Shown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by zonked on June 3, 2011, at 16:27:16
How fast did you go up? The last two times I required a total of 90mg/day.
I am thinking of scheduling my follow up for two weeks to the day of initiating therapy (or thereabouts) to discuss this with the doc....I will be taking 15 t.i.d. (45 total) until then.
A little frustrating to wait, but that's part of the process, I suppose. :-)
-z
Posted by jedi on June 4, 2011, at 1:21:10
In reply to Nardil users: How fast was your titration?, posted by zonked on June 3, 2011, at 16:27:16
> How fast did you go up? The last two times I required a total of 90mg/day.
>
> I am thinking of scheduling my follow up for two weeks to the day of initiating therapy (or thereabouts) to discuss this with the doc....I will be taking 15 t.i.d. (45 total) until then.
>
> A little frustrating to wait, but that's part of the process, I suppose. :-)
>
> -zz,
The first time I started Nardil, about 13 years ago, it took weeks to get to the effective dosage. The PDOC didn't know how I would react to the side effects or what final dosage I needed for efficacy.Subsequent titration of the medication, after being off Nardil for several months, has been much faster. I know how my body reacts to the medication and the dosage I am shooting for. By increasing quicker, I have less of a lag time to efficacy. I also have more intense initial side effects. For me, as an experienced user of the medication, the additional side effects are outweighed by achieving faster relief from the depression.
I have been off Nardil a half dozen time in 13 years for various reasons. I am one of the lucky ones that the medication always works for my major depression. I have augmented with various meds for the social anxiety, insomnia, and residual dysthymia; but Nardil has always knocked out the major depression.
Good luck and be well,
Jedi
Posted by zonked on June 4, 2011, at 23:20:38
In reply to Re: Nardil users: How fast was your titration? » zonked, posted by jedi on June 4, 2011, at 1:21:10
I am hoping I receive instructions to increase to 60 for a week and then up to 90, since that's what's been required before for consistent effect.
While a part of me is tempted to do this myself, I have to do exactly as the doctor says (and scripts), because if I go up myself and refill too early, my insurance will refuse to pay for it.
I.E., with each dose titration a new prescription must be written...
-z
Posted by jedi on June 4, 2011, at 23:44:29
In reply to Re: Nardil users: How fast was your titration? » jedi, posted by zonked on June 4, 2011, at 23:20:38
> I am hoping I receive instructions to increase to 60 for a week and then up to 90, since that's what's been required before for consistent effect.
>
> While a part of me is tempted to do this myself, I have to do exactly as the doctor says (and scripts), because if I go up myself and refill too early, my insurance will refuse to pay for it.
>
> I.E., with each dose titration a new prescription must be written...
>
> -zBest to follow your PDOC's instructions z. Surely don't do like me. My GP always writes my script for 90mg. I usually need 60mg to be fairly well, sometimes 75mg. I always have a reserve supply of Nardil now.
Once, when I was off the medication, it took me many months to find a MD to prescribe the medication I needed. I swear the PDOC I was seeing would have let me die before giving me the only medication that had ever worked for me. I fought this person for half a year before starting a letter writing campaign to find someone who would prescribe Nardil. I live in a small, fairly rural, town. Choices in psychiatrists are limited or non-existent. I've had to break some rules to survive. I will never go off of Nardil again without a few months supply to get me by. I've had prescribing doctors retire, move 3000 miles away, and just refuse to prescribe MAOIs. So I do what I have to. In a more metropolitan area, I'm sure it is easier to find someone to prescribe the MAOIs.
Good luck and be well z,
Jedi
Posted by SLS on June 5, 2011, at 6:24:22
In reply to Re: Nardil users: How fast was your titration? » zonked, posted by jedi on June 4, 2011, at 1:21:10
Hi Jedi.
> I have been off Nardil a half dozen time in 13 years for various reasons. I am one of the lucky ones that the medication always works for my major depression. I have augmented with various meds for the social anxiety, insomnia, and residual dysthymia; but Nardil has always knocked out the major depression.
Which drugs have you combined with Nardil in order to help with social anxiety, insomnia, and dysthymia? Dosages?
That would be great information for myself and others.
Thanks. I am very glad that you have not received diminishing returns with Nardil.
- Scott
Posted by jedi on June 5, 2011, at 22:43:25
In reply to Re: Nardil users: How fast was your titration? » jedi, posted by SLS on June 5, 2011, at 6:24:22
> Which drugs have you combined with Nardil in order to help with social anxiety, insomnia, and dysthymia? Dosages?
>
> That would be great information for myself and others.
>
> Thanks. I am very glad that you have not received diminishing returns with Nardil.
>
>
> - ScottHi Scott,
My main augmenter, over the years, has been clonazepam. Even after many years, and a dosage reduction form 2mg to .5mg, it still works synergistically with Nardil on my social anxiety and general anxiety. Amazingly, the clonazepam still helps with insomnia. Also gives me almost total CRS (Can't Remember Shi*!). Too bad on that one!Over the years, I've used many different meds for the Nardil induced insomnia. Started out with Trazodone. Gives me a really drugged, hungover feeling. Used micro doses of Seroquel for a while when I had good insurance. Usually from 12.5 to 25mg. Now I mostly use 50mg of Benadryl, combined with the .5 of clonazepam, and sleep very well. I really haven't seen any users of MAOIs that don't have to have some kind of ongoing treatment for insomnia. One of the prices we pay. I am lucky, in that I react very strongly to the histamine medications. Very little tolerance to the sleep inducing side effects of these meds. I wonder what kind of long term effects Nardil will have, because of the reduction in REM sleep? I very rarely remember my dreams on Nardil, though I know I dream some.
I've also augmented with nortriptyline and bupropion. The bupropion seemed to help some with the dysthymia, but made me really aggressive. This is very unlike my normal personality.
I would like to try adding a small dose of methylphenidate to Nardil for the dysthymia and lack of motivation. Haven't been able to talk my MD into this one yet. I do believe that most of my motivation deficit is a learned behavior. After fighting the depression for so many years and putting things off until "I feel better", the procrastination becomes a habit. I was never like this before my first major depression hit. Probably some CBT would help with this.
I'm sure there are other things I've use with Nardil. But CRS!
Be well Scott,
Jedi
Posted by Lamdage on June 10, 2011, at 8:30:09
In reply to Re: Nardil users: How fast was your titration? » SLS, posted by jedi on June 5, 2011, at 22:43:25
I wonder if some acetylcholine heightening supplements would help the rem sleep a little.. I think it would help with cognition for sure.
I titrated pretty slowly. 45mg was already an effective dosage for me. Id say dont go up to 60 until youve waited a long enough period of time for the effects of 45mg to come. I did the mistake not to do that and suddenly.. like the 4th day of 60mg i was shot into another world lol.
Posted by Lamdage on June 10, 2011, at 8:31:29
In reply to Re: Nardil users: How fast was your titration?, posted by Lamdage on June 10, 2011, at 8:30:09
Ok its a contradiction.. my pdoc wanted me to titrate slowly and had me on 15 and 30mg for a fairly long time.
This is the end of the thread.
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