![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 59. This is the beginning of the thread.
Posted by 4WD on April 17, 2008, at 18:14:04
Ihave been on Nadil 45mg for six weeks now and it has already changed my life. The depression isn't always completely gone but there is so much difference. I am doing stuff like cleaning out the refrigerator and working in the garden.
I am still experiencing some side effects which pretty much kicked in when the Nardil did. Constipation, fluctuating blood pressure, dry mouth and insomnia. I go to sleep okay but wake at 3, 4, 5 and 6. Some mornings I just go ahead and get up. At first, I was going to bed at 11and waking up at 1:30 and not being able to go back to sleep. But a doctor (an older guy who used to prescribe Nardil a lot) suggested that I take my last dose of Nardil by 3pm and that has helped.
The scaredness hasn't gotten any better, however. I have had to raise my dose of Valium to 20mg a day and most days, I am still scared even after taking 10mg in the morning and 10mg in the afternoon. I am also taking 1.5mg Klonopin a day - .75 in the morning and .75 in the afternoon. I am using the Valium to taper off the Klonopin. I knokw the extra scaredness isn't from that though because it started before I lowered the dose the last time. Just this week I went from 2mg Klonopin a day to 1.5mg per day. But the extra scaredness started several days before that.
It's worth all the side effects though. I feel like I have my life back. If this is how I feel at 6 weeks, imagine how I'll feel at 10 weeks.
The older doctor who used to prescribe Nardil a lot told me something very interesting. In fact, he read it to me from the PDR. It said that once complete remission has been achieved on Nardil, the dosage should be lowered slowly by one pill a day over a period of time. It even said that you should go as low as one pill a day or even one every other day and the Nardil would still maintain it's efficacy. I don't think I'd go to one pill every other day but it's exciting to think that after I've achieved complete remission, I can go down to 30mg a day instead of 45. Maybe that will lessen the side effects. And then if I don't feel depression creeping back in, I'll try going to 15 mg a day.
Anyway, I am so excited and happy to have my life back. As some others here have said, I wish I had tried Nardil sooner. Instead of continuing 4 years on the SSRI/SNRI merry-go-round. I'm lucky to have a pdoc who is willing to prescribe an MAOI.
I've ordered a medic alert bracelet that says I'm on on MAOI and that I have hypotension. I was in Walmart the other day and felt faint and lightheaded. I checked my blood pressure at the pharmacy and it was 85/55. I have started sipping salt water periodically during the day to try to combat the hypotension. But then one day, my BP went up to 135/65. So I'll have to find the right balance. I was drinking two pints of salty water every day. I've gone down to one pint of less salty water a day now. We'll see how that works.
Just wanted to bring you all up to date on my Nardil experience. It's a miracle drug as far as I'm concerned.
Marsha
Posted by Fathe on April 17, 2008, at 20:29:00
In reply to 6 weeks on Nardil, posted by 4WD on April 17, 2008, at 18:14:04
HI Marsha, I am relatively new here but reading your post made me want to acknowledge your success in feeling better. Your words overflow with positive thoughts and outlook. I am very happy for you and I think that you deserve lots of credit for keeping your head to the grindstone in never stopping in your search to help yourself feel better. I alway admire people who can dust themselves off after some difficult times, get back up and keep on forging forward.
So again, even though I am new here and not familiar with your overall history, I am smiling for you and glad you are feeling better... :)
Posted by 4WD on April 17, 2008, at 20:53:31
In reply to Re: 6 weeks on Nardil, posted by Fathe on April 17, 2008, at 20:29:00
Fathe,
Thank you for the kind words. It has indeed been a long hard struggle. But you do pick yourself up and keep trying. The only other option is suicide and I thought about that last January but I got myself to the hospital immediately when I recognized I had a plan in place.
I do have a much more positive outlook and I attribute it to Nardil and a lot of hard work, writing, and talking with a special friend. I also largely attribute my ability to keep hanging on to God. He has helped me through the rough times even though I couldn't feel his presence much of the time. But he must have been there or I'd be dead or have given up by now.
Again, thank you for the kind words. You post meant a lot to me.
Thanks,
Marsha
> HI Marsha, I am relatively new here but reading your post made me want to acknowledge your success in feeling better. Your words overflow with positive thoughts and outlook. I am very happy for you and I think that you deserve lots of credit for keeping your head to the grindstone in never stopping in your search to help yourself feel better. I alway admire people who can dust themselves off after some difficult times, get back up and keep on forging forward.
>
> So again, even though I am new here and not familiar with your overall history, I am smiling for you and glad you are feeling better... :)
Posted by Phillipa on April 17, 2008, at 21:19:48
In reply to Re: 6 weeks on Nardil » Fathe, posted by 4WD on April 17, 2008, at 20:53:31
Marsha so great to hear you're doing so well. I never knew you were so depressed as to be suicidal so glad you didn't hurt yourself. Keep posting your journey. Love Phillipa
Posted by Fathe on April 17, 2008, at 21:41:07
In reply to Re: 6 weeks on Nardil » Fathe, posted by 4WD on April 17, 2008, at 20:53:31
I think the Nardil provided the assistance for you to work to get better. Your own strength and internal drice did all the rest. You refused to give up and now you are realizing the fruits of your hard work. And this is hard work....constant struggle, falling down occaisionally, forging forward just when you want to go back to bed for a day :) Even your enjoyment of gardening made me smile because these are the things that I want and deserve to do again. I am struggling with the decision to go back on Effexor. I have been off it a few years and had been fine but lately feeling the weight of life and the world on me. Just having trouble keeping myself going. Effexor worked well for me but then I think it plateaud and certainly the withdrawal was horrible for me. So my decsion to go back of Effexor is tough. But this is what I mean - the struggles we go through and you beat them! I am very proud.
keep us updated on yourprogress - we care about you.
Lee Ellen
Posted by 4WD on April 18, 2008, at 20:33:49
In reply to Re: 6 weeks on Nardil » 4WD, posted by Phillipa on April 17, 2008, at 21:19:48
> Marsha so great to hear you're doing so well. I never knew you were so depressed as to be suicidal so glad you didn't hurt yourself. Keep posting your journey. Love Phillipa
Yes, I got that bad. Thanks for the words of encouragement. I am having some pretty severe side effects - constipation, a little nausea now and then and some insomnia plus the problems with hypotension. But it's worth it to feel so much better. I'll keep posting as I go along.
love,
Marsha
Posted by SLS on April 18, 2008, at 20:47:03
In reply to 6 weeks on Nardil, posted by 4WD on April 17, 2008, at 18:14:04
Hi Marsha.
> Ihave been on Nadil 45mg for six weeks now and it has already changed my life.
The sweet-spot for Nardil is between 60-75mg. You might profit from a dosage increase if you can tolerate it. Otherwise, if you experience diminishing returns, you can opt to use Deplin as an augmentor. I have personal experience to attest to its efficacy when used in combination with Nardil. Another Deplin responder I know also has used it to augment Nardil.
- Scott
Posted by 4WD on April 18, 2008, at 20:49:24
In reply to Re: 6 weeks on Nardil, posted by Fathe on April 17, 2008, at 21:41:07
Hi Lee Ellen,
Thank you for your kind words. You are right in a sense. Before Nardil, though, I had no motivation - except to get better. It's all I thought about, how am I going to get better. I do have a strong internal drive and it was directed toward finding some med that would work. Nardil was the one. And now I am feeling so much better. I cleaned out the laundry room closet today; an hour job. A month ago I couldn't have even borne the idea of doing something that required that much effort and motivation. But I am doing work other than just taking Nardil. I go for a walk every morning; have been doing this since November. I always managed to keep the house neat and the cats taken care of. And I prayed a lot. And did a lot of reading, some spiritual and some motivational.
It sounds as if your depression is getting worse. I had the same experience with Effexor that you had. I was on it for 4-5 years and then it pooped out. But if you've been off it for a while, it may work again. If not, there is always Cymbalta; it's an SNRI also. I know so well the feeling you describe - wanting to want to do things. But you just can't make yourself want to do them, like working in the garden, as you mentioned.
It sounds like you care a lot about other people. Itis so kind of you to post to me with encouragement and your words about my internal drive. You deserve the same thing. See your pdoc, get back on meds. Maybe you can have your life back as I nowhave mine. And if you have been on the SSRI/SNRI merry-go round for years and none of them work, then there is always Nardil. I recommend it highly for when nothing else works,
Take care of yourself.
Marsha
> I think the Nardil provided the assistance for you to work to get better. Your own strength and internal drice did all the rest. You refused to give up and now you are realizing the fruits of your hard work. And this is hard work....constant struggle, falling down occaisionally, forging forward just when you want to go back to bed for a day :) Even your enjoyment of gardening made me smile because these are the things that I want and deserve to do again. I am struggling with the decision to go back on Effexor. I have been off it a few years and had been fine but lately feeling the weight of life and the world on me. Just having trouble keeping myself going. Effexor worked well for me but then I think it plateaud and certainly the withdrawal was horrible for me. So my decsion to go back of Effexor is tough. But this is what I mean - the struggles we go through and you beat them! I am very proud.
>
> keep us updated on yourprogress - we care about you.
>
> Lee Ellen
Posted by 4WD on April 18, 2008, at 21:33:14
In reply to Re: 6 weeks on Nardil » 4WD, posted by SLS on April 18, 2008, at 20:47:03
Hi Scott,
Thanks for responding. I don't think I can tolerate a dosage increase right now. I am having some pretty good side effects as it is. I think I'll try to stay at 45 for another few weeks and then if I'm not in complete remission maybe I'll be able to go up to 60mg by then. But I'm doing pretty great on 45. Just a little breakthrough depression now and then. I keep thinking it will continue to build in my system and after a full ten week trial at 45, I will not need to increase the dosage.
I have considered Deplin. I even asked my pdoc about it but he had never heard of it. I guess I need to look up the web page and print it out for him. But I may not need it. (I am already on 5 meds). If I continue to improve on the Nardil I may not need to augment it. But I will definitely keep it in mind and ask my pdoc about it again if I don't achieve full remission on Nardil alone. I think I might rather augment the Nardil than increase the dose.
What do you think about what my other doctor reading to me from the PDR that once full remission on Nardil is achieved, the dosage should slowly be lowered by one pill a day over a period of time? The PDR actually says this. It says that you should be able to maintain remission on as little as 15mg a day - once you have achieved full remission. I told this to my pdoc and he said he had heard that too. But no one on this board that I know of has ever tried going this route. It's something I would consider trying. of course if the depression returned I'd up the dose again in a heartbeat.
Thanks for you response,
Marsha
> Hi Marsha.
>
> > Ihave been on Nadil 45mg for six weeks now and it has already changed my life.
>
> The sweet-spot for Nardil is between 60-75mg. You might profit from a dosage increase if you can tolerate it. Otherwise, if you experience diminishing returns, you can opt to use Deplin as an augmentor. I have personal experience to attest to its efficacy when used in combination with Nardil. Another Deplin responder I know also has used it to augment Nardil.
>
>
> - Scott
Posted by SLS on April 19, 2008, at 5:18:29
In reply to Re: 6 weeks on Nardil » SLS, posted by 4WD on April 18, 2008, at 21:33:14
Hi Marsha.
> Thanks for responding.
For you, I'll always try to respond.
> I don't think I can tolerate a dosage increase right now.
I find that the side effects of Nardil dissipate over time. I'm currently taking 90mg. But then again, my brain was a tough nut to crack.
> I think I'll try to stay at 45 for another few weeks and then if I'm not in complete remission maybe I'll be able to go up to 60mg by then.
The best you could ever hope for given your treatment resistance is a saw-tooth improvement instead of a linear one. You might not really need more, as some people do respond to 45mg. It is the exception rather than the rule. Nardil is purported to be useful at dosages up to approximately 1mg/1kg of body weight.
> But I'm doing pretty great on 45. Just a little breakthrough depression now and then.
"Great" is an awefully big word. Perhaps you should give 45mg longer than just a week. Either way, you will arrive at an optimal dosage through trial-and-error. Breakthrough depression is expected early in treatment. I do not refer to these periodic worsenings as breakthrough depression nor partial relapse. Rather, I like to call them recessions during the initial stages of response. One of my doctors at the NIMH thought that these infrequent episodes were almost like the brain resetting itself.
> I keep thinking it will continue to build in my system and after a full ten week trial at 45, I will not need to increase the dosage.
Good thinking. :-)
> I have considered Deplin. I even asked my pdoc about it but he had never heard of it. I guess I need to look up the web page and print it out for him. But I may not need it. (I am already on 5 meds).
Deplin is nothing more than a super-charged folic acid. It induces an increase in the amounts of DA, NE, and 5-HT synthesized (as described by its manufacturer). If you get a little insomnia (or more insomnia), that might mean that Deplin is doing its work.
> If I continue to improve on the Nardil I may not need to augment it.
Absolutely.
> What do you think about what my other doctor reading to me from the PDR that once full remission on Nardil is achieved, the dosage should slowly be lowered by one pill a day over a period of time?
Yes, I have heard of this phenomenon. It sometimes does indeed take a higher dosage to achieve sufficient MAO inhibition than it does to maintain it. However, I don't think that the magnitude of dosage decrease as is described by the PDR is particularly smart. It is a very old idea that evolved in the late 1970s and early 1980s.
> The PDR actually says this.
I know.
> It says that you should be able to maintain remission on as little as 15mg a day - once you have achieved full remission. I told this to my pdoc and he said he had heard that too. But no one on this board that I know of has ever tried going this route. It's something I would consider trying. of course if the depression returned I'd up the dose again in a heartbeat.
You darn well better!
- Scott
Posted by Fathe on April 19, 2008, at 12:38:02
In reply to Re: 6 weeks on Nardil » Fathe, posted by 4WD on April 18, 2008, at 20:49:24
Thank you Marsha. You are very sweet. And you have alot of inner strength . The best thing is you believe in yourself. Even without the medication, you believed in yourself and wanted to get better. Nardil just helped you in your efforts. But the basic strength was always there. You sound like you are really enjoying life now. Side effects from the medication, if tolerable, is always worth it if you can have a better outlook on life.I am poking around seeing if I should restart Effexor or maybe try another medication which the withdrawals are not so brutal. Effexor withdrawal was pretty bad for me, not unlike many others who have posted here. But in the end, I may try the Effexor and when time to stop, may try the dose or two of Prozac which helps Effexor withdrawal. Like you, I have the will and strength to want to feel better and enjoy even simple things (like gardening :) ) again. I will get there and be right along side you in the feeling better group !!!
Keep up the good progress and know we are all here for support. This board helps me tremendously.
Lee Ellen
> Hi Lee Ellen,
>
> Thank you for your kind words. You are right in a sense. Before Nardil, though, I had no motivation - except to get better. It's all I thought about, how am I going to get better. I do have a strong internal drive and it was directed toward finding some med that would work. Nardil was the one. And now I am feeling so much better. I cleaned out the laundry room closet today; an hour job. A month ago I couldn't have even borne the idea of doing something that required that much effort and motivation. But I am doing work other than just taking Nardil. I go for a walk every morning; have been doing this since November. I always managed to keep the house neat and the cats taken care of. And I prayed a lot. And did a lot of reading, some spiritual and some motivational.
>
> It sounds as if your depression is getting worse. I had the same experience with Effexor that you had. I was on it for 4-5 years and then it pooped out. But if you've been off it for a while, it may work again. If not, there is always Cymbalta; it's an SNRI also. I know so well the feeling you describe - wanting to want to do things. But you just can't make yourself want to do them, like working in the garden, as you mentioned.
>
> It sounds like you care a lot about other people. Itis so kind of you to post to me with encouragement and your words about my internal drive. You deserve the same thing. See your pdoc, get back on meds. Maybe you can have your life back as I nowhave mine. And if you have been on the SSRI/SNRI merry-go round for years and none of them work, then there is always Nardil. I recommend it highly for when nothing else works,
>
> Take care of yourself.
>
> Marsha
>
>
> > I think the Nardil provided the assistance for you to work to get better. Your own strength and internal drice did all the rest. You refused to give up and now you are realizing the fruits of your hard work. And this is hard work....constant struggle, falling down occaisionally, forging forward just when you want to go back to bed for a day :) Even your enjoyment of gardening made me smile because these are the things that I want and deserve to do again. I am struggling with the decision to go back on Effexor. I have been off it a few years and had been fine but lately feeling the weight of life and the world on me. Just having trouble keeping myself going. Effexor worked well for me but then I think it plateaud and certainly the withdrawal was horrible for me. So my decsion to go back of Effexor is tough. But this is what I mean - the struggles we go through and you beat them! I am very proud.
> >
> > keep us updated on yourprogress - we care about you.
> >
> > Lee Ellen
>
>
Posted by 4WD on April 19, 2008, at 12:43:35
In reply to Re: 6 weeks on Nardil » 4WD, posted by SLS on April 19, 2008, at 5:18:29
Hi Scott,
Thanks for responding again. Thanks for the advice about not thinking of it as breakthrough depression. It's much better to think of it the way you do.I'm already having insomnia so not sure about the Deplin. B vitamins have a tendency to make me more anxious. I have noticed that if I take a B complex tablet, I will be more scared all day. I do go ahead and take one at bedtime a few times a week because I have heard that Nardil can deplete B vitamins or some particular B vitamin. If I take it at bedtime, I sleep through the extra scaredness. I guess one thing I could do is take a lot of folic acid. I know it doesn't begin to compare to Deplin but it couldn't hurt. Maybe just folic acid won't make me more scared.
You don't have an anxiety disorder, do you? That's really my bugaboo. I was up to 8 mg of clonazepam a day. I have brought it down to 1.5mg a day plus 15mg a day of Valium in divided doses. My pdoc has suggested adding Inderal when I take 5mg of Valium instead of having to take 10 mg of Valium at a whack. It does seem to be helping a bit but it's only been two days. I'll keep trying though because I'd like to keep the Valium down to 10mg a day if possible. But even at 15mg a day plus my 1.5 Klonopin that's still only equivalent of 3mg of Klonopin a day. I'm very proud of myself for titrating it down so rapidly (it has been about a months worth of titrating). I started titrating down during the second of third week of Nardil because in the beginning it had a definite anxiolytic effect. I don't know if that has pooped out of if I'm more scared these days because I have titrated down fairly rapidly.
The main reason I think 45mg of Nardil may be enough is that I only weigh 51kg. And I'd rather keep the dose as low as possible so as to minimize side effects. Constipation, insomnia (which is better if I take my last Nardil of the day by 3 or 3:30. Also, a little nausea ocasionally and a serious problem with hypotension. I have measured it when I was feeling very lightheaded and it has been as low as 70/50. I am drinking a pint a day of salty water to help combat that. My internist told me that my last electrolyte check showed that I had a low salt level anyway. He rechecked it when I saw him Thursday but I don't have the results back yet.
But I feel I am 70% in remission from depression; maybe 80%. So I am so happy. Nardil is really working for me. Here's to the dissipation of side effects.
Anyway, thanks again for responding. You know more about meds than anyone on this board and it's great to have your opinion because I trust your advice more than that of anyone else.
I am so glad for you that you are doing well and have your life back. I remember when you first starting posting that you were achieving remission
I was thrilled for you. I am so glad you found Deplin - finally - something that worked. You have had such a long hard stuggle, it makes me exceedingly glad that you have finally found relief. You deserve it.Thanks again,
Marsha
> Hi Marsha.
>
> > Thanks for responding.
>
> For you, I'll always try to respond.
>
> > I don't think I can tolerate a dosage increase right now.
>
> I find that the side effects of Nardil dissipate over time. I'm currently taking 90mg. But then again, my brain was a tough nut to crack.
>
> > I think I'll try to stay at 45 for another few weeks and then if I'm not in complete remission maybe I'll be able to go up to 60mg by then.
>
> The best you could ever hope for given your treatment resistance is a saw-tooth improvement instead of a linear one. You might not really need more, as some people do respond to 45mg. It is the exception rather than the rule. Nardil is purported to be useful at dosages up to approximately 1mg/1kg of body weight.
>
> > But I'm doing pretty great on 45. Just a little breakthrough depression now and then.
>
> "Great" is an awefully big word. Perhaps you should give 45mg longer than just a week. Either way, you will arrive at an optimal dosage through trial-and-error. Breakthrough depression is expected early in treatment. I do not refer to these periodic worsenings as breakthrough depression nor partial relapse. Rather, I like to call them recessions during the initial stages of response. One of my doctors at the NIMH thought that these infrequent episodes were almost like the brain resetting itself.
>
> > I keep thinking it will continue to build in my system and after a full ten week trial at 45, I will not need to increase the dosage.
>
> Good thinking. :-)
>
> > I have considered Deplin. I even asked my pdoc about it but he had never heard of it. I guess I need to look up the web page and print it out for him. But I may not need it. (I am already on 5 meds).
>
> Deplin is nothing more than a super-charged folic acid. It induces an increase in the amounts of DA, NE, and 5-HT synthesized (as described by its manufacturer). If you get a little insomnia (or more insomnia), that might mean that Deplin is doing its work.
>
> > If I continue to improve on the Nardil I may not need to augment it.
>
> Absolutely.
>
> > What do you think about what my other doctor reading to me from the PDR that once full remission on Nardil is achieved, the dosage should slowly be lowered by one pill a day over a period of time?
>
> Yes, I have heard of this phenomenon. It sometimes does indeed take a higher dosage to achieve sufficient MAO inhibition than it does to maintain it. However, I don't think that the magnitude of dosage decrease as is described by the PDR is particularly smart. It is a very old idea that evolved in the late 1970s and early 1980s.
>
> > The PDR actually says this.
>
> I know.
>
> > It says that you should be able to maintain remission on as little as 15mg a day - once you have achieved full remission. I told this to my pdoc and he said he had heard that too. But no one on this board that I know of has ever tried going this route. It's something I would consider trying. of course if the depression returned I'd up the dose again in a heartbeat.
>
> You darn well better!
>
>
> - Scott
Posted by 4WD on April 19, 2008, at 12:59:44
In reply to Re: 6 weeks on Nardil, posted by Fathe on April 19, 2008, at 12:38:02
Hi Lee Ellen,
> Thank you Marsha. You are very sweet. And you have alot of inner strength . The best thing is you believe in yourself. Even without the medication, you believed in yourself and wanted to get better. Nardil just helped you in your efforts. But the basic strength was always there.Thank you for that. It makes me feel good to hear it from you. But I have to tell you, Nardil has really been the turning point in bringing me into remission from depression. I had the will and the strength to keep hanging on and keep trying stuff but it was the Nardil which brought me out of the depression. I am strong enough, though, to deal with the side effects and keep on slogging through on days when I still don't feel so good. And also the strength to cut my klonopin down from 8 mg a day to 1.5 plus 10-15 mg of Valium a day. Now that has been hard and has required inner fortitude.
You sound like you are really enjoying life now. Side effects from the medication, if tolerable, is always worth it if you can have a better outlook on life.
>
> I am poking around seeing if I should restart Effexor or maybe try another medication which the withdrawals are not so brutal. Effexor withdrawal was pretty bad for me, not unlike many others who have posted here. But in the end, I may try the Effexor and when time to stop, may try the dose or two of Prozac which helps Effexor withdrawal.I wouldn't worry about the withdrawal effects right now. right now the issue is to get you depression in remission. Worry about tomorrow when it gets here. The important thing for today is to get you better.
Like you, I have the will and strength to want to feel better and enjoy even simple things (like gardening :) ) again. I will get there and be right along side you in the feeling better group !!!
>
> Keep up the good progress and know we are all here for support. This board helps me tremendously.I don't know how I'd have gotten through some of this without the support of the people on this board. I have had better and more advice here than from any doctor. I still listen to my doctor of course, but here I learn what actually happens to people, not what is *supposed* to happen.
Get to your doctor and get on your meds. I want you to be well and join the feeling good group as much as you do!
Love,
Marsha
Posted by Fathe on April 19, 2008, at 19:14:57
In reply to Re: 6 weeks on Nardil » Fathe, posted by 4WD on April 19, 2008, at 12:59:44
You are absolutely right, Marsha. I am not going to worry about the withdrawal from Effexor when I have not even restarted it. The goal is to feel better and Effexor was a good med for me when I first started it.
I have also found such great information here. When I stopped Effexor a few years ago, the tips I found here were like gold to me. If it were not for some of the suggestions, I probably would have been unable to go to work for a few days as the symptoms were pretty debilitating. So this board is worth its weight in gold.
I also like suporting others (like you) who I know are struggling and fighting this strange thing called depression. Weird story - I was cleaning my gutters on my house two years ago and fell off my roof and was badly injured. I broke both my arms, some ribs, had gashes on my face, mouth and legs and I was in the hospital for 5 days, having surgery to repair one of my arms. I was basically incapacitated for two mos afterward and felt pretty sorry for myself. Also beign fiercely independent, having to then depend on everyone for everything totally shot my whole being. But it still is *nothing* compared to having a bout with chronic depression like I did a few years before that. Right now I am not so bad yet but if I did not recognize the feelings of blue-ness and loss of joy early enough, I could descend further like I did back then. Now I recocnize this in myself so Effexor it is PLUS I now have this board at the beginning of my treatment. This board is invaluable.
Anyway, keep your good progress going. You are my stimulus right now in how one can feel better :)
Lee Ellen
Posted by 4WD on April 20, 2008, at 14:23:17
In reply to Re: 6 weeks on Nardil, posted by Fathe on April 19, 2008, at 19:14:57
Hi Lee Ellen,
I'm glad you are going to restart the EFfexor. No since borrowing trouble. And Effexor is not really any worse to get off of than most of the others.
I appreciate so much your support. Your posts about how I have an inner drive and strength have meant a lot to me. I need to spend more time thinking about what you have said. What I mean is that I never gave myself credit for any of that but your posts have made me realize that. I do need to give myself credit for having the inner fortitude to keep hanging on and to keep trying. I will try to spend some time thinking about it and even writing about it so that it gets imprinted in my brain. Thank you again for getting me to thinking about it.
You are right. Physical stuff is so much easier to deal with than depression - like your accident. I would hear about people who were battling cancer and were cheerful and optimistic through it all. And I would think to myself - "Yeah, but they are not depressed. I could battle cancer or whatever cheerfully and optimistically too if I weren't depressed."
I'm glad you recognize you are heading downward and are going to do something about it before it gets to the point where you are desperate. You get to your pdoc ASAP and get started on that Effexor.
Love,
Marsha
> You are absolutely right, Marsha. I am not going to worry about the withdrawal from Effexor when I have not even restarted it. The goal is to feel better and Effexor was a good med for me when I first started it.
>
> I have also found such great information here. When I stopped Effexor a few years ago, the tips I found here were like gold to me. If it were not for some of the suggestions, I probably would have been unable to go to work for a few days as the symptoms were pretty debilitating. So this board is worth its weight in gold.
>
> I also like suporting others (like you) who I know are struggling and fighting this strange thing called depression. Weird story - I was cleaning my gutters on my house two years ago and fell off my roof and was badly injured. I broke both my arms, some ribs, had gashes on my face, mouth and legs and I was in the hospital for 5 days, having surgery to repair one of my arms. I was basically incapacitated for two mos afterward and felt pretty sorry for myself. Also beign fiercely independent, having to then depend on everyone for everything totally shot my whole being. But it still is *nothing* compared to having a bout with chronic depression like I did a few years before that. Right now I am not so bad yet but if I did not recognize the feelings of blue-ness and loss of joy early enough, I could descend further like I did back then. Now I recocnize this in myself so Effexor it is PLUS I now have this board at the beginning of my treatment. This board is invaluable.
>
> Anyway, keep your good progress going. You are my stimulus right now in how one can feel better :)
>
> Lee Ellen
>
>
Posted by 4WD on April 20, 2008, at 14:34:15
In reply to Re: 6 weeks on Nardil, posted by Fathe on April 19, 2008, at 19:14:57
I am having a major problem with my blood pressure now that I have been on Nardil for a while. My BP has always run low 105/65 or so but that is fairly normal.
But now it is fluctuating. Sometimes it is okay but I am having episodes where it drops to 65/45. I get lightheaded and faint and have to drop down to the floor or sit down at least. Trouble is, as soon as I get up I am faint and have all the symptoms again. It is especially bad when I first wake up in the morning and the first half of the day.
I have been sipping salty water during the day to try to raise it but it doesn't seem to be helping much. It is truly debilitating and makes me scared to drive sometimes. I spend a lot of time just sitting because I can't stand. In church this morning, I had to stay seated during the hymns because I couldn't stand.
I am only on 45mg of Nardil and would consider increasing it eventually (after a 10 week trial at 45) but I am afraid I can never increase it. I wouldn't be able to function because of the hypotension.
Anyone have any suggestions?
Marsha
Posted by kaleidoscope on April 20, 2008, at 15:58:55
In reply to Extremely Low Blood Pressure, posted by 4WD on April 20, 2008, at 14:34:15
Hi Marsha
Your doctor might prescribe a low dose of fludrocortisone to raise your blood pressure. Fludrocortisone cannot be given to anyone with heart disease or peripheral edema (fluid retention eg. in the ankles). Fludrocortisone is a mineralocorticoid hormone which raises blood pressure by retaining sodium. It may cause potassium loss and blood tests will be needed.
Fludrocortisone tends to cause fluid retention initially but this may decrease over time. The dose should be kept as low as is needed to relieve symptoms adequately ie. if BP is still rather low but symptoms are improved the dose should not be increased.
>I am only on 45mg of Nardil and would consider increasing it eventually (after a 10 week trial at 45) but I am afraid I can never increase it.
It doesn't sound like you will need to increase it. Many people require higher doses for optimal benefit but this is only a guide and may not apply to you.
Take care
ed_uk
Posted by Phillipa on April 20, 2008, at 19:46:13
In reply to Re: Extremely Low Blood Pressure » 4WD, posted by kaleidoscope on April 20, 2008, at 15:58:55
Glad you're here to help Marsha. Love PJXO
Posted by undopaminergic on April 21, 2008, at 0:11:52
In reply to Re: 6 weeks on Nardil » SLS, posted by 4WD on April 19, 2008, at 12:43:35
>
> My pdoc has suggested adding Inderal when I take 5mg of Valium instead of having to take 10 mg of Valium at a whack. It does seem to be helping a bit but it's only been two days.
>
> Also, a little nausea ocasionally and a serious problem with hypotension. I have measured it when I was feeling very lightheaded and it has been as low as 70/50. I am drinking a pint a day of salty water to help combat that.
>First, make sure you aren't taking any drugs with hypotensive effects unless they are absolutely necessary. Inderal, for example, is an antihypertensive agent and lowers blood pressure.
Someone else suggested fludrocortisone, and that may very well work. Another suggestion, from PubMed, is metoclopramide. Other options include L-dopa, phenylephrine, ephedrine, and of course stimulants, like methylphenidate. Amphetamine is probably overkill since your depression is almost in remission - you probably don't want to get *too* high.
You need to make sure your doctor knows about your hypotensive problem. It doesn't appear that he does, since he suggested adding Inderal.
Posted by 4WD on April 21, 2008, at 13:17:26
In reply to Re: Extremely Low Blood Pressure » 4WD, posted by kaleidoscope on April 20, 2008, at 15:58:55
Hi Ed,
thanks for the reply. I hate to go on *another* med as I'm already on five. But I told my doctor when I started Nardil that I was willing to put up with*any* side effect if the drug gave me life back. And it has. I think for now I'll continue sipping salt water through the day. I went to my internistlast week and he did some lab work. He told me that the last time he did an electrolyte panel on me my sodium was low. So maybe that's the problem. I'llfind out this week if it's still low. In the meantime it's salty water for me.
Thanks again,
Marsha
Posted by 4WD on April 21, 2008, at 13:38:15
In reply to Re: 6 weeks on Nardil, posted by undopaminergic on April 21, 2008, at 0:11:52
Hi,
My pdoc knows about the hypotension but it had not gotten as bad when I last talked to him. I will be talking to him on Thursday and I will stress to him the extent of the problem. He suggested the Inderal as a trial to see if I took it with my Valium in the morning whether it would help with my anxiety. It didn't and it made me more depressed the two days i tried it. So I'm not taking it now.
I think a lot of the stimulants you mentioned may be contraindicated with Nardil. In any case, I'd rather not have to tr eat it with another drug. Sipping salty water though the day seems to help.
> >I'm hanging in there though. It's worse during the first part of the day and gets better as the day goes along. I hope it will balance itself out, as I get more and more used to the Nardil. Who knows - maybe it will go away. I've only been on the Nardil for less than 7 weeks. Lots of people have said the side effects subside with time so maybe this one will.
Thanks for you response.
Marsha
>
> First, make sure you aren't taking any drugs with hypotensive effects unless they are absolutely necessary. Inderal, for example, is an antihypertensive agent and lowers blood pressure.
>
> Someone else suggested fludrocortisone, and that may very well work. Another suggestion, from PubMed, is metoclopramide. Other options include L-dopa, phenylephrine, ephedrine, and of course stimulants, like methylphenidate. Amphetamine is probably overkill since your depression is almost in remission - you probably don't want to get *too* high.
>
> You need to make sure your doctor knows about your hypotensive problem. It doesn't appear that he does, since he suggested adding Inderal.
Posted by octothorpe on April 21, 2008, at 19:35:21
In reply to 6 weeks on Nardil, posted by 4WD on April 17, 2008, at 18:14:04
I think you can get salt tablets at your pharmacy. I've read the recommended amount is 600-1800 mg twice per day for about 8 weeks, for MAOI-induced hypotension. Perhaps that would be more convenient than drinking salt water. Of course you would want to talk to your doctor about it, drink plenty of liquids, and monitor your blood pressure.
I have heard that sleeping with your head higher than your feet may help. Have also heard there are support hose that can be purchased that may also help with the hypotension.
I am also on Nardil since February 28 - now at 75 mg having titrated up very slowly. I am not having to deal with hypotension (at least not yet :).
I hope this passes for you.
Best regards,
Tom
Posted by deniseuk190466 on April 22, 2008, at 9:37:01
In reply to 6 weeks on Nardil, posted by 4WD on April 17, 2008, at 18:14:04
Hi Marsha,
How long was it before you noticed that the Nardil was working?
Thanks....Denise
Posted by 4WD on April 22, 2008, at 18:15:43
In reply to Re: 6 weeks on Nardil » 4WD, posted by octothorpe on April 21, 2008, at 19:35:21
Hi,
Thanks for your response. When I posted my request for info or suggestions, I was really looking for a
non-drug solution. The salt tablets might be a good idea. I have had some trouble figuring how how muchh salt water to drink - a pint, two pints? But I am doing much better today.I don't mind the inconvenience of drinking the salt water. I just mix up a pint jar of it every day and take sips periodically through the day. I don't make it so salty that it's too nasty tasting to drink.
I think a pint and a half a day might be about right. It would probably easier to calibrate how much salt I was getting if I took the tablets though. I will call the pharmacy and ask if they sell salt tablets.
Thanks for the recommendation.
Marsha
Posted by 4WD on April 22, 2008, at 18:24:21
In reply to Re: To Marsha, posted by deniseuk190466 on April 22, 2008, at 9:37:01
> Hi Marsha,
>
> How long was it before you noticed that the Nardil was working?
>
> Thanks....DeniseIt was about five weeks. During the second and third week, I noticed a distinct lessening of anxiety but that has gone away now and I'm back to having to take my full amounts of benzos.
Then during the fourth week, I think I started to feel a little better but it didn't really kick in until the 5th week. It's kicked in more since then - it will be seven weeks on Thursday.
I am truly doing so well. I am so glad I was willing to try Nardil and put up with the side effects (which I'm still having). I told my pdoc that I was willing to endure any side effect to get my life back and sure enough, I have my life back. I wish I had tried Nardil years ago.
How are you? I haven't heard from you for a while but then I haven't been spending a lot of time on BAbble lately either. I have a really spotty wireless connection and it's very difficult to post. I can only post when the computer decides to let me.
Hope you are okay. But you must not be doing all that great if you are thinking about Nardil. I promise you, I am a big proponent of it now.
Marsha
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