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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Cee on March 15, 2013, at 22:48:02
Hello it seems like your knowledge of the Nardil question is is very extensive can you share with us what you think is the best way to go with all the old and new Nardil questions and what would be the best way to go to feeling your best on Nardil. Thank you again. Cee from Canada
Posted by Tomatheus on March 15, 2013, at 23:56:00
In reply to Nardil tomatheus, posted by Cee on March 15, 2013, at 22:48:02
Hi Cee,
I personally think that the best way to proceed if someone is prescribed Nardil would be to first try taking the regular film-coated tablets and see what kind of response develops after at least several weeks on the medication. There are some individuals who took both the "old" and "new" versions of Nardil who did not report noticing a difference between the two versions of the medication, so there is a possibility that taking "new" Nardil could help bring about remission of the symptoms of depressive and anxiety disorders.
I think that getting Nardil compounded to be more like the "old" Nardil would probably be the best option to consider for someone who's spent at least two months taking 60-90 mg of the medication without significant lasting results. Does this mean that getting Nardil compounded will make the medication more effective for everybody? Of course not. No medication is universally effective, not even the "old" Nardil. However, out of the strategies that members of the Anxiety Community's Nardil forum have tried, getting Nardil compounded seemed to work the best. Putting the contents of one's film-coated Nardil tablets into enteric capsules was a strategy that I and one other Psycho-Babble member found helpful for some time, but that was a real hassle, and I still noticed a loss in effectiveness if my film-coated tablets were sitting in the pill bottle on the shelf for too long before I put the contents of the tablets into the enteric capsules. Additionally, there were at least a few members of the Anxiety Community's Nardil forum who tried putting the contents of their Nardil tablets into enteric capsules and did not feel any better on the enteric Nardil than they did on regular film-coated Nardil. So, I think that getting your Nardil tablets compounded right after picking up your prescription from your pharmacy would probably be the best strategy to follow if you want to take Nardil that might possibly perform in in a way that's similar to the way that the old version of the medication performed. Compounded Nardil probably wouldn't be exactly the same as "old" Nardil, but I can't think of anything else that would be closer to the old version in this day and age than a compounded version of the medication.
What ultimately led me to discontinue Nardil when I was taking the medication using the enteric capsules was what at least seemed to be a bad batch of the medication. I just didn't see the point in continuing to take the medication if it was not only ineffective but also intolerable at times, depending on what may have been the quality of the batch that I got. Others taking Nardil have reported possible bad batches since the medication's formulation was changed in 2003, but it doesn't seem to be clear how frequently the problem of possible bad batches surfaces. As far as I know, bad batches of the Gavis phenelzine and versions of Nardil other than that made by Pfizer in Angers, France, have not been reported. So, with the Gavis phenelzine being an option in the U.S., the problems associated with receiving what may be bad batches of Nardil shouldn't be so much of a concern.
Well, I hope that this answers your questions. Others may think that taking a course of action that's different from what I recommended would be best, but what I've written sums up my thoughts on what I think would be the best course of action to take.
Tomatheus
Posted by brklyn233342 on March 16, 2013, at 0:04:34
In reply to Nardil tomatheus, posted by Cee on March 15, 2013, at 22:48:02
Tom is the best.....personaly id say if youre comfortable enough and your doc is,which is unlikly lol,see if a mild stimulant like modfanil in small doses can be added.
Posted by Tomatheus on March 16, 2013, at 0:08:01
In reply to Re: Nardil tomatheus, posted by brklyn233342 on March 16, 2013, at 0:04:34
> Tom is the best.....personaly id say if youre comfortable enough and your doc is,which is unlikly lol,see if a mild stimulant like modfanil in small doses can be added.
Yes, augmenting Nardil with something like a stimulant is something else to consider. I probably should have mentioned that in my post.
Tomatheus
Posted by SLS on March 16, 2013, at 7:08:53
In reply to Re: Nardil tomatheus » Cee, posted by Tomatheus on March 15, 2013, at 23:56:00
I am only one person, but I find no differences in the way the old Nardil and new Nardil affect me. Perhaps I am in the minority.
- Scott
Posted by SLS on March 16, 2013, at 7:11:19
In reply to Nardil tomatheus, posted by Cee on March 15, 2013, at 22:48:02
What symptoms or illnesses are you being treated for?
- Scott
Posted by Tomatheus on March 16, 2013, at 12:02:34
In reply to Re: Nardil tomatheus » Cee, posted by SLS on March 16, 2013, at 7:11:19
> What symptoms or illnesses are you being treated for?
Yes, that does need to be considered when coming up with augmentation options. In my opinion, the option of augmenting with a stimulant (as mentioned earlier) may be useful for those experiencing problems with low energy, but may be counterproductive if anxiety is a bigger problem. Augmenting Nardil with a benzodiazepine seems like it would be a good option in cases where anxiety symptoms predominate.
Anyway, Scott, I'll step back and let Cee answer your question.
Tomatheus
Posted by Cee on March 16, 2013, at 12:23:50
In reply to Re: Nardil tomatheus » SLS, posted by Tomatheus on March 16, 2013, at 12:02:34
Hello Scott
I have tried many many other anti depresants without ant thing good happening after a bad depression and anxiety back in 2000my doc put me on Nardil and after hang in in there for 9 weeks it finally lifted my depression it was the best feeling I have ever had. My pdoc retired so I did not have anybody to guide me .I took to much and developed seratonon syndrome and had to quit the old Nardil. Years past buy with my depression anxiety getting th worse it has ever been so they hospitalized me for nine weeks and put me on new Nardil. The new Nardil has worked for me about 80 percent but I am hoping for more. Basically Scott I have a bad dep with bad anxiety. Cee
Posted by SLS on March 16, 2013, at 14:30:47
In reply to Re: Nardil tomatheus, posted by Cee on March 16, 2013, at 12:23:50
Unfortunately, when treating depression, it is not so uncommon for someone to receive a diminished therapeutic effect when returning to a previously effective drug. I have seen quite a few reports of this happening with Nardil. It happened to me. You could try increasing the dosage to an equivalent of 1.0 milligram per kilogram of body weight. When taking Nardil, I do best at 90 mg/day. Your other option is to augment Nardil with another drug.
Which is more troublesome right now - depression or anxiety?
How do you respond to paroxetine?
- Scott
Posted by ChicagoKat on March 18, 2013, at 20:25:26
In reply to Re: Nardil tomatheus » Cee, posted by SLS on March 16, 2013, at 14:30:47
> Unfortunately, when treating depression, it is not so uncommon for someone to receive a diminished therapeutic effect when returning to a previously effective drug. I have seen quite a few reports of this happening with Nardil. It happened to me. >
>
> - ScottYep, happened to me too. The first go-round with Nardil was great: it really helped my anxiety and depression. Unfortunately negative side effects led us to stop it as there were still things left in the arsenal to try. When those drugs failed, pdoc and I tried Nardil again. Not only did it not work as it did the first time, I actually got MORE anxious on it, which is REALLY weird.
Kat
This is the end of the thread.
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