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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Girlnterrupted78 on August 7, 2007, at 23:53:43
Just suddenly I began having yet a new reaction to Nardil.
Today, right after taking my night dose of Nardil (45mgs) and also after taking the one this morning (30mgs) my chest and back (from the bottom of my neck down to the top of my stomach) and back (only the upper area of the back) became red, some areas fully red, while others are stains--rash-like stains, some bigger, some smaller. There's no itchiness, just the red. Looks a bit like sunburn, except for the discoloration in certain areas.
Then I became very sleepy and even took a mini nap with my fingers still in the keyboard
This was within 30 minutes of taking the 45mgs of Nardil and it was accompanied by heart beating faster and louder. I actually can feel the strong beating in my neck.
I wonder if this is normal? If anyone knows about this new side-effect I have, I'd really appreciate any info.
Thanks,
GI78
Posted by stargazer2 on August 8, 2007, at 10:10:33
In reply to New Nardil side-effect: body redness, posted by Girlnterrupted78 on August 7, 2007, at 23:53:43
GI, sounds like a drug reaction of some type. Hard to say if your BP was affected (without a monitor, did you get one?) but it sounds like your heart rate was increased, but without counting it for a minute, unable to say if it was higher or lower than a normal heart rate of 60-100. It certainly warrants a call to your pdoc, because the rash could be serious enough to have you stop or wean down the dosage immediately. Are you on a total of 75 mg per day? I just went down to 30 mg/day after my hypertensive reaction of past weekend. These drugs are too dangerous and my inclination is that you have had some type of drug reaction along with an increase in your heart rate and potentially your BP as well. Can not tell what is happening but a monitor would give you a better idea than no BP or heart rate readings.
I feel asleep (almost) the other day at the computer and my BP was extremely low, both my dogs came over to me instinctively when this happened so I think that was a sign something was wrong. I made myself drink alot of fluid to help raise my BP. That made me feel more alert and is an easy solution to my extreme low BP. As far as athe risk of high BP, that is definately more dangerous since you can have a stroke with an increase in BP. Rashes are always a symptom to report to your doctor as they most always are signalling an allergic reaction. Be safe and call you doc today, OK?
I may be coming off Nardil myself since I am very scared of the effects it has had on my BP, both high and low. I want to take something I am not in fear of always having a reaction to and with my past reaction I do not feel safe taking it anymore. I have a feeling my pdoc will want me to come off it too when I see him next week. The elevation of BP was too scarey for me to go through ever again. Jedi says the Nifedipine is not the best thing to take for a hypertensive reaction but my pdoc has always given me Nifedpine and this avoided me going to the ER so I'm glad I had it prescribed, else I would have been in the ER,which would have been a real scene since they are clueless about MAOI's.
Stargazer
Posted by Phillipa on August 8, 2007, at 11:29:46
In reply to Re: New Nardil side-effect: body redness/GI, posted by stargazer2 on August 8, 2007, at 10:10:33
Stargazer for your sake I'm glad you're going off it hopefully. Love Phillipa
Posted by Girlnterrupted78 on August 8, 2007, at 12:01:33
In reply to Re: New Nardil side-effect: body redness/GI, posted by stargazer2 on August 8, 2007, at 10:10:33
Thank you, Stargazer.
I don't want to call my doctor because supposedly I was on 60mgs. Since I only see him every month, sometimes I end up doing a few things on my own (i.e. going up to 75mgs)
I had decided to give up Nardil because it wasn't working after 8 weeks. However, I wasn't giving it up before trying 75mgs. Which isn't that big of a deal, considering my doctor had already put me on 90mgs. 90mgs also gave me a reaction--a 1hr long splitting, pounding headache.
After that headache, *I* decided to go down to 60mgs--my doctor was fine with that. So now that 60mgs doesn't seem to work, *I* decided to try 75mgs before quitting. Although I might actually not quit but instead do what others have adviced: I'll wait 3 months and see if it actually kicks in. But I guess I have to go down to 60mgs again after this strange rash.
The rash only lasted a few minutes. It didn't itch, it was just a red discoloration. The pounding in my neck is kind of normal, except it was a bit stronger this time. Whenever I take Nardil, I can feel my heart beating faster.
In fact, I went for a physical one time, and I felt my heart beating faster (to Nardil,) so I figured the nurse would tell me something was wrong. But nothing. My doctor then felt my back with her device (whatever it's called) and also said everything was fine. I was surprised, but figured maybe everything's really fine.
As for you, are you totally sure you're giving up on Nardil? I mean, the dangers of Nardil are only the contraindications. Your recent episode was due to your taking an amphetamine, not really due to Nardil itself, and amphetamines are contraindicated. So as long as you follow the diet and medication advice properly, I believe Nardil should not be a problem for you. Have you tried Provigil with Nardil? My doctor refused to give it to me, but I have heard of many others taking it with Nardil. I'm not sure if it's contraindicated, but if it's not, maybe it's another choice?
I don't recall if Nardil is already working for you, but if it is, would you give it up?BTW, the ER isn't as clueless about MAOIs as they seem to be. Well, at least the doctor who saw me seemed to be acquainted with them. This was in St. Luke's, in NYC. Have you had a bad experience before?
Well, thank you again, and best of luck.
Keep us posted,
GI78
Posted by stargazer2 on August 8, 2007, at 12:56:38
In reply to Re: New Nardil side-effect: body redness/GI » stargazer2, posted by Girlnterrupted78 on August 8, 2007, at 12:01:33
I have an article, written by the doctors at McLean Hospital in Belmont,MA, who sanctioned the addition of an amphetamine at 5 mg but never said you could not go higher if required. I have tried Provigil in the past with resultant tiredness and little improvement if any.
I'm not sure I'll stop Nardil yet, I have a call into my pdoc to inquire what should I do with the Nardil, Abilify and Wellbutrin, since I stopped everything except 'N' after "the episode" of hypertension.
I had a full endocrine workup yesterday and after looking at my labs from a year ago, the nurse practitioner (endo couldn't see me until 3/08)started me on Synthroid, after my bloods were drawn today. I had a whole slew of labs drawn along with TSH to see if it has gone higher in the last year. Also I had my cortisol level drawn which may show a deficiency in that as well, so I will be on new meds starting today with 25 mcg of synthroid (Phillipa you should know all about this type of treatment). And now with the addition of Synthroid, some of my other meds may need a reevaluation too. I see my pdoc next Friday, he was already informed that the nurse practitioner thought my thyroid was indicative of mild hypothyroid with the results of the labs drawn last year during my workup for M.S. What a mess it's been for the last 2-3 years straight.
Today, I actually thought I'm going to have to find a job soon especially if I start to feel less depressed and more focused and actually feel like i could work again. Finances are really tight since my husband has been shouldering the burden almost a full year, since I quit my job with my depression in full fury. The last year I have focused on getting to the bottom of the depression and I hope and pray all this testing and searching for results will provide answers. This is my last workup to see if my endocrine results are abnormal or if anything could be causing poor responses to most depression meds.
In the past 20 years no one had sent me to an endocrinologist and this could make a big difference in how I feel. I hope so.
SG
Posted by Phillipa on August 8, 2007, at 22:01:57
In reply to Re: New Nardil side-effect: body redness/GI/, posted by stargazer2 on August 8, 2007, at 12:56:38
Stargazer it's not over yet. Now you need to find out if it's autoimmune type did they mention hasimotos? If it's that it's been a year of the endo trying to regulate it. Things keep throwing it out of kilter as the spider bite just when it was down to 2.5 went back up to 9,5. Not good the ideal is l-3. Better yet a l would give more energy. Mine won't scan mine. But my niece in Milford CT had a great endo scanned it had nodules. Now in Ohio scanned each time and it's stable and she take zoloft and loves it. And today my therapist recommended a good rheumotoidologist as they deal with autoimmune disorders. Been tested for lupus, Sjorens, rheumatoid arthiritis. Google all the autoimmune diseases you will be amazed. My MRI ruled out ms and remember to repeat lymes titer western blot. I'm starting to hate doctors all I ever do is see one. Love Phillipa ps loss of taste and smell which I've had for three years came up on one search I did on autoimmune. Chronic fatigue symdrome also and fibromyalgia suspected.
Posted by stargazer2 on August 9, 2007, at 8:32:18
In reply to Re: New Nardil side-effect: body redness/GI/ » stargazer2, posted by Phillipa on August 8, 2007, at 22:01:57
Since this is GI's post (sorry Girl) I don't want to start on the endo thing here so I'll start another post on that. Plus I'm not sure what you are telling me or how it relates to what I have just told you which was very little. I'm just beginning a new angle of figuring out why my depression is not responding to the meds. I have no reason to believe it is anything more than hypothyroidism, and in a mild form at that. My post was just to inform others that an endo workup may help zero in on a med resistant depression, nothing more than that. Your situation is much more complicated than mine and I can only focus on that not to google the autoimmune diseases when I have no reason to believe I have Hasimoto's or anything else at this point. I know you mean well but your situation is so involved, I cannot go there since it will make me more depressed and I hope I don't have anything too serious to contend with. Googling autoimmune disorders is not idea of a beneficial endeavor for me at this point and time.
Stargazer
Posted by Girlnterrupted78 on August 9, 2007, at 11:04:30
In reply to Re: New Nardil side-effect: body redness/Phillipa, posted by stargazer2 on August 9, 2007, at 8:32:18
Oh thank you, Stargazer. You don't have to apologize, it wasn't even you who changed the subject so drastically.
I myself was surprised to suddenly find that post from Phillipa, which really has zero to do with Nardil or rashes (or any MAOI side-effect for that matter..)-- I thought about saying something, but when I realized it was about you, I didn't want to say anything.
I'd suggest to Phillipa to maybe start a different thread when she needs to change the subject so drastically, otherwise, my thread could go in such a different direction that I might end up losing it completely.
Thanks
Posted by Phillipa on August 9, 2007, at 20:52:40
In reply to Re: New Nardil side-effect: body redness/GI/, posted by stargazer2 on August 8, 2007, at 12:56:38
Sorry not trying to hyjack you're thread just that thyroid conditions are usually hasimotos. That's a fact. Hope the rash disappeared never to return. I apologize to you Girl Interruped. Guess I interruped you. Sorry about that. Love Phillipa
Posted by Girlnterrupted78 on August 10, 2007, at 13:47:16
In reply to Re: New Nardil side-effect: body redness/GI, posted by stargazer2 on August 8, 2007, at 10:10:33
Just an update: the rash is completely gone now that I went down to 60mgs again. So, once again, the problem was the dose. After taking 75mgs for a few days, it kind of built up in my system to a higher amount that I could handle. Seems like every time I go above 60mgs, something really bad happens (eg. the unbearable headache on 90mgs, the rash on 75mgs..) So I guess the safest dose now will be 60mgs.
Nardil hasn't "kicked in" yet. But it's helping in my sleeping patterns a LOT. I've had insomnia for the last 7 years. But for the last 2-3 weeks, I am able to go to bed at 11pm and get up at 6-7am spontaneously on my own, getting 7-9 hours of sleep. That's amazing.
Posted by stargazer2 on August 10, 2007, at 19:39:48
In reply to Re: body redness/rash gone completely » stargazer2, posted by Girlnterrupted78 on August 10, 2007, at 13:47:16
Well there is something to be said for a good night's sleep when it comes to depression, so that's a plus. I'm still on Nardil myself but only at 30 mg since I had my BP reaction and since I went on Synthroid on 8/8. I don't see my pdoc for a week so I wanted to be off everything but Nardil and be on a low enough dose so if we decide for me to come off it it will be easier to withdraw from it.
The Synthroid is giving me energy and my depression is under fairly good control I think although I'm feeling quite stressed about finding a job if my depression is better now that I'm on Synthroid. I will get the results of all the bloods I had drawn on 8/8 in a week or two after the nurse practitioner gets back from her vacation. Again, with the synthroid I may not need as much medication as I have been taking if the Synthroid helps with energy and motivation. We'll see good results hopefully soon. I'll increase the Thyroid dose next Wed to double the dose I'm now on which is a very small amount but that is all I need since my thyroid is very slightly hypothyroid, nothing like others who have full fledge hypo or hyperthyroidism. It's just that it is felt that depression medications work better with extra thyroid hormone if the med isn't working well on it's own. Thyroid used to be added to AD's quite routinely to supplement them. I had taken Cytomel years ago with the AD I was then on, can't remember much about the effect if any.
Stargazer
Posted by Phillipa on August 10, 2007, at 21:18:13
In reply to Re: body redness/rash gone completely, posted by stargazer2 on August 10, 2007, at 19:39:48
Cytomel is still added as an ad booster but not for true hypothroidism as my endo says your thyroid will not cause you to not need meds or make much of a difference in how you feel. Mine was down to 2.5. Optimal is l-3. New guidelines. I'll find a link after dinner and post it. Love Phillipa
Posted by Phillipa on August 10, 2007, at 22:11:52
In reply to Re: body redness/rash gone completely » stargazer2, posted by Phillipa on August 10, 2007, at 21:18:13
One link Love Phillipa
- Answers to Common Questions
From Mary Shomon,
Your Guide to Thyroid Disease.
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About.com Health's Disease and Condition content is reviewed by our Medical Review BoardSix Questions to Ask Your Doctor
When hypothyroidism sets in following a thyroidectomy or after treatment with radioactive iodine (RAI), or if you are diagnosed with an underactive thyroid due to autoimmune Hashimoto's thyroiditis, there will be many important questions to ask your doctor. Here are six of the most common and important ones.What is the normal thyroid-stimulating hormone (TSH) range at your lab?
The TSH test is the most commonly used test for diagnosis and management of hypothyroidism in the United States. But different labs often have slightly different values for what is known as the "TSH reference range." This measure is the range of test values deemed to reflect a normal population.At the lab used by my doctor, the TSH reference range is 0.5 to 5.5 as of fall 2006. A TSH value of less than 0.5 is considered hyperthyroid (overactive thyroid), while a TSH value of more than 5.5 is considered hypothyroid (underactive thyroid).
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Different labs might use a lower limit of anywhere from 0.35 to 0.6, and an upper threshold of anywhere from 4.0 to 6.0. In any case, it is important for you to be aware of the reference range at the lab where your blood is sent, so you know the standards by which you are being diagnosed.
NOTE: Since late 2002, the American Association of Clinical Endocrinologists (AACE) and other professional groups have recommended a narrower TSH reference range of 0.3 to 3.0. This means that hyperthyroidism is now suspected at TSH levels below 0.3, while levels of 3.0 and above are considered potentially indicative of hypothyroidism. To learn more about these standards, check out Does Your Doctor Know About the New TSH Lab Standards?
What TSH level will you use as a target for me?
This is a loaded but important question. Your physician's answer will reveal her or his philosophy about what represents a "normal" level for TSH. Some doctors believe that getting a patient into the very top of the normal range is the objective of hypothyroidism treatment. For example, using the 5.5 TSH standard from my own lab, some physicians believe that prescribing thyroid hormone replacement medication to get a patient's TSH down to below 5.5 (even perhaps just down to 5.4) would constitute full treatment.Physicians vary in what TSH level within the normal range they believe makes an ideal target. Some practitioners, for example, might target a TSH level between 1.0 and 2.0 based on their own experience suggesting that patients may feel best at these levels.
Other doctors closely follow the new AACE standards discussed earlier, and believe that thyroid hormone replacement treatment should target a TSH level of no more than 3.0 in hypothyroid patients.
Finally, some practitioners believe that thyroid treatment decisions should be based primarily on a patient's individual response, with TSH used mainly as a guideline. (For example, Dr. Steven Hotze, the author of "Hormones, Health and Happiness," relies on this approach in his practice, described in this interview.
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Does Your Doctor Know About the New TSH Lab Standards?
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Posted by girlnterrupted78 on August 11, 2007, at 12:59:36
In reply to Re: body redness/rash gone completely, posted by stargazer2 on August 10, 2007, at 19:39:48
I didn't know you could add Synthroid to an MAOI. Is it totally safe?
And that's a very low dose of Nardil as well, just 30mgs? Did you go down from a higher dose after the problem with adderall or that's been your dose all along?
I think you might be taking that incident too seriously and blaming Nardil when it wasn't Nardil's fault! lol. Sorry, but it seems like adderall was the culprit and Nardil will be harmless as long as you keep the contraindications on check.
Is Nardil at 30mgs doing anything at all, or do you think it's mainly the Synthroid working?
As for my rash, I'm still wondering what could have happened there. I don't recall having a rash at 90mgs, so why would I have it at 75?
And I hear of so many others being on 90mgs of Nardil for years, while I can only stand it for a 4 days before a horrible reaction suddenly appears. Could it be my body weight? I'm 5'7", 130lbs. Maybe it's too much Nardil for me.
Anyway, are you going to quit Nardil after the adderall incident, or you're going to continue with the trial? How long have you been on Nardil so far?
This is the end of the thread.
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