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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by mworkman on July 19, 2005, at 11:52:04
Hi, my pdoc wants to keep me at 45 mg of nardil. I though 60 mg was supposed to be the dose where it really starts becoming effective. Does this mean I won't get the full benefit, just partial? It seems kind of stupid to be trying this drug and then keep the dose lower than it needs to be.
Posted by Declan on July 19, 2005, at 16:03:39
In reply to 45 mg nardil?, posted by mworkman on July 19, 2005, at 11:52:04
Hi
If I took Nardil I'd like to be on the minimum effective dose. But maybe the therapeutic effects start with the side effects? How wide is the therapeutic window? Once you go to a higher dose will the lower dose work for you as it did? Will weight gain, sex problems, constipation, edema be a problem long term?
It sounds like a great drug. I don't know the answers to those questions, but I'd be thinking long term.
I'd like to hear from Chairman MAO how Nardil is going with him
Declan
Posted by 4WD on July 19, 2005, at 23:24:19
In reply to Re: 45 mg nardil?, posted by Declan on July 19, 2005, at 16:03:39
Posted by ace on July 19, 2005, at 23:39:11
In reply to 45 mg nardil?, posted by mworkman on July 19, 2005, at 11:52:04
> Hi, my pdoc wants to keep me at 45 mg of nardil.
Why?
I though 60 mg was supposed to be the dose where it really starts becoming effective.Usually is. And 90mg blows your mind!
Does this mean I won't get the full benefit, just partial?Yes. I think so.
It seems kind of stupid to be trying this drug and then keep the dose lower than it needs to be.It is. Find another doctor....doesn't have to be a pdoc.
Ace
Posted by KaraS on July 20, 2005, at 2:22:15
In reply to 45 mg nardil?, posted by mworkman on July 19, 2005, at 11:52:04
Could it be that he just wants to see how you do at 45 before he raises it (in case you don't need it raised)? Or is he dead set on never going over 45 mg?
Posted by gardenergirl on July 20, 2005, at 11:39:18
In reply to Re: 45 mg nardil? » mworkman, posted by KaraS on July 20, 2005, at 2:22:15
Makes sense to me about seeing how 45 mg does. Why take more of a med than you need?
And just fyi, I know 90 mg works for Ace, but I could not tolerate anything above 67.5 mg. At 75 mg I get akasthisia something awful.Good luck,
gg
Posted by mworkman on July 20, 2005, at 17:09:26
In reply to Re: 45 mg nardil? » mworkman, posted by ace on July 19, 2005, at 23:39:11
I will just try 45 mg for a month and see how it does. If it isn't working as well as I think it can I will ask to go up. Maybe 45 mg is enough.
Posted by Jedi on July 22, 2005, at 3:19:59
In reply to Re: 45 mg nardil? » mworkman, posted by mworkman on July 20, 2005, at 17:09:26
I have been on and off phenelzine (Nardil) for the past nine years. This is the only medication out of at least twenty-five different combinations that has worked for my severe, treatment resistant, atypical depression. The usual effective dose is stated as 1mg per kg of body weight. Thus a 165 pound person will likely require a 75mg daily dose or five 15mg tablets daily. The maximum dose is stated as 90mg per day, however this has been exceeded in patients with severe depression and a gutsy doctor. Psychiatrists will start at a low dose and ramp up in an attempt to minimize the drug side effects. The problem with this is it will take about three or four weeks for the medication to kick in after the effective dose is reached. This will seem like an awfully long time for someone who is deathly ill.
For me, the worst side effect has been severe carbohydrate cravings resulting in weight gain of about 30kg. The only way I’ve been able to control the weight is with two hours of strenuous exercise daily. I believe that weight gains, along with the sexual side effects, are the primary reasons patients stop taking phenelzine. However, with true treatment resistant depression, there will be no question which is the worst of the evils.
Posted by willyee on July 22, 2005, at 9:10:50
In reply to Re: Nardil Effective Dosage, posted by Jedi on July 22, 2005, at 3:19:59
"The only way I’ve been able to control the weight is with two hours of strenuous exercise daily. I believe that weight gains, along with the sexual side effects, are the primary reasons patients stop taking phenelzine. However, with true treatment resistant depression, there will be no question which is the worst of the evils."
Thank you,cheers!!!! I see this complaint too many times,i mean i can understand the frustration of weight gain,but if we are all experiacning the same hell i associate my depression with when it`s untreated,then i invited something trival as weight gain,i dont even see the dilema,suffer grueling internal pain,possably bed ridden,without any options to pursue,or gain a few pounds which unlike depression u do have an option to attempt to loose it.
I am not happy about my medications ability to make orgasm near impossable for me,but again trivial i can not,CAN NOT bear depression there is simply not a debate as too the compromise.Thanks for someone finally seeing that to be crystal clear after so many posts are to the contary.
"
Posted by gardenergirl on July 22, 2005, at 11:45:34
In reply to Re: Nardil Effective Dosage, posted by Jedi on July 22, 2005, at 3:19:59
Posted by JohnB11 on July 22, 2005, at 12:40:56
In reply to 45 mg nardil?, posted by mworkman on July 19, 2005, at 11:52:04
Hi, I think the right Nardil dosage varies somewhat from person to person. What you really want is the lowest dose to bring your SP down to a manageable level. Hopefully, for you, this will be less than 60 mg/day. The problem with 60 mg is that, though effective, many people have intolerable side effects, such as complete sexual dysfunction, and orthostatic hypotension (low blood pressure makes you almost feint when you stand up). While I've been on 60 mg of Nardil before, I always left the Nardil, due to these very side effects. For this reason, I currently taking Nardil 45 mg/day, with the hope of reducing to 30 mg/day. At 45 mg/day, I still have significant sexual dysfunction. My hope is 30 mg/day, augmented by Klonopin, will achieve the desired effect without the loss of libido and ability to achieve orgasm.
JohnB11
Posted by ed_uk on July 22, 2005, at 14:04:24
In reply to Re: Nardil Effective Dosage, posted by willyee on July 22, 2005, at 9:10:50
I agree. Anyone who thinks anorgasmia is worse than being depressed must have been suffering from an extremely mild/trivial form of depression.
~Ed
Posted by Declan on July 22, 2005, at 16:07:07
In reply to Re: Nardil Effective Dosage, posted by willyee on July 22, 2005, at 9:10:50
Hi Willy
So you're on Parnate 30mg/d? Is that right? And it makes orgasm near impossible? Just orgasms, or everything?
Declan
Posted by willyee on July 22, 2005, at 19:21:39
In reply to Parnate and orgasms » willyee, posted by Declan on July 22, 2005, at 16:07:07
> Hi Willy
> So you're on Parnate 30mg/d? Is that right? And it makes orgasm near impossible? Just orgasms, or everything?
> DeclanUnfortunatly im not on a set dose as of yet,i am however under a umbrella meaning a mean range.I take no less than 40 mg daily,and no more than 80.
Im adjusting increments still,as well as adjunct meds trying to find the best theputic combo/dose.
Regardless however at any dose the sexual side effects are the same,there is no loss of sexual desire,in fact erections and desire are at times enhanced,but acheining orgasism can be damn near impossable at times,its very very frustrating,and times embarrsing but so is being bed ridden so again i just say oh well.Getting the med to be theputicaly effective is much much more of a concern and priority for me then solving the sexual issue,i have plenty of time for that and have already had a great drug free teen life,the memories are still there,lol yess!
This is the end of the thread.
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