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Questions on phenelzine/Nardil (@jedi and others)

Posted by europerep on July 3, 2011, at 11:43:52

Hello there..

To make it short, I have decided to try out phenelzine (Nardil) for treatment-resistant depression. The reason for that is, on the one hand, that I want to have failed on both tranylcypromine and phenelzine before I ever consider ECT, and on the other hand, that I am wondering whether my depression isn't "atypical" after all. A couple of days ago I read a paper by Michael Thase and others that stated how positive mood reactivity may actually not be such a decisive factor in recognizing atypical depression as it was once thought, i.e. atypical depression can also be without positive mood reactivity. (The paper can be found here: ) In terms of other symptoms/criteria, I am pretty sure it's atypical:
- early age of onset: check
- eating (too) much: check (I am not overweight, but I eat much more than others)
- sleeping too much: double check
- rejection sensitivity: check

So, if this is atypical, I would definitely want to try phenelzine before doing anything else. I have taken tranylcypromine before, so I know all the diet stuff and all that, and I just have a couple of questions relating specifically to phenelzine:

1) Are there any "rules" on when to take a dose? (As with tranylcypromine not after 1PM or so, in order to avoid insomnia)

2) Do those of you who take it successfully also take vitamin B6 supplements? There is this issue of phenelzine maybe causing vit B6 deficiency.

3) Concerning meals and eating, I actually have a question for the jedi(-master) here ;-)
You mentioned you have implemented a special diet that allows you to counter the weight gain side effects. What is that you eat a lot of, and what do you eat rarely or not at all? Do you know how many calories you have per day?
I'm asking because you mentioned how you wished you had started that diet right when starting nardil, so in the unlikely case that it will work for me, I would really like to "pre-emptively" implement a good diet so as to not gain too much weight from it.

4) Anything else I should know about phenelzine that isn't covered by the general "MAOI rules"?

As always, thanks a lot in advance!





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