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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by mantus on December 24, 2010, at 19:57:47
Hello everybody,
I wanted to follow up a bit on my Nardil experience. Basically, I haven't felt any difference for the positive and only maybe worse. I don't think it is the medicine making things worse, but I just wanted some input from people that might know more than me. I am struggling greatley right now, (everything seems daunting, crying daily, getting completely lost in my negative thinking and can't seem to get out, no desire to be around people or do anything, hopelessness, things are very, very badetc...) I do have some levels of anxiety, but alot of it is being masked by me taking 1.5mgs of ativan 3x/day in hopes that the nardil will kick in, but it doesn't seem to really do much other than help me make it through a normal day. I have been on 45mgs of nardil since 12/4 and really need some sign that this medicine is going to do something. I know plenty of people do not respond to 60mgs or more, but please give any support or advice you would have right now. please
Posted by atypical on December 24, 2010, at 23:36:44
In reply to Nardil Follow-Up, posted by mantus on December 24, 2010, at 19:57:47
Sounds like you've only been on 45mg of Nardil for three weeks. That is not enough time. Furthermore, a lot of people start responding at 60mg (like me). And stay at that dose. For other people who have some response at 60 or 75mg but still have residual symptoms, some doctors will go to 90mg.
Hang in there.
Atypical
Posted by mantus on December 25, 2010, at 7:29:56
In reply to Re: Nardil Follow-Up, posted by atypical on December 24, 2010, at 23:36:44
Atypical,
Can you describe the time frame it took for you to feel a response? Were you on 45mgs like me for awhile with no response at all? And how long were you on 60 before you did feel a response? I am just having more and more difficulty getting through the days, and even though I know I need to give it more time, that thought doesn't seem to help me at all. I haven't noticed any definitive side effects either, do you have any significant side effects? I don't want to feel side effects, obviously, but some parts of me just feel like if I feel side effects then I at least know the medicine is doing something.
Thanks
Posted by Phillipa on December 25, 2010, at 11:04:53
In reply to Re: Nardil Follow-Up, posted by mantus on December 25, 2010, at 7:29:56
You bring up a good point. Basically for all meds is it necessary to feel something good or bad in terms of side effects to know the med is working or not working. Good luck in the nardil trial. Phillipa
Posted by atypical on December 26, 2010, at 23:02:36
In reply to Re: Nardil Follow-Up, posted by mantus on December 25, 2010, at 7:29:56
When I was on 45mg for a few weeks I recall having some suicidal feelings. After going up to 60mg they disappeared and I felt generally better. I think 45mg is not an effective dose for most people so going up to 60mg might cause some positive change. Regarding side effects, it is surprising that you are feeling no side effects. I usually don't have side effect problems, but with Nardil I had ALL of them. After a few months they dissipated, but let me tell you I had lots of side effects (euphoria, then sleepiness, then sexual, etc.)
Posted by mantus on January 1, 2011, at 20:23:22
In reply to Re: Nardil Follow-Up, posted by atypical on December 26, 2010, at 23:02:36
> When I was on 45mg for a few weeks I recall having some suicidal feelings. After going up to 60mg they disappeared and I felt generally better. I think 45mg is not an effective dose for most people so going up to 60mg might cause some positive change. Regarding side effects, it is surprising that you are feeling no side effects. I usually don't have side effect problems, but with Nardil I had ALL of them. After a few months they dissipated, but let me tell you I had lots of side effects (euphoria, then sleepiness, then sexual, etc.)
Atypical,
I appreciate the insight you have given in regards to Nardil. I raised my dose to 60mg on 12/28. I still haven't noticed any real changes for the positive, but I also know that 60mgs and higher usually tends to be the more effective dose range. How long were you on 60mgs before you noticed a difference? After everything I have been through, it is almost impossible for me to believe that it is going to give me the significant relief I need. Did you struggle with similar hopelessness during your time before noticing a change? And when you noticed a change, was it definitive? I know these are silly questions, but I have really struggled with not receiving any significant benefits from medications over the years, and at this point I can't even imagine what it would be like to one day say, "hmmmm, I think this medicine is really helping." It seems like a live in an endless game of saying "well, I haven't given the med enough time yet, or the dose isn't right" and eventually months have passed and I'm always left thinking, "ummm, so is that it?" Any more insight/support would be greatly appreciated.
Thank You,
Mantus
Posted by stewie on January 5, 2011, at 9:04:44
In reply to Re: Nardil Follow-Up, posted by mantus on January 1, 2011, at 20:23:22
I was on Nardil about 5 years ago and didn't start to see results until 75 mgs. I wanted to feel more anti-anxiety, so we took it to 90 mgs. A lot of things got better -- regarding both depression and anxiety, but in the end, the side-effects were too much for me.
It was very emotionally rough to taper off of the med.
I know that this can be a life-changer for people.
All the best...
Stewie
Posted by mantus on January 5, 2011, at 9:09:23
In reply to Re: Nardil Follow-Up, posted by stewie on January 5, 2011, at 9:04:44
> I was on Nardil about 5 years ago and didn't start to see results until 75 mgs. I wanted to feel more anti-anxiety, so we took it to 90 mgs. A lot of things got better -- regarding both depression and anxiety, but in the end, the side-effects were too much for me.
>
> It was very emotionally rough to taper off of the med.
>
> I know that this can be a life-changer for people.
> All the best...
> StewieStewie,
How long were you on lesser dosages of nardil before you decided to move up to higher? Also, if you wouldn't mind, what side effects did you encounter that made your nardil trial too difficult?Thanks,
Mantus
Posted by stewie on January 5, 2011, at 16:38:47
In reply to Re: Nardil Follow-Up, posted by mantus on January 5, 2011, at 9:09:23
Hi Mantus,
I ramped up quickly I guess... I don't think it was more than 2 months (if that long) till I got to 90 mgs.
The side effect that was too much for me was the afternoon exhaustion. I just could not function. That was the clincher - though I was not thrilled with the tremendous weight gain, nighttime insomnia or severe constipation either.
I wish you well...truly...
Stewie
Posted by mantus on January 5, 2011, at 19:44:31
In reply to Re: Nardil Follow-Up, posted by stewie on January 5, 2011, at 16:38:47
Stewie,
Those side effects seem to be very common in my research of nardil. Strangely enough, I still don't think I am experiencing any side effects or positive effects either for that matter. I do worry a bit about insomnia, as that has always been a trigger for anxiety for me. I do not worry too much about the weight gain though, as I have always been the type that watches what I eat very closely and exercises regularly (well, that is when I'm not in a low like I am right now). Did you not think that those side effects would go away with time? I have read other posters say that they did go away after awhile. How are you now? Have you found another medicine that has helped? I hope you are doing well.
Thanks,
Mantus
Posted by stewie on January 6, 2011, at 15:37:15
In reply to Re: Nardil Follow-Up, posted by mantus on January 5, 2011, at 19:44:31
> Stewie,
>
> Those side effects seem to be very common in my research of nardil. Strangely enough, I still don't think I am experiencing any side effects or positive effects either for that matter. I do worry a bit about insomnia, as that has always been a trigger for anxiety for me. I do not worry too much about the weight gain though, as I have always been the type that watches what I eat very closely and exercises regularly (well, that is when I'm not in a low like I am right now). Did you not think that those side effects would go away with time? I have read other posters say that they did go away after awhile. How are you now? Have you found another medicine that has helped? I hope you are doing well.
> Mantus,,
For what it is worth, I really do hope you can get some relief. I imagine that if you have gotten to Nardil that you have been down the road with everything else. It is awful.
I expected those side effects, but hoped that they would go away with time. I forgot to mention urinary retention. In spite of my screen name, I am a woman and very susceptible to UTIs. That was another clincher for me.
I wound up revisiting lamictal and celexa as a combo. It took the edge off. I also take neurontin and klonopin for anxiety.
As for how I am - well, I am not as profoundly depressed as I was at that juncture, but I have lowered my expectations a good deal. I am not "living up to my potential", but I try to be grateful for what I do have. I try to use exercise as an antidepressant. It does help. Soooooo... I'm not great, but I could be a lot worse.
I hope that helps...Take care,
Diane
> Thanks,
> Mantus
Posted by Ron Hill on January 8, 2011, at 21:09:12
In reply to Nardil Follow-Up, posted by mantus on December 24, 2010, at 19:57:47
Mantus,
I've been on Nardil for about four years, and it is a tremendous antidepressant for me.
The appropriate dosage is 1 mg of Nardil/kg of body weight. Having said that, often patients end up taking 90 mg/day regardless of their body weight.
For me, Nardil did not kick-in fully until I increased to 90 mg/day. At 90 it kicked-in within a couple of weeks.
Please listen to me carefully about the side effects and how to minimize them. I say this because, in retrospect, I wish someone had told me these things before I started Nardil.
First, weight gain is the biggest issue. Therefore, I encourage you with all of my might to weight yourself everyday and DO NOT allow yourself to gain weight. Diet and exercise as much as it takes to keep from gaining weight. It is easier to keep the weight off than it is to lose it once the weight is packed on. Please, please do this, otherwise the weight gain can be huge.
I'd always been a thin person all of my life. As an adult I always weighted 177 lb at 5'11.5". An exception was when I was at my triathlon racing weight of 155 lb. Now that I am on Nardil I weigh 260 lbs and I hate it. Mantus, please keep the weight off right from the start.
Second, for the constipation, take a large dosage of a good magnesium chelation (not mg oxide). Keep raising the dosage until the constipation problem is resolved. Also, eat a lot of fiber.
As a male, due to Nardil I have lost my sex drive, I have erectile dysfunction, and I have very delayed orgasm, often to the point of anorgasmia. Viagra helps the ED.
You might wonder why in the world anyone would put up with these very difficult side effects. In my case, the answer is that Nardil is a necessary component in my med combo.
Lest I mislead you, Nardil did not resolve all of my psychiatric symptoms. For example, I continued to ultra rapid cycle even after my addition of Nardil. But, Nardil reduced the severity of the depressive phase of my ultra rapid cycling. It was only when I added Valdoxan that my ultra rapid cycling stopped and I became fully well. See my list of meds, vitamins, and supplements, below.
Nardil distroys B6, so take a good multi-vitamin:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1188621/And, I'm sure you know the diet restrictions.
-- Ron
dx: Bipolar II and mild OCPD
600 mg/day Trileptal (oxcarbazepine)
200 mg/day Lamictal (lamotrigine)
500 mg/day Keppra (levetiracetam)
90 mg/day Nardil (phenelzine)
12.5 mg at betime Valdoxan (agomelatine)
3.75 mg/day Deplin (taken with 2500 mcg/day of sublingual methyl B-12, and 12.5mg/day of sublingual P-5-P)
2.5 mg/day Adderal XR45 ml/day of Carlsons Bottled Fish Oil
100 mg/day phosphatidylserene
One Multi-vitamin/day; Only 100% of all the usual vitamins; Look for good chelations. NO VANADIUM!!
2000 IU/day Vitamin D-3
850 mg/day of Mg 212% of RDA (as 5 grams of Mg Malate)
200 mcg/day GTF Chromium
600 mcg/day Chromium Picolinate
200 mg/day Co-Q10
1000 mg/day Cinnamon
480 mg/day Milk Thistle
2 g Vitamin C
Whats next to add?:
NAC, + 8 to 10 glasses of water, + Acetyl-L-Carnitine, + Alpha-Lipoic Acid-----------------------------------
> Hello everybody,
>
> I wanted to follow up a bit on my Nardil experience. Basically, I haven't felt any difference for the positive and only maybe worse. I don't think it is the medicine making things worse, but I just wanted some input from people that might know more than me. I am struggling greatley right now, (everything seems daunting, crying daily, getting completely lost in my negative thinking and can't seem to get out, no desire to be around people or do anything, hopelessness, things are very, very badetc...) I do have some levels of anxiety, but alot of it is being masked by me taking 1.5mgs of ativan 3x/day in hopes that the nardil will kick in, but it doesn't seem to really do much other than help me make it through a normal day. I have been on 45mgs of nardil since 12/4 and really need some sign that this medicine is going to do something. I know plenty of people do not respond to 60mgs or more, but please give any support or advice you would have right now. please
Posted by roscopeeco on January 9, 2011, at 8:30:57
In reply to Re: Nardil Follow-Up » mantus, posted by Ron Hill on January 8, 2011, at 21:09:12
Hello Ron,Are you saying that you saw some initial benefits before 90mg? If so, what were the initial benefits. You said it didn't fully kick in until two weeks on 90mg. The "fully kick in" quote is what makes me think you saw some positives before the 90mg. How long were you on Nardil including the two weeks at 90mg. Once you were two weeks into the 90mg where the drug fully kicked in, what did that feel like as opposed to previous weeks. I think this will help both mantus and I to understand a little more.
TY
Jesse
Posted by Ron Hill on January 9, 2011, at 21:39:35
In reply to Re: Nardil Follow-Up--ron hill, posted by roscopeeco on January 9, 2011, at 8:30:57
Jesse,
I'm not the usual Nardil patient. Prior to four months ago when I added Valdoxan to my combo, I had been a Bipolar II ultra rapid cycler. My cycle was 15 days in duration; 6 days of debilitating depression, followed immediately by 9 days of no depression. The 15 day cycle repeated over and over without stopping for 14.5 years.
Therefore, when I say that Nardil helped me, I mean that Nardil reduced the severity of the depressive phase in my ultra rapid cycling. Nardil did not by any means take away all of my depression.
Nardil is just one medication in my combo. For me to be well, it requires all of my medications working together collectively. It is important to understand that I continued to ultra rapid cycle until I added Valdoxan. With the addition of Valdoxan, my ultra rapid cycling stopped and, therefore, my depressive phase ceased. At this point, I don't experience depression, and at long last, I am fully well. However, my entire medication combination is required for my wellness, not just Nardil. It is a very important component of my medication combo, but not the only one.
As a side note, now that I am fully well I might try to very slowly reduce my Nardil dosage from 90 mg/day to 75 mg/day in order to reduce my Nardil side effects.
I added Nardil on 6/30/2006. Therefore, I don't remember all of the circumstances of my start-up of Nardil. However, I have a daily diary of my medications and how I was feeling on each day. I do not have time to go back through all of my diary entries. The best I can do is to provide an overview of how I reacted to Nardil start-up, increases in dosage, and at the final dosage of 90 mg/day.
> Are you saying that you saw some initial benefits before 90mg?As I look back in my diary, I see that I started taking Nardil at 30 mg/day on 6/30/2006. I responded favorably right from the first day that I took it. At the time, I was trying to hold the Nardil dosage to a minimum so as to avoid the side effects. Therefore, I very slowly ramped up to 45, 60, 75, and finally 90. After every dosage increase, my diary shows that I experienced a noted improvement. In other words, the severity of my depressive phase was lessened by each increase in Nardil dosage. The improvement occurred the very day that I increased the dosage.
Due to the fact that I wanted to keep the Nardil dosage low to reduce the side effects, I ended up spending almost a year ramping up from 30 to 75. I started 90 on 7/28/2007. Like all the other dosages, my depressive phase was reduced in severity right from the start of the higher dosage of 90. If I were to do it again, I would ramp up very quickly from zero to 90 mg/day.
Having looked at my med diary, I retract what I said in my previous post about 90 mg/day of Nardil kicking-in about two weeks after the dosage increase. Not so. The improvement occurred starting the very day that I increased the dosage.
However, there are several things that muddy the water. My ultra rapid cycling has to be taken into account when looking at my data. What appears to be a reduction in the effectiveness of the medication may well be just the onset of my depressive phase. Further complication occurs in that I had already decided Nardil was a "keeper" in my med cocktail and, therefore, I was conducting trials of other medication add-ons during the time frame of my increase in Nardil dosage to 90 mg/day.
The bottom line answer to your question is that I experienced improvement from the very first day of every increased dosage. As an aside, the biggest side effect problem as I was ramping up in dosage was hypotension (low blood pressure). When I stood up I would get really dizzy due to low blood pressure. That side effect no longer occurs for me.
> If so, what were the initial benefits.
I felt less depressed during my ultra rapid cycling depressive phase.
> You said it didn't fully kick in until two weeks on 90mg. The "fully kick in" quote is what makes me think you saw some positives before the 90mg. How long were you on Nardil including the two weeks at 90mg. Once you were two weeks into the 90mg where the drug fully kicked in, what did that feel like as opposed to previous weeks. I think this will help both mantus and I to understand a little more.
As I mentioned above, after looking at my medication diary, I retract what I had previously stated about the two week period. My diary shows that I experienced an improvement the very same day that I began the increased Nardil dosage.
-- Ron
dx: Bipolar II and mild OCPD
600 mg/day Trileptal (oxcarbazepine)
200 mg/day Lamictal (lamotrigine)
500 mg/day Keppra (levetiracetam)
90 mg/day Nardil (phenelzine)
12.5 mg at betime Valdoxan (agomelatine)
3.75 mg/day Deplin (taken with 2500 mcg/day of sublingual methyl B-12, and 12.5mg/day of sublingual P-5-P)
2.5 mg/day Adderal XR45 ml/day of Carlsons Bottled Fish Oil
100 mg/day phosphatidylserene
One Multi-vitamin/day; Only 100% of all the usual vitamins; Look for good chelations. NO VANADIUM!!
2000 IU/day Vitamin D-3
850 mg/day of Mg 212% of RDA (as 5 grams of Mg Malate)
200 mcg/day GTF Chromium
600 mcg/day Chromium Picolinate
200 mg/day Co-Q10
1000 mg/day Cinnamon
480 mg/day Milk Thistle
2 g Vitamin C
Whats next to add?:
NAC, + 8 to 10 glasses of water, + Acetyl-L-Carnitine, + Alpha-Lipoic Acid
Posted by Joseph2578 on January 10, 2012, at 9:53:44
In reply to Re: Nardil Follow-Up--ron hill » roscopeeco, posted by Ron Hill on January 9, 2011, at 21:39:35
This is my first posting, so please bear with mew, I was on Nardil 90mg a few years ago, it took me around 1-2 months for it to start having an effect once it started working it treated all my anxiety&depression issues, I felt confident, outgoing, I felt a little euphoric it was amazing but after a month of feeling this way it pooped out, and I went off it, I tried parnate after that, but it didn't do anything foe me has anyone ever gone through this?
This is the end of the thread.
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