![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 4 to 28 of 28. Go back in thread:
Posted by Kim on May 28, 2000, at 1:10:44
In reply to Re: NARDIL AUGMENTATION??!!!!, posted by z on May 27, 2000, at 20:54:32
I haven't taken Nardil, but I've had lots of augmentation to Parnate (another MAOI). I've had Ritalin, Dexedrine, lithium, Visken, Neurontin, and Risperdal with the Parnate (not all at once, of course) along with Ambien and temazepam. There are lots of options if you have an open-minded Pdoc.
Kim
Posted by stjames on May 28, 2000, at 2:27:25
In reply to Re: NARDIL AUGMENTATION??!!!!, posted by z on May 27, 2000, at 20:54:32
> so when i read that it can
> poop out, i got a little scared! have any of you
> tried nardil? what are the chances of it
> pooping out and what do you do if it does?
> also, does it impair memory/concentration?
>
> thanx,
> z
James here...All AD's poop out in some people. Just because Nardil stops working for another does not mean it will in you. I have not seen any studies on the rate but as we really don't know the reason why it happens it is better to deal with it when it happens.
What to do when this happens ? You can try upping the dose or try same class but different drug, move to new class, or add an augmenting agent to the med you are taking.
For me I started TCA's in 85 then pooped out and added Effexor in early 90's (I recovered) and moved off TCA's to Remeron + Effexor in 1997
Posted by SLS on May 28, 2000, at 12:10:58
In reply to Re: NARDIL AUGMENTATION??!!!!, posted by Kim on May 28, 2000, at 1:10:44
> I haven't taken Nardil, but I've had lots of augmentation to Parnate (another MAOI). I've had Ritalin, Dexedrine, lithium, Visken, Neurontin, and Risperdal with the Parnate (not all at once, of course) along with Ambien and temazepam. There are lots of options if you have an open-minded Pdoc.
> Kim
Hi Kim.I would imagine that you added these things because Parnate alone was unsatisfactory. Most likely, I will be beginning Parnate within the next few weeks and combining it with things like desipramine, Adderal, Mirapex, Lamictal, Neurontin, Synthroid, and possibly lithium - all at once.
I would like to ask a few questions if you wouldn't mind answering them.
1. What is your diagnosis?
2. How would you describe your depression?
3. What has been the course of your illness?
- Does it come and go?
- Has there ever been rapid-cyclicity involved?
- How long have your good periods been versus your bad?
4. Why was it necessary to augment Parnate?
5. Which combination(s) have been successful?
6. What other drugs have you been partially responsive to?
7. How well are you doing now?
8. For how long have you remained well.
9. Do you have an innie or an outie. Oops. Sorry.
Gosh. That was more than just a few questions. Any input would be great.Thanks.
Sincerely,
Scott
Posted by forth Meg on May 28, 2000, at 17:18:24
In reply to Re: NARDIL AUGMENTATION??!!!!, posted by stjames on May 28, 2000, at 2:27:25
> All AD's poop out in some people. Just because Nardil stops working for another does not mean it will in you. I have not seen any studies on the rate but as we really don't know the reason why it happens it is better to deal with it when it happens.
I dunno. I think Nardil poops out in a LOT of people, from what I've read. Could be wrong. Certainly did in me. Still a very very good drug I think.
Posted by forth Meg on May 28, 2000, at 17:36:27
In reply to Re: NARDIL poop-out, posted by forth Meg on May 28, 2000, at 17:18:24
> > All AD's poop out in some people. Just because Nardil stops working for another does not mean it will in you. I have not seen any studies on the rate but as we really don't know the reason why it happens it is better to deal with it when it happens.
>
> I dunno. I think Nardil poops out in a LOT of people, from what I've read. Could be wrong. Certainly did in me. Still a very very good drug I think.I want to qualify what I said - I've never read any studies or anything about Nardil poop-out. It's from POSTS I've seen that it seems that Nardil poops out on people a lot. It may just be that I tend to notice those posts more because it pooped out on me.
Posted by Jennifer on May 28, 2000, at 21:53:17
In reply to NARDIL AUGMENTATION??!!!!, posted by z on May 27, 2000, at 14:27:05
I've been on Nardil for years. Had to eventually increase my dose from 30mg twice a day to 45. I did take Klonopin to augment and I think it did help. See my new thread today about the American Psychiatric Mtg. They have info on augmentation that was just discussed at their annual get together.
> HEY,
> DOES ANYONE KNOW IF THERE IS ANYTHING YOU CAN TAKE TO
> AUGMENT THE EFFECTS OF NARDIL WHEN IT POOPS OUT??!!
> I KNOW YOU CAN'T TAKE HARDLY ANYTHING ELSE WHEN ON
> AN MAOI BUT WHAT DO PEOPLE DO WHEN NARDIL'S EFFECTS
> WEAR OFF?!
>
> THANX,
> Z
Posted by stjames on May 28, 2000, at 22:20:04
In reply to Re: NARDIL poop-out, posted by forth Meg on May 28, 2000, at 17:36:27
> > I dunno. I think Nardil poops out in a LOT of people, from what I've read. Could be wrong. Certainly did in me. Still a very very good drug I think.
>
> I want to qualify what I said - I've never read any studies or anything about Nardil poop-out. It's from POSTS I've seen that it seems that Nardil poops out on people a lot. It may just be that I tend to notice those posts more because it pooped out on me.James here...
Do remember that this board is not a fair sampling
as it tends to be a small number and a group of people who are having trouble with meds. My experiance is that several classes of meds have pooped out on me but I can always find another that works. Meds (for me) tend to work for 5-7 yrs and then I need a change. I am glad to have 5-7 good years. I am more conserned in finding something that works now and I will worry about things when a med stops working.james
Posted by SLS on May 29, 2000, at 7:52:08
In reply to Re: NARDIL AUGMENTATION??!!!!, posted by Jennifer on May 28, 2000, at 21:53:17
> I've been on Nardil for years. Had to eventually increase my dose from 30mg twice a day to 45. I did take Klonopin to augment and I think it did help. See my new thread today about the American Psychiatric Mtg. They have info on augmentation that was just discussed at their annual get together.
Hi Jennifer,Is there any way I can twist your arm and have you summarize their suggestions as what to use to supplement an MAO inhibitor? That stuff's pretty long.
Thanks.
- Scott
Posted by kate99999 on May 31, 2000, at 12:05:33
In reply to NARDIL AUGMENTATION??!!!!, posted by z on May 27, 2000, at 14:27:05
After briefly discussing this on alt.support.depression.medication I'm toying with the idea of trying vitamin B6 supplements to counteract poop-out. On the hypothesis that maybe poopout is related to Nardil's depletion of B6 (pyroxidine).
I've seen research that Nardil can deplete B6, but never any research on the relationship between that and Nardil poop-out. So this is a shot in the dark.
> HEY,
> DOES ANYONE KNOW IF THERE IS ANYTHING YOU CAN TAKE TO
> AUGMENT THE EFFECTS OF NARDIL WHEN IT POOPS OUT??!!
> I KNOW YOU CAN'T TAKE HARDLY ANYTHING ELSE WHEN ON
> AN MAOI BUT WHAT DO PEOPLE DO WHEN NARDIL'S EFFECTS
> WEAR OFF?!
>
> THANX,
> Z
Posted by Kim on May 31, 2000, at 14:38:27
In reply to Re: NARDIL AUGMENTATION - Vitamin B6? , posted by kate99999 on May 31, 2000, at 12:05:33
>
> I've seen research that Nardil can deplete B6, but never any research on the relationship between that and Nardil poop-out. So this is a shot in the dark.
>
Was the research specific to Nardil, or do other MAOIs also cause B6 depletion?
Posted by kate99999 on May 31, 2000, at 15:24:36
In reply to Re: Vitamin B-6 and MAOIs, posted by Kim on May 31, 2000, at 14:38:27
> > I've seen research that Nardil can deplete B6, but never any research on the relationship between that and Nardil poop-out. So this is a shot in the dark.
> >
> Was the research specific to Nardil, or do other MAOIs also cause B6 depletion?Well, this originally came from Elizabeth on alt.support.depression.medications mentioning hydrazine-based compounds (of which Nardil is one) can deplete B6. It's under the thread "Nardil side effects..." So she'd be the one to ask which MAOIs are and aren't hydrazine-based.
The research I saw was just about Nardil (phenelzine). But then I'd only looked up phenelzine and pyroxidine, not parnate and pyroxidine.
Posted by SLS on May 31, 2000, at 16:07:19
In reply to Re: Vitamin B-6 and MAOIs, posted by kate99999 on May 31, 2000, at 15:24:36
Nardil poop-out.
I just want to offer two tricks used by some doctors to deal with Nardil "poop-out".1. Lower the dose.
2. Stop, wait awhile, and restart.
- Scott
Posted by Jennifer on June 1, 2000, at 4:59:25
In reply to Re: Nardil Augmentation ? - Jennifer, posted by SLS on May 29, 2000, at 7:52:08
Ok, it took me 3 very long days to finally get back on line, sorry...but yes, my arm has been twisted. Hope this helps:
Aumentation is adding 1 or more drugs which by themselves don't have established antidepressant effects. But, with another antidepressant can increase the reponsiveness. Combination therapy is the use of more than 1 antidepressant.
They suggested several meds for "antidepressant augmentation" without being specific if it would interact with the Nardil. Lithium, Klonopin, and thryroid are all ok - as I am not dead, and I always research until I'm blue in the face before taking new meds. Other recommendations were pindolol (Visken) and Mirapex-which I am unsure if they are safe with MAOI's. You'll need to ask a pharmacist on that one. Mirapex does lower your blood pressure though, and since Nardil was originally for lowering blood pressure (and then when everyone was in a good mood, they found a new use for it!) you may get a double whammy of low b/p. Good luck...maybe call a pharmacist on these, and then talk with your pdoc. Didn't he/she have any recommendations? Or were they not trusted recommendations? Jen.
PS: My old pdoc told me that if you discontinue Nardil, and then go back on later, 10% of the patients no longer respond, or respond poorly. I don't know if this is true. I do know I needed the higher dose when I went back on.> > I've been on Nardil for years. Had to eventually increase my dose from 30mg twice a day to 45. I did take Klonopin to augment and I think it did help. See my new thread today about the American Psychiatric Mtg. They have info on augmentation that was just discussed at their annual get together.
>
>
> Hi Jennifer,
>
> Is there any way I can twist your arm and have you summarize their suggestions as what to use to supplement an MAO inhibitor? That stuff's pretty long.
>
> Thanks.
>
>
> - Scott
Posted by Jennifer on June 1, 2000, at 5:10:57
In reply to Re: Nardil Augmentation ? - Jennifer, posted by SLS on May 29, 2000, at 7:52:08
Oops, forgot one more that was not on the list, but is not contraindicated with MAOI's...Wellbutrin. I haven't taken it, but I've heard it can help. Jen
> > I've been on Nardil for years. Had to eventually increase my dose from 30mg twice a day to 45. I did take Klonopin to augment and I think it did help. See my new thread today about the American Psychiatric Mtg. They have info on augmentation that was just discussed at their annual get together.
>
>
> Hi Jennifer,
>
> Is there any way I can twist your arm and have you summarize their suggestions as what to use to supplement an MAO inhibitor? That stuff's pretty long.
>
> Thanks.
>
>
> - Scott
Posted by SLS on June 1, 2000, at 16:30:45
In reply to Re: Jennifer back 2 Scott-Nardil Aug, posted by Jennifer on June 1, 2000, at 4:59:25
> > Is there any way I can twist your arm and have you summarize their suggestions as what to use to supplement an MAO inhibitor?
> Ok, it took me 3 very long days to finally get back on line, sorry...but yes, my arm has been twisted. Hope this helps:
Hi Jennifer.I really appreciate your reply. Use ice for the first three days, then alternate ice and heat for another five.
> Aumentation is adding 1 or more drugs which by themselves don't have established antidepressant effects. But, with another antidepressant can increase the reponsiveness. Combination therapy is the use of more than 1 antidepressant.
I was always a bit unclear about this distinction.
> They suggested several meds for "antidepressant augmentation" without being specific if it would interact with the Nardil. Lithium, Klonopin, and thryroid are all ok - as I am not dead,
LOL - Can you hear me?
> and I always research until I'm blue in the face before taking new meds.
I'll know who to ask from now on.
> Other recommendations were pindolol (Visken) and Mirapex-which I am unsure if they are safe with MAOI's.
It is.
> You'll need to ask a pharmacist on that one. Mirapex does lower your blood pressure though, and since Nardil was originally for lowering blood pressure (and then when everyone was in a good mood, they found a new use for it!) you may get a double whammy of low b/p. Good luck...maybe call a pharmacist on these, and then talk with your pdoc. Didn't he/she have any recommendations?
Or were they not trusted recommendations? Jen.I have thrown a lot of crap at Parnate, but not Nardil. Obviously, these attempts have not been terribly successful. I am ALWAYS looking for new ideas, and this is probably one of the best places to find them. This is such a great pooling of the expertise of the psychiatrists treating us, not to mention the brilliance of their patients.
> PS: My old pdoc told me that if you discontinue Nardil, and then go back on later, 10% of the patients no longer respond, or respond poorly. I don't know if this is true. I do know I needed the higher dose when I went back on.
This often happens, although I don't know the statistics behind it. It is so tragic to see. I am an advocate of extended treatment periods. For a subgroup of us, treatment should be continued indefinitely. You may want to take inventory to see if you are eligible to join the club of which I am a member.
If someone has been taking Nardil and begins to experience "poop-out", sometimes stopping and restarting it will work to recapture a strong antidepressant response. I would say that it is prudent to try other strategies first.
Thanks again.
:-)
- Scott
Posted by Jennifer on June 2, 2000, at 2:35:13
In reply to Re: Jennifer back 2 Scott-Nardil Aug - Thanks, posted by SLS on June 1, 2000, at 16:30:45
Scott, You thought the APA article was a bit confusing? How about parts of your reply. Remember I've been on this site for an entire week! You've got the ice/heat thing all wrong. For swelling caused by a contusion, it's cold for 24 hours, then heat from then on. Easy to remember because "c" comes before "h" in the dictionary. Of course migraines get "cold" only, and arthritis is "heat" only. Nardil causes heat intolerance in some people...so what do arthritic's on Nardil do?!!
What the heck is LOL? Person, place or thing?
I think at this point I am a member of the Lifelong Nardil Association (LNA), except for my brief hiatus a couple years ago. May I recommend you NEVER let someone give you estrogen/progesterone.......totally psycho response...although psycho people have psycho responses, which this is obviously one because I'm sure you would question ANY doctor that would prescribe female hormones (unless Scott isn't your real name!) OK, I'm getting out of this goofy mood and going off to bed. Doc appt in the am...should probably get a bit of sleep. Jen> > > Is there any way I can twist your arm and have you summarize their suggestions as what to use to supplement an MAO inhibitor?
>
> > Ok, it took me 3 very long days to finally get back on line, sorry...but yes, my arm has been twisted. Hope this helps:
>
>
> Hi Jennifer.
>
> I really appreciate your reply. Use ice for the first three days, then alternate ice and heat for another five.
>
> > Aumentation is adding 1 or more drugs which by themselves don't have established antidepressant effects. But, with another antidepressant can increase the reponsiveness. Combination therapy is the use of more than 1 antidepressant.
>
> I was always a bit unclear about this distinction.
>
> > They suggested several meds for "antidepressant augmentation" without being specific if it would interact with the Nardil. Lithium, Klonopin, and thryroid are all ok - as I am not dead,
>
> LOL - Can you hear me?
>
> > and I always research until I'm blue in the face before taking new meds.
>
> I'll know who to ask from now on.
>
> > Other recommendations were pindolol (Visken) and Mirapex-which I am unsure if they are safe with MAOI's.
>
> It is.
>
> > You'll need to ask a pharmacist on that one. Mirapex does lower your blood pressure though, and since Nardil was originally for lowering blood pressure (and then when everyone was in a good mood, they found a new use for it!) you may get a double whammy of low b/p. Good luck...maybe call a pharmacist on these, and then talk with your pdoc. Didn't he/she have any recommendations?
> Or were they not trusted recommendations? Jen.
>
> I have thrown a lot of crap at Parnate, but not Nardil. Obviously, these attempts have not been terribly successful. I am ALWAYS looking for new ideas, and this is probably one of the best places to find them. This is such a great pooling of the expertise of the psychiatrists treating us, not to mention the brilliance of their patients.
>
> > PS: My old pdoc told me that if you discontinue Nardil, and then go back on later, 10% of the patients no longer respond, or respond poorly. I don't know if this is true. I do know I needed the higher dose when I went back on.
>
> This often happens, although I don't know the statistics behind it. It is so tragic to see. I am an advocate of extended treatment periods. For a subgroup of us, treatment should be continued indefinitely. You may want to take inventory to see if you are eligible to join the club of which I am a member.
>
> If someone has been taking Nardil and begins to experience "poop-out", sometimes stopping and restarting it will work to recapture a strong antidepressant response. I would say that it is prudent to try other strategies first.
>
> Thanks again.
>
> :-)
>
>
> - Scott
Posted by SLS on June 2, 2000, at 7:14:57
In reply to Re: Jennifer back 2 Scott-again, posted by Jennifer on June 2, 2000, at 2:35:13
> Scott, You thought the APA article was a bit confusing? How about parts of your reply.
Which parts?
> Remember I've been on this site for an entire week!
O.K.
You know, it's funny. Regardless of how long I am here, I still never feel like any kind of veteran. I think it is because I was always teased as a kid, and I never felt that I was part of the crowd. (See, I did that all by myself. I didn't need Freud's help - this time). I have been floating around here for about 8 months.
> You've got the ice/heat thing all wrong. For swelling caused by a contusion, it's cold for 24 hours, then heat from then on.
Things change so often. You can eat eggs and saccharine now.
No wonder I haven't been able to ease my bruised ego. The swelling has gone down a bit, though.
> Easy to remember because "c" comes before "h" in the dictionary.
I can't remember my own name sometimes.
> Of course migraines get "cold" only, and arthritis is "heat" only. Nardil causes heat intolerance in some people...so what do arthritic's on Nardil do?!!
Ben Gay. It used to work on T.V., but I haven't seen any infommercials about it yet.
Actually, my grandmother has severe osteoarthritis that has really affected her knees. She is 90yrs and doesn't want to undergo replacement surgery. Do you know anything about how to treat it?
> What the heck is LOL? Person, place or thing?
That is an acronym for "laughing out loud". You are funny, and I enjoyed your humor, so I laughed. "I love to laugh. Ha ha ha. Long and loud and clear". (Might be before your time). I thought I was the only one here who didn't know all of the lingo. That particular one is about all do I know. These things are used to enhance communication on the Internet. You'll see a lot of this sort of thing on newsgroups. I don't know how to go about learning them, so I haven't bothered. Also, symbols like the smily :-) are used for expression. I don't know these either.
> I think at this point I am a member of the Lifelong Nardil Association (LNA), except for my brief hiatus a couple years ago.
I think this is probably wise.
What is your diagnosis? What drugs have you tried? Which ones were you partially responsive to? Which ones made you feel worse?
Being on Nardil, you may want to check your liver enzymes from time to time. This should be done routinely when you get a physical. No big deal though, so don't worry about it. Most drugs are broken down by the liver, so you just want to check things out from time to time. I think doctors may get kickbacks from the labs. :-)
> May I recommend you NEVER let someone give you estrogen/progesterone.......totally psycho response...although psycho people have psycho responses, which this is obviously one because I'm sure you would question ANY doctor that would prescribe female hormones (unless Scott isn't your real name!)
It is now.
> OK, I'm getting out of this goofy mood and going off to bed. Doc appt in the am...should probably get a bit of sleep. Jen
I sincerely doubt that your goofiness disappears upon awakening.
You're fun. Stay well.
- Scott
Posted by Jennifer on June 3, 2000, at 6:35:27
In reply to Re: Jennifer back 2 Scott back 2 Jeniffer-again, posted by SLS on June 2, 2000, at 7:14:57
Hi Scott..thought I'd send one more reply to this (it's 3:55am, what else would I be doing, sleeping?)
Once again, you are dating yourself. It's not eggs and saccarhin. It's eggs and Nutrisweet. Nutrisweet is broken down into formaldihyde in your body, so it helps to keep you preserved. My daily diet coke sustains my few remaining brain cells through this method of preservation. And no, I don't know what "I Love to Laugh ha ha ha" is, so you're probably from another time. But then again, maybe it was lost from my brain while I was still using saccarhin!
As far as grandma is concerned, she's got the right idea. Any MD that suggests surgery on a 90 year old is insane. She's already 10 years over the usual lifespan, and she wouldn't make it much longer after surgery. It's not like she's a perky 70 year old that will force herself to get up and walk to promote healing and give her lungs a workout. Not long after surgery, when she's unable to walk much, she'll come down with pneumonia, from chronic underinflation of her lungs, and die. OK grim, but honest. That's the #1 cause of death in elderly after this type of surgery. And best case, she lives 5 years? Not worth the months of recovery and risk of illness, and anesthesia risks to me. If her doc is so set on surgery, how about ditching out to a pain control center. They are much better about these things. And how about a home care visit to point out some ways to make her life easier? You didn't say how much she was walking, but even at the minimum, little things like putting the couch up on blocks so it's not far to stand up can really help. I think I'd have to know more about her status to offer any other "not so professional" advice. Kids are really my thing.
She wouldn't have a teething problem or anything would she? (LOL)
My diagnosis? Would that be what the doctors diagnose, or what I diagnose? Quite contradictory. Let's see, first it was irritable bowel from stress after my oldest had some bad medical stuff. Then it was changed to depression, although no anti-depressants worked. As things took a nose-dive it was agoraphobia for a year (Ok, this one I agreed with). Then breaking out of that it was panic attacks. New pdoc started me on Nardil & xanax. Instant recovery. On it for about 6 years. No xanax for over 3 years so discontinued the Nardil. Did great. Then some idiot gives me hormones to fix other crud, and I am insane once again. Back on Nardil with not nearly the response as prior. pdoc dies (yes dies at age 50). New pdoc says I'm manic/depression. I disagree, but it's on lithium I go. He says I don't sleep because of being manic. I say I don't sleep because I don't feel any different when I do. (Yes this does sound like denial, but read on) Attempt to sleep, but having major twitching. Adds Klonopin to help with the twitching, and to enhance the Nardil. It didn't help with the twitching, so I discontinued it, and just upped my Nardil to 45 twice a day. Feeling better, but something is still wrong. Gain a ton of weight last year with no reason. (Ok maybe not a ton, but when you pass your husband's weight, it's not looking good!) Forgetful, no sleep, stretch marks, acne. Don't look anything like myself. I take my picture of the "old" me to my regular MD and say I've had it and I don't care what he says, but something else is wrong. Go to a couple specialists and end up at the only endocrinologist in town. He tells me I'm fat because it's the American way of life and get over it. I'm depressed because I'm fat, so get over it. What a lovely dispostion he had! Tell him I want anti-thyroid antibodies and a cortisol level drawn. He tells me I'm insane. I say I know. And he orders them. Meanwhile a few weeks ago they had me do a sleep study. That was interesting becuase you have to be asleep by 10 at the latest. I asked if I could just stay up with them and watch the other people sleep. No go though. Had to stay up 48 hours to ensure I could sleep for them. Results then come today.
Back up to the lab results. Get those after the sleep study is done. Doctor is amazed that I have a high cortisol level. Really? No s---! Through a friend of a friend I get an awesome referral to an awesome REAL endocrinologist who I see the 12th. Meanwhile, get my sleep results today (ok, yesterday since it's not today anymore) I stop breathing for 15 seconds or so about 9 times and hour. Mild he says. Mild? Ok, he's the specialist. Talk about other symptoms. He says my airway is sensitive to the extra weight around my clavicle. Tells me I really look like Cushing's Disease. REALLY... now how long has it taken for me to convince people something was wrong. The high cortisol is Cushing's Disease. I did not tell the sleep doc about it when I went in, just to see what his eval was. He was thrilled when I told him he was the first doc to come up with the diagnosis besides me (and the ridiculous endocrinologist whom I forced to write me a lab order). So, how will things change in the next few weeks, who knows. Right now I'm only on the Nardil and my inhaler. I want to stay on as little as possible till we figure this all out.
Now, not only has this been extremely long winded, but you know my entire life story. In addition, it's 4:30 am and since the sleep doc says I only get 20 minutes of REM sleep and it's from 5:30-6am, I need to get to bed. As far as my goofiness, it has yet to subside. I'm trying to hold onto it a few more days...off to Disneyland on Sunday! Stay well, Jennifer
PS: Why the heck doesn't this thing have spell-check?!
> > Scott, You thought the APA article was a bit confusing? How about parts of your reply.
>
> Which parts?
>
> > Remember I've been on this site for an entire week!
>
> O.K.
>
> You know, it's funny. Regardless of how long I am here, I still never feel like any kind of veteran. I think it is because I was always teased as a kid, and I never felt that I was part of the crowd. (See, I did that all by myself. I didn't need Freud's help - this time). I have been floating around here for about 8 months.
>
> > You've got the ice/heat thing all wrong. For swelling caused by a contusion, it's cold for 24 hours, then heat from then on.
>
> Things change so often. You can eat eggs and saccharine now.
>
> No wonder I haven't been able to ease my bruised ego. The swelling has gone down a bit, though.
>
> > Easy to remember because "c" comes before "h" in the dictionary.
>
> I can't remember my own name sometimes.
>
> > Of course migraines get "cold" only, and arthritis is "heat" only. Nardil causes heat intolerance in some people...so what do arthritic's on Nardil do?!!
>
> Ben Gay. It used to work on T.V., but I haven't seen any infommercials about it yet.
>
> Actually, my grandmother has severe osteoarthritis that has really affected her knees. She is 90yrs and doesn't want to undergo replacement surgery. Do you know anything about how to treat it?
>
> > What the heck is LOL? Person, place or thing?
>
> That is an acronym for "laughing out loud". You are funny, and I enjoyed your humor, so I laughed. "I love to laugh. Ha ha ha. Long and loud and clear". (Might be before your time). I thought I was the only one here who didn't know all of the lingo. That particular one is about all do I know. These things are used to enhance communication on the Internet. You'll see a lot of this sort of thing on newsgroups. I don't know how to go about learning them, so I haven't bothered. Also, symbols like the smily :-) are used for expression. I don't know these either.
>
> > I think at this point I am a member of the Lifelong Nardil Association (LNA), except for my brief hiatus a couple years ago.
>
> I think this is probably wise.
>
> What is your diagnosis? What drugs have you tried? Which ones were you partially responsive to? Which ones made you feel worse?
>
> Being on Nardil, you may want to check your liver enzymes from time to time. This should be done routinely when you get a physical. No big deal though, so don't worry about it. Most drugs are broken down by the liver, so you just want to check things out from time to time. I think doctors may get kickbacks from the labs. :-)
>
> > May I recommend you NEVER let someone give you estrogen/progesterone.......totally psycho response...although psycho people have psycho responses, which this is obviously one because I'm sure you would question ANY doctor that would prescribe female hormones (unless Scott isn't your real name!)
>
> It is now.
>
> > OK, I'm getting out of this goofy mood and going off to bed. Doc appt in the am...should probably get a bit of sleep. Jen
>
> I sincerely doubt that your goofiness disappears upon awakening.
>
> You're fun. Stay well.
>
>
> - Scott
Posted by Elizabeth on June 3, 2000, at 7:40:41
In reply to Re: Vitamin B-6 and MAOIs, posted by kate99999 on May 31, 2000, at 15:24:36
> > Was the research specific to Nardil, or do other MAOIs also cause B6 depletion?
>
> Well, this originally came from Elizabeth on alt.support.depression.medications mentioning hydrazine-based compounds (of which Nardil is one) can deplete B6. It's under the thread "Nardil side effects..." So she'd be the one to ask which MAOIs are and aren't hydrazine-based.Nardil and Marplan are hydrazine derivatives (so is Marsilid, which is no longer used AFAIK). Parnate is not. Selegiline is not.
The research was specific to Nardil (I don't believe Marplan has been looked at specifically), but it is also true (as I mentioned on ASDM) that other hydrazine-like drugs (such as isoniazid) have this potential side effect. At the same time, Nardil and Marplan aren't chemically identical, and it's possible that some of the small differences could be relevant.
> The research I saw was just about Nardil (phenelzine). But then I'd only looked up phenelzine and pyroxidine, not parnate and pyroxidine.
(You might try pyridoxal phosphate - the form of B6 that's active in your body - too.)
Posted by Elizabeth on June 3, 2000, at 7:50:15
In reply to Re: Jennifer back 2 Scott-Nardil Aug, posted by Jennifer on June 1, 2000, at 4:59:25
> Mirapex does lower your blood pressure though, and since Nardil was originally for lowering blood pressure (and then when everyone was in a good mood, they found a new use for it!) you may get a double whammy of low b/p.
Nardil has always been used primarily for depression and anxiety. The first MAOI used for depression, iproniazid (Marsilid), was an anti-TB drug that was found to be a "mood elevator," which got people all interested in MAOIs as antidepressants. It was taken off the market because it tended to be hepatotoxic, but its cousin isoniazid (INH), which is not an MAOI of any significance, is still a first-line tx for TB.
There was an MAOI - Eutonyl (pargyline) - that popped up at some point and was used as an antihypertensive, but it's no longer available AFAIK.
BTW, I wouldn't necessarily trust anything a pharmacist said about MAOIs. IME, they tend to get a lot of things wrong, especially in regard to interactions; I pretty much feel I can count on them to parrot the PDR (though there are exceptions). I attribute this to a lack of real clinical experience.
Posted by SLS on June 3, 2000, at 9:26:37
In reply to history - Jennifer, posted by Elizabeth on June 3, 2000, at 7:50:15
> > Mirapex does lower your blood pressure though, and since Nardil was originally for lowering blood pressure (and then when everyone was in a good mood, they found a new use for it!) you may get a double whammy of low b/p.
> There was an MAOI - Eutonyl (pargyline) - that popped up at some point and was used as an antihypertensive, but it's no longer available AFAIK.
I don't think pargyline is terribly effective as an antidepressant. One reason may be that it is fairly selective for MAO-B. An interesting lessen in trying to infer drug activities based upon molecular heritage (not that you need one) is that a propargyl cousin of pargyline, deprenyl is also selective for MAO-B, while another cousin, clorgyline, is specific for MAO-A.
> BTW, I wouldn't necessarily trust anything a pharmacist said about MAOIs. IME, they tend to get a lot of things wrong, especially in regard to interactions; I pretty much feel I can count on them to parrot the PDR (though there are exceptions). I attribute this to a lack of real clinical experience.
Except for Cam W. :-)
Dear Elizabeth,Does Mirapex, or any of the other DA agonists, potentiate the hypotensive effect of Nardil or any of the other MAOIs? I didn't experience this when I added Parlodel to Parnate + desipramine.
Oh, and while I've got you here, I'm having trouble deciding whether to use Nardil or Parnate for treating my bipolar depression. I am aware of the traditional choice of Parnate in this situation. However, having experienced a partial response to both, I like the way I feel on Nardil better. It is becoming increasingly apparent that anhedonia can persist in many people who otherwise respond robustly to Parnate. A confounding factor is that I will be using a tricyclic along with either MAOI. I experience one hell of a synergism between Nardil and a tricyclic with regard to hypotension and the ability to initiate urination. Imipramine is out, although it is probably more effective. I will be using desipramine, and will be throwing in as much other crap as I can find.
Any suggestions?
Any opinions on Gabitril?
What is your gut-reaction to Tegretol?
I will be eternally grateful if you would be kind enough to cure me.
Sincerely,
Scott
Posted by Jennifer on June 3, 2000, at 12:41:32
In reply to history - Jennifer, posted by Elizabeth on June 3, 2000, at 7:50:15
Nardil's use as an antihypertensive dates back decades to the original tx's for HTN. There were very limited choices in those days, and with the major side effects related to diet, tyramine breakdown, and hypertensive crisis, it wasn't well tolerated. Once new classes of drugs came about, Nardil went out of style, but the older MD's are still happy with their antideppresive effects. Many new MD's, due to lack of experience, choose not to rx Nardil. Mostly because they are afraid of the side effects. With all the new classes of Antidepressives out, why risk it? I remind them again and again...sometimes it's the only one that works! Jennifer
>
> Nardil has always been used primarily for depression and anxiety. The first MAOI used for depression, iproniazid (Marsilid), was an anti-TB drug that was found to be a "mood elevator," which got people all interested in MAOIs as antidepressants. It was taken off the market because it tended to be hepatotoxic, but its cousin isoniazid (INH), which is not an MAOI of any significance, is still a first-line tx for TB.
>
> There was an MAOI - Eutonyl (pargyline) - that popped up at some point and was used as an antihypertensive, but it's no longer available AFAIK.
>
> BTW, I wouldn't necessarily trust anything a pharmacist said about MAOIs. IME, they tend to get a lot of things wrong, especially in regard to interactions; I pretty much feel I can count on them to parrot the PDR (though there are exceptions). I attribute this to a lack of real clinical experience.
Posted by Elizabeth on June 9, 2000, at 4:22:38
In reply to Re: history and pharmacists » Elizabeth, posted by SLS on June 3, 2000, at 9:26:37
> I don't think pargyline is terribly effective as an antidepressant.
Dunno, never tried it :)
> One reason may be that it is fairly selective for MAO-B. An interesting lessen in trying to infer drug activities based upon molecular heritage (not that you need one) is that a propargyl cousin of pargyline, deprenyl is also selective for MAO-B, while another cousin, clorgyline, is specific for MAO-A.
Whatever happened to clorgyline, anyway? I don't think it was ever in clinical use for anything.
> > BTW, I wouldn't necessarily trust anything a pharmacist said about MAOIs. IME, they tend to get a lot of things wrong, especially in regard to interactions; I pretty much feel I can count on them to parrot the PDR (though there are exceptions). I attribute this to a lack of real clinical experience.
>
> Except for Cam W. :-)Definitely falls under "though there are exceptions!"
> Does Mirapex, or any of the other DA agonists, potentiate the hypotensive effect of Nardil or any of the other MAOIs? I didn't experience this when I added Parlodel to Parnate + desipramine.
I have no idea! (Did the Parlodel do anything useful, BTW?)
> Oh, and while I've got you here, I'm having trouble deciding whether to use Nardil or Parnate for treating my bipolar depression. I am aware of the traditional choice of Parnate in this situation.
Really? I'm not.
> However, having experienced a partial response to both, I like the way I feel on Nardil better.
Go with it, then.
> It is becoming increasingly apparent that anhedonia can persist in many people who otherwise respond robustly to Parnate.
OH *YEAH*. (Although actually I have to say, most of my other symptoms are still here too, though somewhat improved. The only thing that is a lot better is mood.)
> A confounding factor is that I will be using a tricyclic along with either MAOI. I experience one hell of a synergism between Nardil and a tricyclic with regard to hypotension and the ability to initiate urination. Imipramine is out, although it is probably more effective. I will be using desipramine, and will be throwing in as much other crap as I can find.
Those anticholinergic effects will get you every time (at least, they got me every time).
> Any suggestions?
>
> Any opinions on Gabitril?No clue -- that's an interesting one. Huh. I mean, my thought when I first read of how it works was, "hey, has this been tried for anxiety?" But I don't know anyone who's actually taken it.
> What is your gut-reaction to Tegretol?
I think it's worth a try, but you do have to monitor your white cells and liver enzymes. Actually I was talking to my pdoc just today (err, yesterday) about whether it would be worth it for me to try Tegretol if the lithium doesn't work any magic, and he thought it would be. He mentioned that he's used it as a PRN for anxiety, which I thought was interesting, and he thought it might help with the insomnia.
> I will be eternally grateful if you would be kind enough to cure me.
I don't think kindness is always enough! :)/:( But I'm always willing to contribute whatever I can.
Posted by SLS on June 9, 2000, at 14:08:24
In reply to Re: history and pharmacists, posted by Elizabeth on June 9, 2000, at 4:22:38
Dear Elizabeth,
I must tell you that I am a bit disappointed in you for not coming up with a cure.
> Whatever happened to clorgyline, anyway? I don't think it was ever in clinical use for anything.
I swallowed quite a few pink capsules containing this gem of a compound. It is probably the best antidepressant in the world. It has been the single most effective drug I have ever tried. Unfortunately, the IND protocol in 1992 did not allow for its being combined with anything else but lithium. I am pretty sure that if I had been allowed to add desipramine to it, I would have maintained a robust response. I had no better option than to discontinue it and move on to other things. I wish that I had twisted my doctor's arm. Liability stuff.
The NIH is the only place I know of that had used clorgyline clinically. It is no longer available as a preparation for human consumption. I envy rats.
> > Does Mirapex, or any of the other DA agonists, potentiate the hypotensive effect of Nardil or any of the other MAOIs? I didn't experience this when I added Parlodel to Parnate + desipramine.
>
> I have no idea! (Did the Parlodel do anything useful, BTW?)Yes. I added it to an ongoing trial of Parnate 120mg + desipramine 200mg. I experienced a mild improvement for the first three days, and then watched it fade. This has also been my experience with other drugs, including Dexedrine, so I wouldn't use Scott as a showcase of effective therapies. As you know, adding stimulants and DA agonists to Parnate are considered to be good strategies in treatment-resistant cases. I recently paid a visit to Pat McGrath. :-) He expressed an interest in Mirapex. I like him.
> > Oh, and while I've got you here, I'm having trouble deciding whether to use Nardil or Parnate for treating my bipolar depression. I am aware of the traditional choice of Parnate in this situation.
> Really?
Yes. However, my doctor does not commit himself to this convention. He has left the decision to me. Dr. McGrath is definitely partial to Parnate.
> > However, having experienced a partial response to both, I like the way I feel on Nardil better.
>
> Go with it, then.Man, it is really a tough decision. The only time I experienced a robust sustained response to treatment was using a combination of Parnate and desipramine. I no longer respond adequately to this combo. It won't get me allow me to return to the work force. I probably wouldn't be here on Babble if the doctor that got me well hadn't discontinued the medication. Long story.
> > It is becoming increasingly apparent that anhedonia can persist in many people who otherwise respond robustly to Parnate.
>
> OH *YEAH*. (Although actually I have to say, most of my other symptoms are still here too, though somewhat improved. The only thing that is a lot better is mood.)I am confused by your response. Do you feel that Parnate effectively treated anhedonia?
How do describe the word mood?
What are the components of your depression that remain?I find your description interesting. I am under the impression that energy and cognition improve before mood does.
By the way, I am very disappointed to hear that you have not responded as well to treatment as I hoped you had. When you "left" here at the start of your classes, I assumed that things were Ok.
> > Any opinions on Gabitril?
>
> No clue -- that's an interesting one. Huh. I mean, my thought when I first read of how it works was, "hey, has this been tried for anxiety?" But I don't know anyone who's actually taken it.I hear of doctors recommending it, but I don't here of people using it.
> > What is your gut-reaction to Tegretol?
>
> I think it's worth a try, but you do have to monitor your white cells and liver enzymes. Actually I was talking to my pdoc just today (err, yesterday) about whether it would be worth it for me to try Tegretol if the lithium doesn't work any magic, and he thought it would be. He mentioned that he's used it as a PRN for anxiety, which I thought was interesting, and he thought it might help with the insomnia.Wow. That is interesting.
So, you are adding lithium to Parnate? Low-dose? Supposedly, if it's going to work in this situation, you'll see a response between 3-10 days.
What *exactly* is you diagnosis? (if you don't mind my asking)
> > I will be eternally grateful if you would be kind enough to cure me.
> I don't think kindness is always enough! :)/:( But I'm always willing to contribute whatever I can.
This means a lot to me coming from you.
Sincerely,
Scott
Posted by shar on June 9, 2000, at 17:03:05
In reply to Re: Vitamin B-6 and MAOIs, posted by Elizabeth on June 3, 2000, at 7:40:41
If you take the form Pyridoxal-5-Phosphate it may be listed on the bottle as P-5-P.
Just FYI.
s
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