jedi on May 3, 2010, at 21:55:58
In reply to Re: When do Nardil Side Effects start?, posted by BlueM on May 3, 2010, at 20:18:54
> Hi Jedi - I do consider myself to have atypical depression, and while I never thought of my self as having social anxiety - I've been told that I do - but I'm comparing myself to someone with extreme social anxiety. I have to take 0.25 to 0.5 mg of Xanax to be able to sleep - are you saying clonazepam might be a better drug? I do know that ativan does nothing for me. Good to know about the difference between dose related side effects - I won't push for more if I'm getting a response with less. Thanks again.
>
> MHey, some people claim that clonazepam(Klonopin) has more of a depressive affect on them than Xanax. It has never affected me that way. I use it because it is strong and has a long half life. Once a day dosing and your not going up and down on it. Clonazepam has a strong affect on GABA and so does Nardil. That is probably why they act synergistically to help with my social anxiety. The benzodiazapines do have some strong side effects. My main concern is on my memory as I get older. Sometimes I Can't Remember Shi* (CRS). However, right now I am taking 2mg of clonazepam daily, which is a fairly large dose. I have tapered off and quit the medication in the past. I don't have a very addictive personality. But, when I need it, I ignore the horror stories, and I'm not afraid to use it.
If the Xanax is working for you, I can see no real reason to change. There is a Xanax XR out there now, but you better have good insurance. I would guess that clonazepam is about twice as strong as alprazolam and probably a half-life that is at least twice as long. Don't quote me, I haven't looked it up lately and you know, CRS.
Best of Luck,
Jedi
Posted by SammyJar on May 3, 2010, at 23:21:01
In reply to When do Nardil Side Effects start?, posted by BlueM on May 3, 2010, at 15:58:42
I want to ask my doctor for Nardil, but I'm a little afraid of it. Does anyone know if it's really anymore dangerous than the more commonly used antidepressants as long as you follow the dietary restrictions and don't mix it with other medications?
Posted by jedi on May 4, 2010, at 0:33:00
In reply to Re: When do Nardil Side Effects start?, posted by SammyJar on May 3, 2010, at 23:21:01
>
> I want to ask my doctor for Nardil, but I'm a little afraid of it. Does anyone know if it's really anymore dangerous than the more commonly used antidepressants as long as you follow the dietary restrictions and don't mix it with other medications?Sammy,
Most doctors will not prescribe Nardil unless you are treatment resistant. That usually means failed trials with at least a couple of SSRIs, a TCA and one of the newer generation medications.Nardil is not dangerous if taken correctly. I have been on it for most of the past 12 years. Pretty much no over the counter cold remedies. Most of the opioids are OK except Demerol, Tramadol and others that affect serotonin. The food restrictions are way overblown but have to be followed. Aged cheese is the biggie.
I have been in the ER twice with mild hypertensive episodes. They were not life threatening. My depression was life threatening. IMHO the dangers of not using MAOIs when needed are far greater than using them.
Google my posts. I have been preaching the benefits of this medication for a lot of years. There are some pretty big side effects for some people. The side effects are definitely not as bad as major, treatment resistant depression and social anxiety. Both of which can mess up or take your life.
Good Luck,
Jedi
Posted by stargazer2 on May 4, 2010, at 12:21:28
In reply to Re: When do Nardil Side Effects start?, posted by SammyJar on May 3, 2010, at 23:21:01
Years ago, before the SSRI's came out, Nardil was the standard of care after the tricyclics (Elavil) as there were very few meds for depression back then (Believe it or not).
I was given Nardil (1986) as the second med tried and it worked almost immediately and restored my life to near normalcy. I thought isn't this great, I am cured. That was short lived.
Fast forward a few years...I'm still struggling to find treatments for depression...I think my depression is biologically based as looking back to my childhood, I was overly sensitive to things (personally and environmentally).
I think for a few of us, MAO's might be the only meds that will work, as none of the other meds ever did much for me, except cause side effects and more symptoms.
To find a doctor to prescribe a MAO might be the biggest hurdle. MOst docs were not trained to prescribe them so they are just uncomfortable with the potential for a hypertensive reaction.
The diet can be rough for many (not me). The worst part is knowing that before you can take any other medications, you have to make sure it is not contraindicated, which requires you to stop and think. So you have to be the type of person who follows rules and limitations. Not everyone can do this so the patient has to be reliable and convince their doc that they will follow the restrictions.
Other than that, it doesn't have any major drawbacks.
This is the end of the thread.
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