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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by jef on January 24, 2003, at 16:49:09
Hi,
After the last Nardil shortage, I considered moving to another A/D.
Has anyone done this successfully, and if so, what was the replacement agent (if any)?
I am still on Nardil. I have a friend who switched to Paxil and is going through a rough time with it.
Regards.
Posted by Jack Smith on January 24, 2003, at 16:58:16
In reply to Has anyone discontinued Nardil, posted by jef on January 24, 2003, at 16:49:09
Why get off Nardil? Side effects, too much? Or are you afraid of another shortage? As for the second, according to what I have heard, the shortage was caused by problems associated with Pfizer taking over the company that made nardil.
Posted by Suzanne on January 24, 2003, at 18:59:06
In reply to Re: Has anyone discontinued Nardil, posted by Jack Smith on January 24, 2003, at 16:58:16
I went off of Nardil on January 1st. It was very difficult to get at the time and I discussed with my doctor and we both agreed. I was on 22 mg. a day. I cut it back to 15mg for a couple of days and then took only .5 Clonaxepam at night. After 14 days, I started Paxil. I started having nightmares and nausea, so after two days, I was switched to Effexor XR- 37.5 mg.
I have been on this for almost a week. I am having some shakiness in the morning, but after the medication kicks in, I feel better. I still take the .5 Clonazepam at night. The mornings seems to be getting better.
I had been on Nardil for almost 17 years. I was somewhat scared to come off of it, but it wasn't very hard. The hardest part was the 14 days before I could take something else. I am very sensitive to medications, so I wasn't ever on a high dosage of Nardil. I see my doctor next Friday and will know more then.
Posted by djmmm on January 24, 2003, at 20:26:37
In reply to Re: Has anyone discontinued Nardil, posted by Jack Smith on January 24, 2003, at 16:58:16
The problems weren't due to Warner-Lambert aquiring Pfizer/Parke-Davis.
The problem is with the spotty standards that Warner-Lambert has an extensive history of. This isn't the first time "manufacturing difficulties" have effected medication availability...
In fact, the reason why they have "manufacturing difficulties" is because Warner-Lambert apparently has problems following the basic standards of manufacturing required by the FDA. The FDA has in the past been forced to get a court injunction to get this co. to comply with basic standards (Good Manufacturing Practice) This court order included: "All laboratory personnel will be trained so as to be fully
qualified to perform their assigned duties."
and "Outside experts will certify that manufacturing processes are in compliance with GMPs.(Good Manufacturing Practice)"One year, more than a dozen meds had to be recalled because this co failed to comply with basic standards.
I believe this is the 3rd time Nardil was involved
Posted by Jef on January 25, 2003, at 2:41:34
In reply to Has anyone discontinued Nardil, posted by jef on January 24, 2003, at 16:49:09
I've been taking 60 mgs/day of this admittedly wonderful drug since 1982. I refer to it a "wonderful" because it seems to accomplish what most of the other psychoactives didn't.
I am now facing a serious of sports related surgeries. Some anesthesia docs are cool with Nardil still on-board, others are not. I had an elbow tendon reattached a couple of yrs ago, and they had trouble bringing BP down post-surgery.
The most clear and present side-effect for me has been insomnia. Nardil keeps me up, piecing the night together with ramblings down the hallways.
Thus...I was thinking it might be time to shift to another drug.
Jeff
Posted by Jef on January 25, 2003, at 2:41:35
In reply to Has anyone discontinued Nardil, posted by jef on January 24, 2003, at 16:49:09
I've been taking 60 mgs/day of this admittedly wonderful drug since 1982. I refer to it a "wonderful" because it seems to accomplish what most of the other psychoactives didn't.
I am now facing a serious of sports related surgeries. Some anesthesia docs are cool with Nardil still on-board, others are not. I had an elbow tendon reattached a couple of yrs ago, and they had trouble bringing BP down post-surgery.
The most clear and present side-effect for me has been insomnia. Nardil keeps me up, piecing the night together with ramblings down the hallways.
Thus...I was thinking it might be time to shift to another drug.
Jeff
Posted by Ame Sans Vie on January 25, 2003, at 5:41:07
In reply to Re: Has anyone discontinued Nardil, posted by Jef on January 25, 2003, at 2:41:35
Ironically, I was lucky enough to quit the Nardil in mid-November, and I believe the difficulty obtaining it began a week or two later. But I was just sick of it-- didn't do *anything* for my social phobia, I was having at least a dozen severe orthohypotension episodes per day, and of course, the sexual side effects. I'd been on it for about seven months, and for the last three, four months I was on 60mg b.i.d. I have to wonder if it was some of the "subpotent" Nardil I was getting... I may just give it another shot to test this theory. The side effects wouldn't have been bothersome at all if it'd work even just a *little*. Oh well, I'll talk to my pdoc in four days.
--Michael
Posted by cosis on January 25, 2003, at 9:11:04
In reply to Re: Has anyone discontinued Nardil, posted by Ame Sans Vie on January 25, 2003, at 5:41:07
Nardil did not work for my social phobia until I bumped it up to 75mg.
Posted by sciutti on January 25, 2003, at 22:41:57
In reply to Re: Has anyone discontinued Nardil, posted by Suzanne on January 24, 2003, at 18:59:06
I think I can help you guys with your qustions about surgery,etc. (I am learning to use a computer STILL! and just found my message) I am a nurse anesthetist, and I just had surgery on 12/12/03. I went to same group I used to work for and the older doc said I needed to be off nardil, but the newer generation won't make you as long as he knows your history,etc. How long can these replies be?? I have only been on nardil since Aug. after looking since '95 and trying 23 other AD and going for ECT in Jan. My doc hadn't used MSO's and was quite leary about starting me on it, but since my serotonin system is obvioulsy screwed up I knew a dopamine class of drug would work and I can't believe it! I have never felt better in my life and I WILL NEVER go off. The other drugs I am taking are: oxycontin 80mg 3 tabs, 3Xday, norco 10mg 6-8 prn, ritalin SR 40mg 3Xday and I have an internal pain pump with dilaudid 12mg/24hr.!!! Yes, quite a tolerance, but it does control my chronic pain for which I am grateful. I have not had any side effects from anything I have taken, so I am quite lucky. It is truly amazing for the depression to be getting better and I wish other patients would have the same results I have. If anyone has any questions, I will try to help and all this info is from my personal experience and not meant to be a "doctor thing!" I am so glad I found this web site cuz I have questions for you guys later. Thanks, Joanne.
Posted by jef on January 26, 2003, at 0:39:18
In reply to Re: Has anyone discontinued Nardil, posted by Ame Sans Vie on January 25, 2003, at 5:41:07
As I mentioned, I've taken Nardil since 1982. A variety of pdocs have all encouraged me to try something else; sometimes I agreed and circled back to Nardil.
Depression/anxiety runs in the family. My mother has also taken Nardil for years, and due to the shortage tried Paxil. She's stubbornly stuck to the trial...and has been miserable, with a plethora of new physical complaints suddenly showing.
Oddly, 60 mg/day hasn't produced any hypotension, I have hypertension and take an ACE inhibitor.
I've had high ferritin (iron) which after a lot of iron panels resulted in good old fashioned phlebotomy (blood-letting.) I've sometimes wondered if Nardil "caused" that.
I am disappointed in Pfizer. They have the resources to have avoided this supply problem. I expect potential problems with their more profitable drugs get quicker remedies. :-)
Jeff
Posted by Luka62 on January 26, 2003, at 19:43:44
In reply to Re: Has anyone discontinued Nardil, posted by jef on January 26, 2003, at 0:39:18
I have been on Nardil since 1985. I have had several trial periods going off it. I didn't have as much trouble with withdrawal but rather sinking into the most terrible depression I'd ever known. I was off it for 3 months a couple of years ago, and after that horrible period I knew it was here to stay. I only pray it continues to be marketed, as nothing else has helped me. Over the years I'd faced a lot of problems with hypotension, as well as hypomania--
and insomnia. I've taken varying doses, from
30mg/day up to 75mg/day. I currently take 30mg.
For a number of years I've had to take my entire daily amount all at once in the morning, otherwise I too would be up all night. (I still have a lot of insomnia problems, but related to other things.)
I recently had surgery too, and at first I was told I'd have to stop the Nardil for 2 weeks, but two anesthesiologists conferred and they called and said not to stop the Nardil. Now this was not inpatient major surgery, but same day surgery. There are some new anesthesia meds in use that are compatible with nardil, but not all docs are up to speed on them, or perhaps they want to stick with the tried and true safe methods.
Posted by Jumpy on January 26, 2003, at 19:56:10
In reply to Re: Has anyone discontinued Nardil » jef, posted by Luka62 on January 26, 2003, at 19:43:44
>Over the years I'd faced a lot of problems with hypotension, as well as hypomania and insomnia.
Hey Luka,
What do you do to control the hypomania? What is hypomania like?
Thanks,
Jumpy
PS I have taken nardil too, I get kind of "speedy", but I think this is just how normal people feel thou, but I am alway scared it might be hypomania
Posted by Luka62 on January 26, 2003, at 20:15:35
In reply to Re: Has anyone discontinued Nardil » Luka62, posted by Jumpy on January 26, 2003, at 19:56:10
Jumpy, Nardil definitely precipitated hypomania in me. Things are not nearly as bad as they used to be, I don't know if it's due to intensive therapy with a great therapist for so long, or maybe the body changes how it responds to it as you get older. It made me hypomanic--to full-blown manic lots of times. The thoughts get very rapid, with a million things going on in my mind at once, and physically it seems impossible to slow down. I'd be up at 3 in the morning cleaning, even wiping down the walls. That's not uncommon. And I was easily distractible; sometimes it would get so bad it would frustrate me to no end not being able to get things done, to the point of both physical and mental collapse. I do have a diagnosis of Bipolar, and D.I.D., so there's more of a tendency toward hypomania; though people who are not bipolar can also experience racing thoughts and hyperactivity on Nardil. If I were to take an extra one, I get to the point know where i am so shaky I feel ill.
Posted by Jumpy on January 26, 2003, at 21:22:56
In reply to Re: Has anyone discontinued Nardil » Jumpy, posted by Luka62 on January 26, 2003, at 20:15:35
> Jumpy, Nardil definitely precipitated hypomania in me. Things are not nearly as bad as they used to be, I don't know if it's due to intensive therapy with a great therapist for so long, or maybe the body changes how it responds to it as you get older. It made me hypomanic--to full-blown manic lots of times. The thoughts get very rapid, with a million things going on in my mind at once, and physically it seems impossible to slow down. I'd be up at 3 in the morning cleaning, even wiping down the walls. That's not uncommon. And I was easily distractible; sometimes it would get so bad it would frustrate me to no end not being able to get things done, to the point of both physical and mental collapse. I do have a diagnosis of Bipolar, and D.I.D., so there's more of a tendency toward hypomania; though people who are not bipolar can also experience racing thoughts and hyperactivity on Nardil. If I were to take an extra one, I get to the point know where i am so shaky I feel ill.
>Hmmmm. Well on nardil, I can't sleep at all without ambien. My libdo returns and I get more active at work and socially. And yes, there have been a couple of times where I couldn't sleep so I would get up and "wash the walls". I tend to be more aggressive and assertive.
So, how do you know if this is normal(with side effects of nardil) or hypomania? Thanks.
Jumpy
PS Also, my I get distracted easier and my concentration is mildly decreased. But is this the normal mental fuzziness of nardil (increased gaba levels?) or hypomania?
BTW I have both bipolar and unipolar relatives
Posted by Luka62 on January 26, 2003, at 22:07:02
In reply to Re: Has anyone discontinued Nardil » Luka62, posted by Jumpy on January 26, 2003, at 21:22:56
I can't sleep at all without taking something to help me, and even then, I still have trouble getting to sleep. It's really interesting that you do have bipolar relatives, Jumpy. Bipolar can run in families. It sounds like you might experience hypomanic symptoms at times, as a byproduct of the Nardil. People who aren't bipolar can show hypomanic symptoms. To what degree differs from one patient to another. I've found that I just have to deal with those symptoms as they come, sometimes with other meds, because the Nardil is so important for me. Have you talked with your doc about it?
Posted by victoria1063 on January 26, 2003, at 22:36:23
In reply to Re: Has anyone discontinued Nardil » Luka62, posted by Jumpy on January 26, 2003, at 21:22:56
Jumpy, You asked:
"But is this the normal mental fuzziness of nardil (increased gaba levels?) or hypomania?
I've been taking 60 mg of nardil a day since 1980. I initially began taking it to help with my agoraphobia and it worked wonders. It's been a life-saving drug for me. But recently I've been dealing with a lot of depression that the nardil doesn't seem to help very much. Also a good deal of "mental fuzziness."
Do you think that after this much time on nardil that I could be experiencing a side effect I've never had before? I think it's probably the depression that's getting to me most, but I'm just curious about this side effect of Nardil. I was never aware that it was a side effect.
Vicky
Posted by Luka62 on January 26, 2003, at 22:45:04
In reply to Re: Has anyone discontinued Nardil, posted by victoria1063 on January 26, 2003, at 22:36:23
Vicky>>
I am wondering the same; the way I respond to Nardil now is so much different than I did in the earlier years.(Been taking it since 1985.) Any studies out there about longterm usage?
Posted by victoria1063 on January 26, 2003, at 23:16:17
In reply to Re: Has anyone discontinued Nardil, posted by Luka62 on January 26, 2003, at 22:45:04
Luka62, Unfortunately, I think "we" may be the studies. And since no one has every surveyed us about long term use of Nardil, I doubt there have been any. When I was pregnant 14 and 3 years ago, I tried to find some actual studies on Nardil and pregnancies. There were none to be found. At least, no human studies. I did not risk it for my first pregnancy, but I took Nardil throughout my second pregnancy and breast fed her for six months while on Nardil. I have a very bright and beautiful 3 year old with no apparent problems. You would think that this should part of Nardil history somewhere for other women considering pregnancy while on Nardil.
I'd like to be wrong. I would love to see some studies done on the long term effects of Nardil. If anyone has heard of any, please let us know.
Thanks,
Vicky
Posted by Jef on January 27, 2003, at 1:40:14
In reply to Re: Has anyone discontinued Nardil » jef, posted by Luka62 on January 26, 2003, at 19:43:44
Interesting thoughts on hypomania. I find I can induce a rather productive mild "hyper" state by ratcheting up my daily Nardil dose by 15-30 mgs (giving me daily total of 75--90 mgs).
And in all kinds of athletic situations, from one form or another of martial arts, to competitive power-lifting, that increased dose helped. It also caused me excessive sweating.
At work, the increased dose causes some minor distraction, but increased sociability and face to face time.
Jeff
Posted by Luka62 on January 27, 2003, at 12:54:46
In reply to Re: Has anyone discontinued Nardil, posted by Jef on January 27, 2003, at 1:40:14
I've had the same experience Jef. I knew when I needed a little boost and increased the dosage for a bit. It really helped with my social anxiety too, which still can be pretty crippling for me. (I've been isolating really bad the past 2 weeks.) But I can no longer increase my dosage anymore. It makes me so shakey, and I feel physically ill. I don't know why the change. For years I could adjust it up or down, I knew so well how I'd respond.
Posted by micky301 on January 27, 2003, at 16:06:45
In reply to Re: Has anyone discontinued Nardil » Jef, posted by Luka62 on January 27, 2003, at 12:54:46
I wanted to ask something. I have been taking Nardil for about 3 weeks without any benefits. The dose I am at now is 45mg/day. I am having alot of problems with nausea, tremors, achy headedness (following the diet), and weakness. Has anyone faced this in the past on Nardil???
Posted by jef on January 27, 2003, at 17:32:02
In reply to Re: Has anyone discontinued Nardil, posted by micky301 on January 27, 2003, at 16:06:45
I remember feeling uncomfortable starting Nardil. I felt spacy and had some tremors. I know that it took about one month (for me)for the psycho-benefits to begin. But the wait was well worth it. You might also notice lighter sleep/insomnia.
I found the following months to be times of constantly feeling better, and away from the pretty deep depression I experienced.
My thought would be to stay in close touch with your doc...and maybe give the stuff a chance to work. It really has for me. Best of luck.
> I wanted to ask something. I have been taking Nardil for about 3 weeks without any benefits. The dose I am at now is 45mg/day. I am having alot of problems with nausea, tremors, achy headedness (following the diet), and weakness. Has anyone faced this in the past on Nardil???
Posted by ace on January 27, 2003, at 19:18:16
In reply to Re: Has anyone discontinued Nardil, posted by micky301 on January 27, 2003, at 16:06:45
> I wanted to ask something. I have been taking Nardil for about 3 weeks without any benefits. The dose I am at now is 45mg/day. I am having alot of problems with nausea, tremors, achy headedness (following the diet), and weakness. Has anyone faced this in the past on Nardil???
I have experienced nausea, a bit of jitterness (after cigarretes usually) weakness.
3 weeks is nothing. They faded with me, probably will fade with you. You might not experience any benifit until 60mg has been continued for at least 4 weeks. Also, some need higher dose and longer times (for type of illness). Csosis didn't experience any social phobia benifits until he reached 75mg. Anti OCD effects usually take 12 weeks -- 4 of them at 90mg.
Some are OK with lower doses but some definately aren't.
Posted by luther on September 10, 2003, at 11:58:18
In reply to Re: Has anyone discontinued Nardil, posted by djmmm on January 24, 2003, at 20:26:37
I recently called Pfizer 1-800-438-1985, not because I can't get Nardil, but the new replacement type doesn't work at all. I've taken Nardil for 10 years without any problems with it not being effective. The new type will not have the orange coating of the old type, it doesn't have a coating. When I called, I was told that is so Nardil can be Gluten free so more people can take it. I was told the formula was not changed. My reply was if it has not been changed why doesn't it work? They said "I need to see my doctor" and I replied that I taught her most of what she knows about SAD, which I thought was funny, but partly true. Now I feel if I had stopped Nardil cold turkey with all the side effects after only a week with the new refill. I would like to know if anyone has had the same experience? Feel free to e-mail me at luthermeeks36@aol.com
Posted by ace on November 6, 2003, at 0:15:49
In reply to Re: Has anyone taken the new Nardil?, posted by luther on September 10, 2003, at 11:58:18
> I recently called Pfizer 1-800-438-1985, not because I can't get Nardil, but the new replacement type doesn't work at all. I've taken Nardil for 10 years without any problems with it not being effective. The new type will not have the orange coating of the old type, it doesn't have a coating. When I called, I was told that is so Nardil can be Gluten free so more people can take it. I was told the formula was not changed. My reply was if it has not been changed why doesn't it work? They said "I need to see my doctor" and I replied that I taught her most of what she knows about SAD, which I thought was funny, but partly true. Now I feel if I had stopped Nardil cold turkey with all the side effects after only a week with the new refill. I would like to know if anyone has had the same experience? Feel free to e-mail me at luthermeeks36@aol.com
Too many times I've seen this response from the 'new' (unimproved!) Nardil- we have to make as many complaints as possible to get the old formulation back world wide. Thankfully, in Australia, I am on the old formulation through Link Pharmaceuticals. But giving out this weak nardil doesn't do the drug justice...Pfizer- wake up to yourselves!
aCE.>
>
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