![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 14 to 38 of 38. Go back in thread:
Posted by gardenergirl on December 6, 2004, at 10:11:42
In reply to Re: MAOI withdrawal, posted by SLS on December 6, 2004, at 0:36:16
Very good point, Scott. I am trying to monitor this. It's so hard to piece out what's situational (like the inlaws and their incessant need for heat) and what's a return of depression. Ugh. But hopefully 45 mg will be okay, will help me with the weight, and will not cause edema.
Oh, and if it could wash my car on occasion, that would be cool, too! ;)
Thanks for you input.
gg
Posted by kellym on December 6, 2004, at 17:34:15
In reply to MAOI withdrawal, posted by ed_uk on December 5, 2004, at 4:43:11
When I first tried to get off Nardil, I went too fast. It was not pretty-I was up to 105 or 120mg (I only started to feel the positive effects at 90mg). I think I tried dropping a couple of tablets at first and I started crying like a baby a day or two later. When I went more slowly it was much better, although I still suffered some effects- "electrical zaps" and nightmares.
I understand the apathy with some drugs. Wellbutrin doesn't cause me any problems in that regard and neither did Nardil; it unfortunately stopped working. At that point there wasn't much point in continuing with the dietary restrictions and the insomnia it caused. However, I understand it works for some people- good for them.
Posted by cubbybear on December 7, 2004, at 0:45:40
In reply to Re: MAOI withdrawal, posted by kellym on December 6, 2004, at 17:34:15
In the old days when I used to try a "holiday" and survive without Parnate (before I discovered I need it daily and probably for the rest of my life), I followed the withdrawal schedule my pdoc gave me:
Going down from 40 mg maintenance dose:
30 mg. for one week,
20 mg. for one week,
10 mg. for one week,
then zero.NEVER had a problem. My only noticeable changes were an increase in the need to sleep (conversely, Parnate reduces my need for sleep) plus a change my dreams--seemingly, they became more vivid. But, as one poster said, withdrawing from Parnate has always been uneventful.
Posted by Dan Perkins on December 7, 2004, at 20:01:34
In reply to Re: MAOI withdrawal, posted by cubbybear on December 7, 2004, at 0:45:40
I had a very bad experience coming off of Parnate. I came off of it too quickly (from 70mg to zero in about two weeks) and it really screwed me up. I just remember walking down the street in absolute misery and having to stop at one point and just stand there paralyzed like a heroine addict. And when I went back on it I found that it was never again as effective as before I stopped taking it.
MAOIs are very good (at least Parnate was for me), but my advice would be to taper off of them as slowly as possible if you do have to stop.
Posted by cubbybear on December 8, 2004, at 5:54:12
In reply to Re: MAOI withdrawal, posted by Dan Perkins on December 7, 2004, at 20:01:34
> I had a very bad experience coming off of Parnate. I came off of it too quickly (from 70mg to zero in about two weeks) and it really screwed me up. I just remember walking down the street in absolute misery and having to stop at one point and just stand there paralyzed like a heroine addict. And when I went back on it I found that it was never again as effective as before I stopped taking it.
>
This is an unusual thread--we don't often see posts here about MAOI withdrawal. Just curious--why did you try coming off the med. so fast? Was it your decision or your doctor's?
Posted by Dan Perkins on December 8, 2004, at 13:05:42
In reply to Re: MAOI withdrawal » Dan Perkins, posted by cubbybear on December 8, 2004, at 5:54:12
> This is an unusual thread--we don't often see posts here about MAOI withdrawal. Just curious--why did you try coming off the med. so fast? Was it your decision or your doctor's?
I came off of Parnate b/c I was planning to have an elective surgery and Parnate and general anesthesia don't mix. I didn't tell my doctor that I was going to stop taking Parnate, so the decisions to stop and to stop so quickly were mine. I knew that the sensible thing would have been to taper more slowly, but I was feeling a bit reckless. So, in other words, there was no good reason to stop so quickly.
Posted by cubbybear on December 10, 2004, at 3:31:52
In reply to Re: MAOI withdrawal » Dan Perkins, posted by Dan Perkins on December 8, 2004, at 13:05:42
>
> I came off of Parnate b/c I was planning to have an elective surgery and Parnate and general anesthesia don't mix. I didn't tell my doctor that I was going to stop taking Parnate, so the decisions to stop and to stop so quickly were mine. I knew that the sensible thing would have been to taper more slowly, but I was feeling a bit reckless. So, in other words, there was no good reason to stop so quickly.Your problem is of much interest to me because I've been putting off an elective procedure (colonoscopy) myself since,among other things, I dread the whole issue of anaesthesia. I made a decision not to come off the Parnate for this procedure but rather to go through with it. If I can get up the guts to make an appointment with the gastroenterologist, I will discuss with her ahead of time, the various analgesics/sedatives that could be used safely. I'm pretty sure that in this case, general anaesthesia would be unnecessary.
Posted by Dan Perkins on December 10, 2004, at 13:55:53
In reply to Re: MAOI withdrawal » Dan Perkins, posted by cubbybear on December 10, 2004, at 3:31:52
If you don't absolutely have to come off of Parnate, then my advice would be to not come off of it. Aside from having a horrible time coming off of the drug, the Parnate never worked as well for me again after I stopped it that first time.
It seems to me that just about every warning that goes along with taking an MAOI is either exagerated or entirely unnecesary. I'm not sure if this is the case w/anesthesia, but I would try everything possible to avoid coming off of Parnate for your colonoscopy.
Your gastroenterologist may tell you that you have to stop the Parnate simply b/c he/she might not have any experience with MAOIs and might be being overly cautious. I think the best way to find out which anesthesia is OK to take w/Parnate would be by posting the question directly on this message board in a seperate topic and maybe in an MAOI discussion forum (I know that Yahoo has an active one) to hear from people who have direct experience with this topic.
Best of luck,
>
> Your problem is of much interest to me because I've been putting off an elective procedure (colonoscopy) myself since,among other things, I dread the whole issue of anaesthesia. I made a decision not to come off the Parnate for this procedure but rather to go through with it. If I can get up the guts to make an appointment with the gastroenterologist, I will discuss with her ahead of time, the various analgesics/sedatives that could be used safely. I'm pretty sure that in this case, general anaesthesia would be unnecessary.
Posted by cubbybear on December 11, 2004, at 6:14:38
In reply to Re: MAOI withdrawal » Dan Perkins, posted by Dan Perkins on December 10, 2004, at 13:55:53
. I think the best way to find out which anesthesia is OK to take w/Parnate would be by posting the question directly on this message board in a seperate topic and maybe in an MAOI discussion forum (I know that Yahoo has an active one) to hear from people who have direct experience with this topic.
>
> You're really on my wavelength, although I haven't experienced any loss of effectiveness in the (distant) past when I stopped the Parnate for a while and then went back on it.
More to the point, I've found that there's a lot of contradiction in warnings regarding what anaesthesia is safe with an MAOI and which isn't. I've already done a lot of research on this topic and think I know the way to go, especially which anaesthesia would NOT be safe.Just to illustrate what we're up against when we try to pose the MAOI vs. anaesthesia question to the doctors themselves, I sent an E-mail to this guy who actually performed the surgery on a Psychobabble poster who was taking an MAOI. The doctor never responded. I myself went to a local hospital to pose the question. The gastroenterologist told me that I should start with the anaesthesiologist. So I went to consult with him, and his department told me to start with the surgeon. Nobody in this rotten profession wants to take responsibility for a difficult decision and we all know why. Hence, we have to do our own homework and our own research and rely on message boards like Psychobabble
Posted by Dan Perkins on December 11, 2004, at 7:44:02
In reply to Re: MAOI and anaesthesia » Dan Perkins, posted by cubbybear on December 11, 2004, at 6:14:38
>Nobody in this rotten profession wants to take responsibility for a difficult decision and we all know why. Hence, we have to do our own homework and our own research and rely on message boards like Psychobabble
Totaly agree with you. I'm always a bit embarassed to tell people that I get medical information from the internet (or worse yet, internet message boards), but I tell you that there is no more reliable source for information than places like these. After a lifetime of dealing with ignorant doctors, I have come to realize that the combination of anecdotal experience (from websites like this one) and first hand research (actually going back and sorting through the studies to figure out which make sense (not many of them) is the only way to find reliable healthcare information. It certainly beats how the doctors themselves get their information, from the always attractive pharmaceutical sales reps who dish out free meds and biased advice.
Posted by KaraS on December 11, 2004, at 16:15:37
In reply to Re: MAOI withdrawal » Dan Perkins, posted by Dan Perkins on December 10, 2004, at 13:55:53
> If you don't absolutely have to come off of Parnate, then my advice would be to not come off of it. Aside from having a horrible time coming off of the drug, the Parnate never worked as well for me again after I stopped it that first time.
>
> It seems to me that just about every warning that goes along with taking an MAOI is either exagerated or entirely unnecesary. I'm not sure if this is the case w/anesthesia, but I would try everything possible to avoid coming off of Parnate for your colonoscopy.
>
> Your gastroenterologist may tell you that you have to stop the Parnate simply b/c he/she might not have any experience with MAOIs and might be being overly cautious. I think the best way to find out which anesthesia is OK to take w/Parnate would be by posting the question directly on this message board in a seperate topic and maybe in an MAOI discussion forum (I know that Yahoo has an active one) to hear from people who have direct experience with this topic.
>
> Best of luck,
>
>
> >
> > Your problem is of much interest to me because I've been putting off an elective procedure (colonoscopy) myself since,among other things, I dread the whole issue of anaesthesia. I made a decision not to come off the Parnate for this procedure but rather to go through with it. If I can get up the guts to make an appointment with the gastroenterologist, I will discuss with her ahead of time, the various analgesics/sedatives that could be used safely. I'm pretty sure that in this case, general anaesthesia would be unnecessary.
>
>Would you mind posting more information on how to get to that Yahoo chat group. I just went to check it out. I found live chat groups on depression but most of the talk was silliness - not about anything medical or even depression related. It was probably a group of teenagers. I must have gone to the wrong place.
Posted by Dan Perkins on December 12, 2004, at 2:40:12
In reply to Re: MAOI withdrawal » Dan Perkins, posted by KaraS on December 11, 2004, at 16:15:37
Here is the link to the an MAOI chat group on Yahoo. I used to post on here a lot and found the other posters to be extremely well informed about all aspects of Nardil/Parnate.
Posted by KaraS on December 12, 2004, at 14:23:58
In reply to Re: MAOI withdrawal, posted by Dan Perkins on December 12, 2004, at 2:40:12
Posted by Dan Perkins on December 12, 2004, at 15:00:42
In reply to Re: You forgot to add the link.... (nm) » Dan Perkins, posted by KaraS on December 12, 2004, at 14:23:58
Sorry, here it is:
Posted by KaraS on December 12, 2004, at 16:36:10
In reply to Re: You forgot to add the link...., posted by Dan Perkins on December 12, 2004, at 15:00:42
> Sorry, here it is:
>
> http://health.groups.yahoo.com/group/maois/I can see that there's a lot of good information there. I'm still trying to figure out how to navigate around. I've been so spoiled here where everything is so easy and visually available.
Posted by Dan Perkins on December 12, 2004, at 19:23:27
In reply to Re: Thanks so much » Dan Perkins, posted by KaraS on December 12, 2004, at 16:36:10
You're welcome. I just looked at that website again for the first time in months and had your same reaction that it could be laid out a lot more clearly. But there is no doubt that there is a ton of useful information about Nardil and Parnate available and a bunch of very knowledgable people who can answer questions about MAOIs.
> > Sorry, here it is:
> >
> > http://health.groups.yahoo.com/group/maois/
>
> I can see that there's a lot of good information there. I'm still trying to figure out how to navigate around. I've been so spoiled here where everything is so easy and visually available.
Posted by KaraS on December 12, 2004, at 20:58:43
In reply to Re: Thanks so much, posted by Dan Perkins on December 12, 2004, at 19:23:27
> You're welcome. I just looked at that website again for the first time in months and had your same reaction that it could be laid out a lot more clearly. But there is no doubt that there is a ton of useful information about Nardil and Parnate available and a bunch of very knowledgable people who can answer questions about MAOIs.
>Definitely. I wonder how you ever found it to begin with. If I go into the groups section and try to look for it, I can't. If I didn't have the link you provided, I'd never find it again.
> > > Sorry, here it is:
> > >
> > > http://health.groups.yahoo.com/group/maois/
> >
> > I can see that there's a lot of good information there. I'm still trying to figure out how to navigate around. I've been so spoiled here where everything is so easy and visually available.
>
>
Posted by tecknohed on December 12, 2005, at 21:28:56
In reply to MAOI withdrawal, posted by ed_uk on December 5, 2004, at 4:43:11
Thought I'd add my 2 cents, despite being sooo late!
I've only come off Nardil once, after 18 months use. It was planned (was switching meds) but i developed a virus at the same time. NASTY! Maybe not a direct cause, but I feel my immune system may have become over-burdoned. I rarely had as much as a sniffle on Nardil.
Other, more direct symptomes were: on/off depression, worsening of Social Phobia, SEVERE worsening of OCD, paranoia (scared of the dark!), and an unsteady physical/mental balance.This all got progressively worse until I got a med back inside me. One thing which was particularly strong was a kind of 'wake up' from Nardil, as if I could feel its psychotropic mechanism 'leave' me. Bear in mind that I'd never been on a med as long as Nardil, niether had anything 'changed' my personality so much.
And I just cann't forget to mention the nice part of it all - the full return of easy orgasm, AND THEN SOME!
Don't get me wrong - it's ALL worth it BELIEVE!
I'm back on Nardil now.
Posted by joemzak on January 12, 2006, at 10:38:34
In reply to MAOI withdrawal, posted by ed_uk on December 5, 2004, at 4:43:11
I just joined this board because it is so relevant to me.
I have been on Nardil for 18 years. From the very beginning, whenever I stopped taking it for one reason or another, I felt worse than I did before I started any medication.
Through the years I have had to get off Nardil 3 additional times for hip replacement surgery. It has gotten so bad- the psychic pain is so unbearable- that I once said: "It was like losing my soul."!
The only thing that stops this pain (along with every mentioned withdrawal symptom posted on this board) is taking opiates...in my case...percocet or just plain oxycodone. These were given to me by my doctor as he knew it to be the only way for me.
I just checked into (on Jan 9) NY Presbeterian Hospital (affiliated with Columbia U. Med School and Cornell Med. School) and they had no idea what to do for me...so I checked out the next day.
I want to get off Nardil, must get off Nardil, because:
I am now literally addicted to carbs (when I don't have them I got physically and mentally sick) and have gained 100 lbs since starting Nardil (60 of those pounds in 6 years)
Some drugs have NO EFFECT on me...like Halcion and Seconal (given to me to try to make me sllep)
Because, Nardil is now interferring with my sleep in a big way
Also, have had BIZARRE and FRIGHTENING side effects when given: Gabitrol, Depakote and Zyprexa (these given to me to "boost" the effects of Nardil-they did not)
I started this mess with only atypical depression and wish I had never taken anything for it. I now feel a good, no make that great psychoanalyst would have done the job 19 years ago. Oh, I have had therapists, but do you know how easy it is to hang a shingle out that says: "Therapist"? Anything from a lower degree in Social Work to a degree from an accredited School of Psychoanalysis!!!
I am LOST what to do and where to go now. I have been contemplating trips to: Mass. General (Harvard), Cleveland Clinic, Johns Hopkins or anywhere I can where I can find a doctor that can take me off this!
If anyone can help me, I would be eternally grateful!
Posted by 4WD on January 14, 2006, at 21:56:13
In reply to Re: MAOI withdrawal, posted by joemzak on January 12, 2006, at 10:38:34
> I just joined this board because it is so relevant to me.
> I have been on Nardil for 18 years. From the very beginning, whenever I stopped taking it for one reason or another, I felt worse than I did before I started any medication.
> Through the years I have had to get off Nardil 3 additional times for hip replacement surgery. It has gotten so bad- the psychic pain is so unbearable- that I once said: "It was like losing my soul."!
> The only thing that stops this pain (along with every mentioned withdrawal symptom posted on this board) is taking opiates...in my case...percocet or just plain oxycodone. These were given to me by my doctor as he knew it to be the only way for me.
> I just checked into (on Jan 9) NY Presbeterian Hospital (affiliated with Columbia U. Med School and Cornell Med. School) and they had no idea what to do for me...so I checked out the next day.
> I want to get off Nardil, must get off Nardil, because:
> I am now literally addicted to carbs (when I don't have them I got physically and mentally sick) and have gained 100 lbs since starting Nardil (60 of those pounds in 6 years)
> Some drugs have NO EFFECT on me...like Halcion and Seconal (given to me to try to make me sllep)
> Because, Nardil is now interferring with my sleep in a big way
> Also, have had BIZARRE and FRIGHTENING side effects when given: Gabitrol, Depakote and Zyprexa (these given to me to "boost" the effects of Nardil-they did not)
> I started this mess with only atypical depression and wish I had never taken anything for it. I now feel a good, no make that great psychoanalyst would have done the job 19 years ago. Oh, I have had therapists, but do you know how easy it is to hang a shingle out that says: "Therapist"? Anything from a lower degree in Social Work to a degree from an accredited School of Psychoanalysis!!!
> I am LOST what to do and where to go now. I have been contemplating trips to: Mass. General (Harvard), Cleveland Clinic, Johns Hopkins or anywhere I can where I can find a doctor that can take me off this!
> If anyone can help me, I would be eternally grateful!Have you tried switching to Parnate? Or to another class of AD?
I know what you mean about the psychic pain. It can be so bad it is physical pain. Writhing in the floor pain. Many of us here have experienced it so you are not alone.
What does your pdoc say?
Marsha
Posted by joemzak on January 15, 2006, at 7:25:34
In reply to Re: MAOI withdrawal » joemzak, posted by 4WD on January 14, 2006, at 21:56:13
> Have you tried switching to Parnate? Or to another class of AD?
>
> I know what you mean about the psychic pain. It can be so bad it is physical pain. Writhing in the floor pain. Many of us here have experienced it so you are not alone.
>
> What does your pdoc say?
>
> MarshaMy doc??? That's another story. (By the way, thanks for writing)
My doc of 10 years said to me that the effects I suffer when I come off Nardil could be either a rebound effect or it could be the state I would be in had I never started with Nardil. A LIE! This past week I found an article at: "http://www.psychiatriat.com/pcc/abstracts/pcc030404.htm" The article basically talks about withdrawal from anti-depressants, with a section on MAOI. Boy, was it an eye opener. He states that if the side effects occur within a few days after stopping your medication, it is NOT depression but withdrawal - which he calls discontinuation symptoms. He talks about all kinds of side effects - including one similiar to withdrawing from SPEED! The article also has recommendations for getting off meds. I now have a new doctor and started coming off Nardil today. I take 6 pills and will reduce by 1/4 pill every 2 weeks. It will take 48 weeks, but that doesn't concern me, as long as I get off these devils!
As far as Parnate, frankly, I need to see what my natural state of being is before I take anything else. I have been on Nardil for 18 years and maybe, just maybe, I am okay without them. 18 years ago, I started seeing a doc and was diagnosed with atypical depression. In retrospect, I believe it was and is more of a social phobic thing than depression. Anyway, the only way I will find out is to stop Nardil.
I have found this board so comforting that I will keep everyone posted how the long road off is progressing. Thank you all. Joe
Posted by ed_uk on January 15, 2006, at 9:02:44
In reply to Re: MAOI withdrawal » 4WD, posted by joemzak on January 15, 2006, at 7:25:34
Best of luck. Let us know how it goes.
.........and thank you for posting on my thread :)
Ed
Posted by Jedi on January 18, 2006, at 2:16:18
In reply to Re: MAOI withdrawal » 4WD, posted by joemzak on January 15, 2006, at 7:25:34
Joe,
Your situation sounds very similar to mine. I've been taking Nardil off and on, mostly on, for the past 10 years. This last run has been for three years and the weight problems have gotten out of hand. I’ve gained and lost about 75 pounds a couple of times in the past three years. The carbohydrate cravings for me are intense on Nardil. I can eat three PB&J sandwiches after a full dinner, without even feeling bad about it. They say watch your chocolate consumption. Does this mean less than two pounds at a time? The only thing that has helped with the weight is two hours of strenuous exercise a day. But now, the 285 pounds has limited my ability to exercise, and is starting to cause joint problems.So, I’m tapering off also. Who told you to take a year to do it? I’ve been dropping 15mg per week, from 90mg to 15mg currently. I have had no withdrawal symptoms other than some fairly vivid dreams. I know everyone is different but a year to taper this drug seems like overkill. Besides, how can you quarter that little pill.
What gave me the courage to come off Nardil are some pretty amazing affects from Omega-3 fatty acids. I am currently taking 2400mg daily of EPA and 2000mg of DHA. This has caused some insomnia but has had some good affects on mood, inflammation, immune response, etc. A couple of months ago, I posted that I was probably a lifer on Nardil. Every time I quit I would be back in major depression. If this happens, I will be back on Nardil as fast as possible. One thing worse than being 100 pounds overweight is being in a pile on the floor with no hope and no will.
I’m just restarting my exercise program. This is all-important for the weight gain problem and overall health. Good luck in your effort to taper off Nardil. Maybe do some research on the Omega-3s. My diagnosis is treatment resistant atypical depression with social and generalized anxiety disorder. Oh, I’m staying on my 1mg of clonazepam, at least for now.
Take care,
JediOmega-3 fatty acids in the treatment of psychiatric disorders.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15907142&query_hl=3&itool=pubmed_docsum
... The article basically talks about withdrawal from anti-depressants, with a section on MAOI. Boy, was it an eye opener. He states that if the side effects occur within a few days after stopping your medication, it is NOT depression but withdrawal - which he calls discontinuation symptoms. He talks about all kinds of side effects - including one similiar to withdrawing from SPEED! The article also has recommendations for getting off meds. I now have a new doctor and started coming off Nardil today. I take 6 pills and will reduce by 1/4 pill every 2 weeks. It will take 48 weeks, but that doesn't concern me, as long as I get off these devils!
> As far as Parnate, frankly, I need to see what my natural state of being is before I take anything else. I have been on Nardil for 18 years and maybe, just maybe, I am okay without them. 18 years ago, I started seeing a doc and was diagnosed with atypical depression. In retrospect, I believe it was and is more of a social phobic thing than depression. Anyway, the only way I will find out is to stop Nardil.
> I have found this board so comforting that I will keep everyone posted how the long road off is progressing. Thank you all. Joe
Posted by joemzak on January 18, 2006, at 12:38:38
In reply to Re: MAOI withdrawal » joemzak, posted by Jedi on January 18, 2006, at 2:16:18
>
Finding this board really eased my worries. But Jedi, when I read your post it was like looking in a mirror!
I too have gained and lost so much weight. I went on liquid diets 3 times and lost (and then gained) 60 pounds. (Now 100 overweight) This was after being on Nardil 5 years and the last liquid diet was 9 years ago. I had read Nardil causes weight gain. But, not being a doctor, I assumed it meant 10-15 pounds. Why it would do that-I didn't know or care as that much weight seemed like an easy trade off for being on something that helped me live without depression. No doctor (psychiatrist) that I ever had (and I had one for 5 years, one for 12 years, one for 1+ years, and a new one I just started with a few weeks ago) ever told me that the weight gain could be enormous. In retrospect, I don't think any of them ever knew that! So, I lived all these years thinking I just had no will power. For most of those years, I worked in the fashion industry in NYC where appearance is so important, so my weight gain was doubly troubling. (Aside - I have seen the light and how shallow that was)
Also, I grew up eating very normal balanced meals. My mother was an excellent cook, enjoyed it, and so every night's dinner was fresh prepared. I often thought about my childhood and could not remember liking sweets. In fact, I remembered eating a half piece of apple pie whenever my mother baked one was my limit! So my new sweet tooth when I started Nardil was very puzzling to my family and me. That sweet tooth turned into a mean addiction to sugar where now I can eat a pint of Hagan Daz, a bag of Famous Amos chocolate Chips, and maybe, a couple hours later, something to top it all off! It was only 9 months ago that I found out that this sugar/carb addiction was COMPLETELY due to Nardil. I found this out from a doctor specializing in weight control/research at NY Presbyterian Hospital. At my first visit he said that all his patients on Nardil have the exact same problem and to get them to stop eating carbs was his most difficult task. Suddenly, a light bulb went off in my head and all the pieces fit. For the first time, I saw it wasn't MY fault or MY will power…it was that damn little orange pill (or 6 of them/day in my case) With that came anger that not one of my psychiatrists ever told me that!
I too, thought of exercising to keep the weight in check. But at 270 pounds (5' 10+" and normal weight of 170 pounds) I huff and puff after a small flight of stairs and my lower back problem -spondylolisthesis - keeps me from even walking more than 4 blocks!Regarding my slow tapering…
As you know, I have been on Nardil for almost 19 years. In the last 3 years, Nardil has been responsible for some very bizarre side effects. I mentioned them in my last post. But to demonstrate how frightening they were, I will elaborate on two of them.
About 2 years ago my sleeping became disturbed. For all of my life, all I needed to do was lie down and sleep came minutes later. And a full 8 + hours was the norm. Suddenly, I couldn't fall asleep and when I did 5-6 hours was the maximum I could stay asleep. Some nights were worse; I got tired, irritable and a bit confused. My Internist gave me some Halcyon (always worked very well for me)
The first night (after taking 50mg - double the recommended dose) I slept 6 1/2 hours. I took it the next night, and IT DIDN'T WORK AT ALL. I was up all night. Went back to my doctor, and he gave me a few 100mg Seconals…a sure way to get to sleep via "passing out". LOL THEY DID NOT WORK! I wound up taking 500mg, which are 5 "reds", and NOTHING. Not even drowsiness!
Another bizarre episode happened in July 2004. I had been taking 6 mgs. of Ativan for 4 days, just 4 days. The 5th day I didn't need it so didn't take it. Within 5 hours of awakening that morning, my walking seemed funny. It got worse and within 2 hours I was unable to coordinate the movement of my legs to walk. I fell a couple of times when I got up to walk to the kitchen…I was now petrified. Then, as the walking worsened, I started finding it difficult to talk. Within an hour of that onset, my speech was so slurred it became unintelligible. Frightened and thinking I was about to die, I called an ambulance and went to the hospital. For 3 days I lied in that bed unable to sleep and with levels of anxiety higher than I ever experienced. I woke up on the 4th day and I was miraculously normal again…no problem walking, talking and no anxiety! I had x-rays, a CAT scan and "you name it" tests done and the results were all normal…they could find nothing to explain what happened to me. As I was being released, a doctor said that the Ativan caused it and that next time I should titrate down for a few days after taking them. RIDICULOUS!!! 3 Ativan per day for 3, maybe 4 days was NOT excessive and does not require titration down off them. Not for most anyone, nor me. And, I had taken Ativan before, for longer time periods, and no problems beset me then. This was just another frightening and bizarre effect that Nardil decided to play on me. But, in deference to my psychiatrist and internist, these effects were no where to be found in any medical literature. But, also finding someone that has been on Nardil for 19 years was also, nowhere to be found in any medical literature!
Okay, after these two mentioned and other problems Nardil was giving me, I knew I had to get off them. My last few experiences getting off Nardil was in 1998 and 1999 and 2001. For the first two times, it was prior to hip surgery. I got off them with the help of oxycodone (Percocets). I suffer so much whenever I try to stop taking them. The psychic pain is so unbearable; I remember saying to a friend that it was like someone taking my soul from me. The only thing that stops this psychic pain (and extreme anxiety, confusion, and so on) is to take narcotics. My psychiatrist of 12 years understood this and was not hesitant to prescribe it for me for the two weeks prior to surgery. The attempt in 2001 was undertaken because this was the time the bizarre episodes began happening. Now, even the oxycodone didn't take all the pain away. The problem was that as I awoke in the morning, I was in a semi-vegetative state…could not even get out of the bed to get to the oxycodone in time.
So, I went to my psychiatrist and said get me off! He said I should take one less pill per day every 2 weeks. Something in my head was telling me to do it slower, so I asked him if I could go down 1/2 pill every two weeks. He said that I could cut it with a pill cutter and thought slower was better. I began the next day-Tuesday. By Thursday, I wasn't feeling right. On Friday, I was feeling "out of my skin" I stayed on course for 6 days and had to give up. Although it was not even close to being as bad as when I had to stop cold turkey prior to surgery, it was bad enough that I knew I could not go on like that. My doctor scratched his head not knowing what to do. I went back on 6 per day.
To skip to where I am now, going down just 1/4 every 2 weeks…
I left the psychiatrist I was seeing and started with a new one. In our first meeting she said she felt that what I felt was not my depression coming back, but some sort of withdrawal.
A few weeks later, I scoured the Internet looking for answers. That was the day I found this board (Thank God) and also the day I found this article from the Journal of Psychiatry on the Web:
"http://www.psychiatrist.com/pcc/abstracts/pcc030404.htm"
Although written for a scientific journal, it is very readable. It was the first time I heard of the extreme difficulty getting off anti-depressants, especially Nardil. Also, in it he states that the effects could be likened to withdrawal from SPEED! He also states that if these effects begin within several days from
The lowering of the dosage, that it was certainly NOT depression returning but was in fact, a withdrawal…which he calls "discontinuation symptoms".
Also, he states anti-depressants should be tapered off by not more that 10% per week. Taking 90 mg of Nardil, that would be roughly 9 mg./week…or realistically 1/2 pill. That didn't work for me. So, I thought that being on Nardil for 19 years, 3 times the length than anyone in the article, so I came up with lowering my dosage by 1/4 pill AND every 2 weeks. What I thought was since I was on it 3 times longer, I should stretch out my tapering by 3 times longer than he suggests (yes hard to cut, but very doable with a good pill cutter) I presented this to my psychiatrist and she thought it was a great idea! (Should I have been a doctor? LOL)
I began this past weekend, and yesterday - Tuesday - was my D-day. It was that amount of time that I started feeling terrible when I tried decreasing my dosage by 1/2 pill. BUT, low and behold, I WAS FINE YESTERDAY! AND I FEEL FINE TODAY! I am beginning to think I found the answer!!!!I guess I should end this, lest I want to write a book. Let me just say, I too tried the Omega 3's, but without going off Nardil. My doctor said it would boost the Nardil. Well, nothing really happened except that when I burped, it tasted like an entire school of fish in my mouth! LOL
Lastly, maybe you too experience a type of "withdrawal" like I do. Just a suggestion, but before you give up and go back on the "orange devil", maybe you should read the article and talk to your doctor about extremely slow tapering like I am doing. So far, it's working for me. AND WE BOTH WERE DIAGNOSED WITH ATYPICAL DEPRESSION WITH ANXIETY DISORDER!!!!!I can't thank you enough for your posting. I also hope that just maybe something I've said helps you. And, if you ever move to New York, let me know. I sure can use a gym buddy!
Regards,
Joe
> Joe,
> Your situation sounds very similar to mine. I've been taking Nardil off and on, mostly on, for the past 10 years. This last run has been for three years and the weight problems have gotten out of hand. I’ve gained and lost about 75 pounds a couple of times in the past three years. The carbohydrate cravings for me are intense on Nardil. I can eat three PB&J sandwiches after a full dinner, without even feeling bad about it. They say watch your chocolate consumption. Does this mean less than two pounds at a time? The only thing that has helped with the weight is two hours of strenuous exercise a day. But now, the 285 pounds has limited my ability to exercise, and is starting to cause joint problems.
>
> So, I’m tapering off also. Who told you to take a year to do it? I’ve been dropping 15mg per week, from 90mg to 15mg currently. I have had no withdrawal symptoms other than some fairly vivid dreams. I know everyone is different but a year to taper this drug seems like overkill. Besides, how can you quarter that little pill.
>
> What gave me the courage to come off Nardil are some pretty amazing affects from Omega-3 fatty acids. I am currently taking 2400mg daily of EPA and 2000mg of DHA. This has caused some insomnia but has had some good affects on mood, inflammation, immune response, etc. A couple of months ago, I posted that I was probably a lifer on Nardil. Every time I quit I would be back in major depression. If this happens, I will be back on Nardil as fast as possible. One thing worse than being 100 pounds overweight is being in a pile on the floor with no hope and no will.
>
> I’m just restarting my exercise program. This is all-important for the weight gain problem and overall health. Good luck in your effort to taper off Nardil. Maybe do some research on the Omega-3s. My diagnosis is treatment resistant atypical depression with social and generalized anxiety disorder. Oh, I’m staying on my 1mg of clonazepam, at least for now.
> Take care,
> Jedi
>
> Omega-3 fatty acids in the treatment of psychiatric disorders.
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15907142&query_hl=3&itool=pubmed_docsum
>
>
> ... The article basically talks about withdrawal from anti-depressants, with a section on MAOI. Boy, was it an eye opener. He states that if the side effects occur within a few days after stopping your medication, it is NOT depression but withdrawal - which he calls discontinuation symptoms. He talks about all kinds of side effects - including one similiar to withdrawing from SPEED! The article also has recommendations for getting off meds. I now have a new doctor and started coming off Nardil today. I take 6 pills and will reduce by 1/4 pill every 2 weeks. It will take 48 weeks, but that doesn't concern me, as long as I get off these devils!
> > As far as Parnate, frankly, I need to see what my natural state of being is before I take anything else. I have been on Nardil for 18 years and maybe, just maybe, I am okay without them. 18 years ago, I started seeing a doc and was diagnosed with atypical depression. In retrospect, I believe it was and is more of a social phobic thing than depression. Anyway, the only way I will find out is to stop Nardil.
> > I have found this board so comforting that I will keep everyone posted how the long road off is progressing. Thank you all. Joe
>
>
Posted by Dr. Bob on January 18, 2006, at 21:29:25
In reply to Re: MAOI withdrawal » Jedi, posted by joemzak on January 18, 2006, at 12:38:38
> Regarding my slow tapering…
Sorry to interrupt, but I'd like to redirect this thread to Psycho-Babble Withdrawal. Here's a link:
http://www.dr-bob.org/babble/wdrawl/20060117/msgs/600509.html
Thanks,
Bob
This is the end of the thread.
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