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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 topdog on April 28, 2013, at 14:24:33
Have anyone found any substance or a combination to come close to effectiveness of Nardil in case the SSRI's, SNRI's and tricyclics have failed? I don't mean only antidepressants, any legal substance that could be used long term?
Thanx!
Posted by Tomatheus on April 28, 2013, at 15:07:08
In reply to Anything comparable to Nardil out there?, posted by topdog on April 28, 2013, at 14:24:33
Topdog,
I never experienced pronounced benefits lasting for more than three days with any psychiatric medication or medication combo other than the Nardil/doxylamine combo that I took from late 2005 through 2006, but I at least suspect that the condition that I've been trying to treat is idiopathic hypersomnia, and not clinical depression. The treatment of my hypersomnia and related symptoms is also more complicated now than it was back in 2006 because I now (since February 2007) have the symptoms of schizoaffective disorder to contend with.
I think that if you're looking for a treatment that compares to Nardil that you'd want to look at Marplan, Parnate, selegiline, Rhodiola rosea, and possibly moclobemide, if that's available to you. All of the substances that I mentioned have been shown to be MAOIs of one type or another. It's my understanding that Marplan and possibly Parnate are both "irreversible" MAOIs (meaning that they remain bound to MAO for the lives of the enzymes), and like Nardil, both Marplan and Parnate inhibit both MAO-A and MAO-B. Selegiline (like Nardil, Marplan, and possibly Parnate) inhibits MAO irreversibly, but if my understanding is correct, it's preferential in its inhibition of MAO-B, especially at lower doses. Moclobemide is a reversible inhibitor of MAO-A, and Van Diermen et al. (2009) found that Rhodiola rosea inhibits both type A and type B MAO. My guess would be that Rhodiola rosea is reversible in its inhibition of the MAO enzymes since dietary restrictions are not required when taking it, but I don't know with 100 percent certainty that that's the case.
It's my understanding that MAOIs come with more interactions than most psychiatric medications, but there are some medications that can be used to augment MAOI medications.
Tomatheus
==
REFERENCE
Van Diermen, D., Marston, A., Bravo, J., Reist, M., Carrupt, P.A., & Hostettmann, K. (2009). Monoamine oxidase inhibition by Rhodiola rosea l. roots. Journal of Ethnopharmacology, 122, 397-401. Abstract: http://www.ncbi.nlm.nih.gov/pubmed/19168123
Posted by gpznos on April 28, 2013, at 16:32:15
In reply to Re: Anything comparable to Nardil out there?, posted by Tomatheus on April 28, 2013, at 15:07:08
Hi
I have been taking Marplan for 9 weeks now and after going up to 30 mg I have experienced close to full remission. I am also taking 600 mg Lithium, 135 mg Noritren and 25 mg Valdoxan.
The most anoying SEs at the moment are dry mouth, constipation and delayed ejaculation + many toilet visits for pissing - but I can live with these SEs as long as I feel as good as I do now.
Posted by topdog on April 29, 2013, at 9:41:18
In reply to Anything comparable to Nardil out there?, posted by topdog on April 28, 2013, at 14:24:33
Thank you guys, this is what i thought.. MAOi's are the only solution. At my location in Europe pharmacies unfortunately don't carry prescription MAOi's at all, so i'm out of luck and depressed as ****. I can't see the road ahead anymore after i ran out my Nardil which i smuggled from UK for years. I don't know guys anymore, i'm really ****.
I can get Rhodiola rosea OTC though, anyone ever heard any success with that?
Posted by Tomatheus on April 29, 2013, at 11:11:04
In reply to Re: Anything comparable to Nardil out there?, posted by topdog on April 29, 2013, at 9:41:18
Topdog,
I don't think that I would say that MAOIs are necessarily the only solution in your case. I do, however, think that other MAOIs would be the first medications you'd want to look at if you're looking for medications that might be similar to Nardil in their effects.
Aside from other MAOIs, treatment options that might possibly produce some of the same types of benefits that you experienced on Nardil include:
* SSRIs
* SNRIs (serotonin-norepinephrine reuptake inhibitors)
* Wellbutrin
* Wellbutrin+SSRI
* SAM-eWhat are your experiences with the treatment options that I mentioned above?
Although I didn't experience long-term success with Rhodiola rosea when I tried it, I have read of many cases in which patients with depressive disorders and/or disturbances in energy reported experiencing good results with the herb. One site that you might want to look at, if only for the customer reviews of Rhodiola rosea, is iherb.com. The Web site sells a variety of herbs and other dietary supplements, and anyone can read the customer reviews of the products that they sell. I know that at least some of the Rhidiola rosea products that iherb sells have received a large number of customer reviews, many of which have been positive.
I hope that this helps some. Feel free to let me know if you have any questions about anything that I've written.
T.
Posted by Tomatheus on April 29, 2013, at 11:26:11
In reply to Re: Anything comparable to Nardil out there? » topdog, posted by Tomatheus on April 29, 2013, at 11:11:04
Topdog,
Here's an abstract summarizing the results of a controlled study that examined the efficacy of Rhodiola rosea in major depressive disorder. The findings seemed to indicate that the herb may have some value in treating mild to moderate cases of depression. The study that was summarized is, of course, just one study. I am not aware of any other studies that have replicated the study's findings, nor am I aware of any studies on Rhodiola rosea in depression that have come up with negative findings.
Here's the link to the abstract:
http://informahealthcare.com/doi/abs/10.1080/08039480701643290T.
Posted by topdog on April 30, 2013, at 11:22:54
In reply to Anything comparable to Nardil out there?, posted by topdog on April 28, 2013, at 14:24:33
Thank you for your response Tomatheus! Today i got a prescription for Remeron and Effexor, I'll give this combo a try as i have to get better. I miss the Nardil days thou..
Posted by Tomatheus on April 30, 2013, at 11:52:52
In reply to Re: Anything comparable to Nardil out there?, posted by topdog on April 30, 2013, at 11:22:54
Topdog,
Good luck with your Remeron/Effexor combo. I hope you find the combo to be beneficial, even if it doesn't end up giving you the same feel that Nardil gave you.
T.
Posted by Bob on April 30, 2013, at 12:55:43
In reply to Re: Anything comparable to Nardil out there?, posted by Tomatheus on April 28, 2013, at 15:07:08
> Topdog,
>
> I never experienced pronounced benefits lasting for more than three days with any psychiatric medication or medication combo other than the Nardil/doxylamine combo that I took from late 2005 through 2006, but I at least suspect that the condition that I've been trying to treat is idiopathic hypersomnia, and not clinical depression. The treatment of my hypersomnia and related symptoms is also more complicated now than it was back in 2006 because I now (since February 2007) have the symptoms of schizoaffective disorder to contend with.
>
> I think that if you're looking for a treatment that compares to Nardil that you'd want to look at Marplan, Parnate, selegiline, Rhodiola rosea, and possibly moclobemide, if that's available to you. All of the substances that I mentioned have been shown to be MAOIs of one type or another. It's my understanding that Marplan and possibly Parnate are both "irreversible" MAOIs (meaning that they remain bound to MAO for the lives of the enzymes), and like Nardil, both Marplan and Parnate inhibit both MAO-A and MAO-B. Selegiline (like Nardil, Marplan, and possibly Parnate) inhibits MAO irreversibly, but if my understanding is correct, it's preferential in its inhibition of MAO-B, especially at lower doses. Moclobemide is a reversible inhibitor of MAO-A, and Van Diermen et al. (2009) found that Rhodiola rosea inhibits both type A and type B MAO. My guess would be that Rhodiola rosea is reversible in its inhibition of the MAO enzymes since dietary restrictions are not required when taking it, but I don't know with 100 percent certainty that that's the case.
>
> It's my understanding that MAOIs come with more interactions than most psychiatric medications, but there are some medications that can be used to augment MAOI medications.
>
> Tomatheus
>
> ==
>
> REFERENCE
>
> Van Diermen, D., Marston, A., Bravo, J., Reist, M., Carrupt, P.A., & Hostettmann, K. (2009). Monoamine oxidase inhibition by Rhodiola rosea l. roots. Journal of Ethnopharmacology, 122, 397-401. Abstract: http://www.ncbi.nlm.nih.gov/pubmed/19168123
>
Hey Tomatheus,Why did you only take the Nardil/Doxylamine combo for one year if it worked so well? Did the Doxylamine have a problematic side effect profile for you?
Bob
Posted by Tomatheus on April 30, 2013, at 14:58:36
In reply to Re: Anything comparable to Nardil out there? » Tomatheus, posted by Bob on April 30, 2013, at 12:55:43
Hi Bob,
See below for my responses to your questions...
> Why did you only take the Nardil/Doxylamine combo for one year if it worked so well?
Well, I actually stayed on the combo for less than a year. It was probably more like six months altogether, if you count all the time that I spent taking film-coated Nardil and the Nardil that I took in the enteric capsules. The reason why I stopped taking Nardil with doxylamine was that even though I had been putting my Nardil into enteric capsules, I reached a point where I noticed a sudden loss of effectiveness combined with extreme agitation in June 2006. I was taking Pfizer's U.S. Nardil at the time and putting the contents of my tablets into enteric capsules, and I suspect that a bad batch of Nardil is what caused the sudden change in the way I responded to the medication. Several Nardil users who used to post on the Anxiety Community's Nardil forum reported receiving bad batches of the medication around that time, although I don't think that anyone on this board other than myself has written about getting bad batches of Nardil. I do recall that the Nardil that I was taking crushed up differently around the time it stopped working for me (I crushed up each Nardil tablet before putting the contents of the tablets into enteric capsules when I used the enteric capsules).
> Did the Doxylamine have a problematic side effect profile for you?
No. I actually don't recall experiencing any side effects that I could attribute to the doxylamine. I originally took the doxylamine hoping that it would help me fall asleep early each night. At one point, I tried discontinuing the doxylamine, and the next day, all of my symptoms (the low energy, slow thinking, hypersomnia, and difficulty concentrating) were back in full force. From that point until the time I stopped my Nardil, I kept taking the doxylamine, because it seemed like it might have been necessary to keep my response going.
T.
This is the end of the thread.
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