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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 zonked on October 26, 2011, at 21:48:44
Hi, all...
Nardil caused me to gain enormous amounts of weight. I have taken myself down to 60mg from 90. So far, nothing noticed at all.
I will be getting my testosterone lab tomorrow, so I should soon find out what AndroGel has done to my levels (up, down, or the same). More or less, I want to get into average or above average for my age (800-1000) and see if that negates the need for an antidepressant.
My shrink is bright enough to handle this complicated case.
Sleep has been problematic. I ripped my (step III) nicotine patch off at 6pm tonight instead of the usual 7 or later, then took a shower *at night* to wash off any hormone gel or nicotine remaining.
I now require 60mg of temazepam to sleep or 20mg ambien. No matter what sleep aid I use, waking up is HELL. Which is weird, because I'm not really depressed-depressed-depressed anymore, but I always wake up feeling as if I've been hit by a truck, and I didn't sleep well. Not the same feeling that one gets from an overly-sedating drug, but a sort of "did I sleep at all?" sort of thing... even if there's an energy drink at my bedside, I have trouble getting up to drink it. I can set the alarm software on this PC To maximum, so much that I worry about the neighbors, and I either won't get up or get up just to turn it off.
I suspect the sleep thing will have to be worked on for awhile.
Xanax consumption varies from 0.5 to 2mg a day, average probably 1.25.
I want to see what 60mg of Nardil + daily workouts allow me to get away with physically. If I can drop these pounds, I have no problem with Nardil sticking around for awhile, but if not I may have to carefully think about what's next.
-z
Posted by creepy on October 26, 2011, at 22:06:35
In reply to Playing with fire?. Nardil taper, T update, sleep, posted by zonked on October 26, 2011, at 21:48:44
Could see if metformin helps with the weight. Its been studied for AAP's but I cant find anything that really says it works for AD related weight gain.
The other alternative is topamax off-label. totally killed my appetite when I was on it.
I wake up every day feeling like Ive been hit by a truck, No idea why.
Posted by zonked on October 26, 2011, at 22:10:16
In reply to Re: Playing with fire?. Nardil taper, T update, sleep, posted by creepy on October 26, 2011, at 22:06:35
> Could see if metformin helps with the weight. Its been studied for AAP's but I cant find anything that really says it works for AD related weight gain.
> The other alternative is topamax off-label. totally killed my appetite when I was on it.
> I wake up every day feeling like Ive been hit by a truck, No idea why.
>I've heard Topamax makes people feel stupid. I don't wanna feel stupid. :/
-z
Posted by creepy on October 26, 2011, at 23:43:59
In reply to Re: Playing with fire?. Nardil taper, T update, sleep » creepy, posted by zonked on October 26, 2011, at 22:10:16
Not necessarily. At 12.5mg I had no side effects (im a hyper-responder) and my appetite was normal for the first time in years.
Some docs wont touch it with a 10' pole though.
Posted by SLS on October 27, 2011, at 5:01:28
In reply to Re: Playing with fire?. Nardil taper, T update, sleep, posted by creepy on October 26, 2011, at 23:43:59
> Not necessarily. At 12.5mg I had no side effects (im a hyper-responder) and my appetite was normal for the first time in years.
> Some docs wont touch it with a 10' pole though.It is my understanding that one can mitigate or avoid altogether the Dopamax cognitive impairing effect by beginning at a low dosage and titrating very slowly. I followed this type of titration method with Topamax did not have the slightest hint of cognitive impairment at a dosage of 200mg. It seems that once triggered, the cognitive side effects persist.
Topamax had no effect on my appetite or body weight. I guess it was no match for Abilify.
- Scott
Posted by SLS on October 27, 2011, at 5:31:26
In reply to Playing with fire?. Nardil taper, T update, sleep, posted by zonked on October 26, 2011, at 21:48:44
I thought I might interject here that for the first episode of depression, the time that one should remain on an antidepressant once remission is obtained is 12-14 months. The rate of relapse is much higher if one discontinues at 9 months. However, if one has demonstrated a lengthy recurrent or chronic course, this rule really doesn't apply. It is likely that one with this case history will require a lifetime of treatment. If relapse is to occur after discontinuing treatment, it will usually do so within the first 4 months. Of course, with mental illness, there are often exceptions to these norms.
- Scott
Posted by Phillipa on October 27, 2011, at 10:52:44
In reply to Re: Playing with fire?. Nardil taper, T update, sleep, posted by SLS on October 27, 2011, at 5:31:26
Zonked hope you find a satisfactory sleep med and your levels come back where you would like to seel them. Phillipa
Posted by zonked on October 27, 2011, at 11:00:16
In reply to Re: Playing with fire?. Nardil taper, T update, sleep, posted by Phillipa on October 27, 2011, at 10:52:44
> Zonked hope you find a satisfactory sleep med and your levels come back where you would like to seel them. Phillipa
Thanks! Guess what - I combined 60mg temazepam with one tablet of doxylamine succinate (25mg I think) and slept like a baby. Getting up wasn't hard, either.
The Doxylamine was added after an hour of no-sleep frustration in bed.
I took an extra hard shower last night and tried to scrub the areas where I apply testosterone gel and my nicotine patch (only a few 7mg patches left and I'm done, btw) extra hard.
So far, so good.
Posted by jono_in_adelaide on October 27, 2011, at 18:00:46
In reply to Re: Playing with fire?. GOOD SLEEP UPDATE NEWS, posted by zonked on October 27, 2011, at 11:00:16
I'm not suprised you wake up feeling crap on 60mg of temazepam, thats enough to sedate an elephant.
Could you try 30mg plus 50mg diphenhydramine?
Might provide just as good a sleep with less hangover
Posted by zonked on October 27, 2011, at 18:05:10
In reply to Re: Playing with fire?. GOOD SLEEP UPDATE NEWS, posted by jono_in_adelaide on October 27, 2011, at 18:00:46
> I'm not suprised you wake up feeling crap on 60mg of temazepam, thats enough to sedate an elephant.
>
> Could you try 30mg plus 50mg diphenhydramine?
>
> Might provide just as good a sleep with less hangoverI'm going to try 30mg + doxylamine tonight. Will wait for an hour, then see. Will update tomorrow...
I actually feel fine on 60mg Nardil + 25mg/2.5gm testosterone + 0.5-2 xanax. The Nardil reduction, so far, has caused no problems and less daytime sedation. The addition of exercise has helped tremendously.
(For those of you curious, when I am in the worst depressive state, exercise does nothing.)
-z
Posted by Phillipa on October 27, 2011, at 20:04:51
In reply to Re: Playing with fire?. GOOD SLEEP UPDATE NEWS » jono_in_adelaide, posted by zonked on October 27, 2011, at 18:05:10
Zonked I am that's interesting about the excercise and level of depression. Phillipa
Posted by zonked on October 29, 2011, at 1:18:41
In reply to Re: Playing with fire?. GOOD SLEEP UPDATE NEWS » jono_in_adelaide, posted by zonked on October 27, 2011, at 18:05:10
Here is my update.
It's working. 25mg doxylamine + 30 temazepam = wake up feeling quite alright!
Feeling good, overall. Life is taking shape, I have some work booked up ahead, personal life is restoring gradually...
This is what recovery from depression is like, I suppose. It's like waking up from a prolonged, forced emotional suffocation...
So when I am able to experience the full gamut of emotions again, including some uncomfortable ones, it takes some getting used to. I am finally creating/finding the balance in my life I've lost the last few years.
The medicines started and are maintaining the process, I am doing what I can to clean up the mess. This is a terrible illness; and while I do not believe there will ever be a *Single* cure or vaccine against major/bipolar depression; there will likely be better treatments.
Do what you can to keep yourself alive and functioning until you find what works for you. In my case:
Nardil 60mg/day
Xanax 0.5-2mg/day
Temazepam 30mg + Doxylamine 25mg qhs
Vigorous aerobic exercise 3-5 days a week + healthy, balanced diet.-z
> > I'm not suprised you wake up feeling crap on 60mg of temazepam, thats enough to sedate an elephant.
> >
> > Could you try 30mg plus 50mg diphenhydramine?
> >
> > Might provide just as good a sleep with less hangover
>
> I'm going to try 30mg + doxylamine tonight. Will wait for an hour, then see. Will update tomorrow...
>
> I actually feel fine on 60mg Nardil + 25mg/2.5gm testosterone + 0.5-2 xanax. The Nardil reduction, so far, has caused no problems and less daytime sedation. The addition of exercise has helped tremendously.
>
> (For those of you curious, when I am in the worst depressive state, exercise does nothing.)
>
> -z
Posted by dale1975 on November 9, 2011, at 17:27:18
In reply to Re: Playing with fire?. GOOD SLEEP UPDATE NEWS, posted by zonked on October 29, 2011, at 1:18:41
Posted by dale1975 on November 9, 2011, at 17:30:26
In reply to Re: Playing with fire?.Risperdal for sleep (nm), posted by dale1975 on November 9, 2011, at 17:27:18
I take Risperdal for Nardil sleep issues. 1 mg at bedtime. It works like a charm and it does not leave you sleepy in the AM.
I have been on Nardil for the last 15 years. If you have any questions please feel free to ask.
Suz
Posted by Avenarius on November 9, 2011, at 22:06:31
In reply to Re: Playing with fire?.Risperdal for sleep, posted by dale1975 on November 9, 2011, at 17:30:26
> I take Risperdal for Nardil sleep issues. 1 mg at bedtime. It works like a charm and it does not leave you sleepy in the AM.
>
> I have been on Nardil for the last 15 years. If you have any questions please feel free to ask.
>
> SuzHave you been taking something for sleep for 15 years as well? I take ambien and it works great but I don't like the idea of taking it every day forever so i'm not sure i can contiue with maoi.
This is the end of the thread.
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