Posted by SLS on November 1, 2015, at 16:21:38
In reply to Nardil, posted by john locke on November 1, 2015, at 13:27:18
> Sup y'all. I'm thinking about starting Nardil (phenelzine) for atypical depression, but have a few questions about it first. Just in case it "poops out" on me (aka loses effectiveness after a period of time), have any of y'all found any effective methods to combat this?
I am not aware of anything you can do preemptively to prevent Nardil poop-out. It is an interesting idea, though. I find that I do better when I take Nardil with desipramine or nortriptyline. Nardil does poop-out from time to time. Other drugs that you can consider that are generally safe to add to MAOIs are Wellbutrin and Buspar. Both of these drugs can enhance the antidepressant effect of Nardil as well as combat sexual side effects.
> Secondly, what medications have you found helps with the potential side effects (insomnia...). When Nardil upset my sleep, I took Ativan. Perhaps Ambien would be a better choice, as it does not impact negatively sleep architecture. Benzodiazepines inhibit delta-wave stage 4 restorative sleep. Ambien has its own side effect profile, which you may or may not experience. It can have significant amnestic effects. Perhaps you can start with melatonin. There is also Belsomra (suvorexant), the first of a new class of orexin antagonist drugs that do not interact with benzodiazepine receptors. I really don't know anything about its efficacy, side effects, or withdrawal potential.
> anorgasmia
Many people recover their ability to reach orgasm after 3 months. If you don't, Buspar or Periactin (cyproheptadine) might help.
> constipation, headaches
I have never known people who describe these things. I guess I just don't know enough people. I would keep things simple and use NSAIDs for headaches. Difficulties urinating is more likely to occur than constipation. A drug named bethanechol can help with this.
Dizziness is often a problem. If it becomes severe, you can try Florinef (fludrocortisone).
Try not to set yourself up for a nocebo effect. Parnate might be a better choice of MAOI if you are concerned with side effects.
Why have you chosen to go with a MAOI?
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1083826
URL: http://www.dr-bob.org/babble/20150929/msgs/1083831.html