![[dr. bob]](/dr-bob-sm.gif)
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 lifelover on April 6, 2011, at 0:03:08
Hey guys, Im gona be starting nardil again with my current lithium dosage(1400mg). Is 1400mg to high? I usually only read of people in the 300-900 range.I weigh 232 pounds so maybe thats why? My blood levels on this dose are just at theraputic levels. Also Im kinda upset cause I just read an article saying that lithium increases tryptophan levels in the brain.Is that one of the chemicals to avoid in food? Wouldnt you think make it a potentially dangerous combo? I would figure the combo is somewhat safe considering as it seems like a lot of people are taking it on the web. Im hoping and praying for the best and hearing good things about the combo.Please guys help with out if u can this is very important!!! Thanks
Posted by desolationrower on April 7, 2011, at 3:53:47
In reply to lithium, nardil, tryptophan and some help please!!, posted by lifelover on April 6, 2011, at 0:03:08
> Hey guys, Im gona be starting nardil again with my current lithium dosage(1400mg). Is 1400mg to high?
yes. Although what really matters is the plasma level, if thats being tested, then go by that. A second issue is that (not sure what you have) higher doses are more about mania, not depression. Go by how it works for you, but if you have just depression that sounds high.
>I usually only read of people in the 300-900 range.I weigh 232 pounds so maybe thats why?
possibly, i wouldn't expect fat level that to make much difference once you reach steady state, except if you are just big, 6'4 linebacker type, everything is bigger in texas, etc. It is cleared through kidney/urine.
>My blood levels on this dose are just at theraputic levels. Also Im kinda upset cause I just read an article saying that lithium increases tryptophan levels in the brain.Is that one of the chemicals to avoid in food?
if you took a supplement of tryptophan you might possibly give yourself serotonin syndrome, but its not like tyramine where certain food processes (fermentation for tyramine) create much higher levels in some foods than others. Also tryptophan isn't directly toxic like tyramine. It is just a precursor to serotonin (aka 5-hydroxytryptamine (5-HT)).
>Li has lots of effects on serotonin systems in the brain, and i think there are case reports of serotonin sydrom occuring wtih MAOI and lithium. But i haven't seen this actually quantified into increased risk, and it is a tested treatment. I wouldn't be afraid to take it myself.
> Wouldnt you think make it a potentially dangerous combo? I would figure the combo is somewhat safe considering as it seems like a lot of people are taking it on the web. Im hoping and praying for the best and hearing good things about the combo.Please guys help with out if u can this is very important!!! Thanks
The antidote for 5ht syndrome is a 5ht2 antagonist. If you are worried, ask for some cyproheptadine to take in case of emergency (its good to have around with an MAOI anyway, since it is a good drug for sleep). MAke sure you know the difference between 5ht syndrome and hypertensive crisis (and panic attack. i'm going to go out on a limb and guess you might get those, too?). Even better, get some nortryptaline along with the nardil, it prevents both 5ht syndrome and hypertensive crisises. Unfortunately, since it is in the TCA class, and some TCAs cause serotonin syndrome, there is medical urban legend that "TCAs and MAOIs shouldn't be taken together". You see this misinformation on all the PDRs. /rant
-d/r
Posted by SLS on April 7, 2011, at 5:41:07
In reply to lithium, nardil, tryptophan and some help please!!, posted by lifelover on April 6, 2011, at 0:03:08
> Hey guys, Im gona be starting nardil again with my current lithium dosage(1400mg). Is 1400mg to high? I usually only read of people in the 300-900 range.I weigh 232 pounds so maybe thats why? My blood levels on this dose are just at theraputic levels. Also Im kinda upset cause I just read an article saying that lithium increases tryptophan levels in the brain.Is that one of the chemicals to avoid in food? Wouldnt you think make it a potentially dangerous combo? I would figure the combo is somewhat safe considering as it seems like a lot of people are taking it on the web. Im hoping and praying for the best and hearing good things about the combo.Please guys help with out if u can this is very important!!! Thanks
I like all of what d/r had to say.
When I first added Nardil to lithium, I believe I experienced muscle hypertonia and hyperreflexia. It disappeared when I removed the lithium. Now - quite interestingly - I am able to add back lithium 300 mg without sequalae. No side effects at all. Maybe a little dry mouth in the beginning. And yes, I am feeling a mild to moderate antidepressant effect and mood stabilizing effect. My mood is higher and less variable.
Currently:
Nardil 90 mg
nortriptyline 150 mg
Lamictal 200 mg
Abilify 10mg
lithium 300 mgI had to wait four months for the addition of Nardil to produce significant benefit.
- Scott
Posted by MatthewDavid on April 8, 2011, at 17:30:12
In reply to lithium, nardil, tryptophan and some help please!!, posted by lifelover on April 6, 2011, at 0:03:08
Hi Life Lover, that much lithium is extremly high, 600-900 is a theraputic dose and anything higher is used to stabilize people who are clinically unstable, I would start the nardil and then slowly increase your lithium as needed. let me know how it goes and best of luck
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.