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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Quintal on September 8, 2008, at 17:12:11
I'm considering asking for Nardil at my next appointment. I suffer from severe social anxiety and obviously Nardil is the number one 'gold standard' treatment for this condition. I'd just like to hear your stories - how it felt from the first dose, the dose you started off on, the dose that worked for you, how long it took to kick in, any troublesome side effects etc and how you dealt with those. The anorgasmia is a deal breaker for me. If I can find no way to counteract that (and not using cyproheptadine or olanzapine) then the deal is off. Please tell me your experiences and any suggestions you might have.
Q
P.S. I'm not expecting everyone's experience to have been positive, but please remember that some people are willing tolerate side effects that others won't put up with.
Posted by Phillipa on September 8, 2008, at 20:15:37
In reply to Nardillians - lend me your ears, posted by Quintal on September 8, 2008, at 17:12:11
Q have you discussed it with your health team? What will you continue to take for psychosis? Love Phillipa
Posted by Tomatheus on September 8, 2008, at 23:47:32
In reply to Nardillians - lend me your ears, posted by Quintal on September 8, 2008, at 17:12:11
Quintal,
It's been a while since I've taken Nardil, so I'm going to try to recall my experiences as well as I can from memory. Please keep in mind that because it's been so long (and because of the cognitive impairment that I experience now that I have schizoaffective disorder), specific details may be difficult to recall.
If I recall correctly, it took me about six weeks to feel Nardil's antidepressant (and pro-social) effects. When I first took Nardil, I took the Australian Nardil, and I took it as it was prepared by its manufacturer (I later tried putting the contents of the pills into emptied-out enteric capsules, but more on that later). Taking the Australian Nardil as prepared by Link Pharmaceuticals, I first noticed a response after about two weeks at 75 mg/day. The antidepressant response was strong (the best that I had ever experienced on an antidepressant without going into hypomania) and wiped out a wide range of symptoms, including hypersomnia, psychomotor retardation, anhedonia, and low energy. The response only lasted for about two weeks, and I actually temporarily regained the response by lowering my dose to 60 mg/day. But unfortunately, as long as I continued to take my Australian Nardil as it was manufactured, my response only lasted for about two weeks. During the time that I responsed to Nardil (as prepared by its manufacturer), I experienced side effects including insomnia, urinary retention, increased sweating, anorgasmia, and weight gain. I took the sleep aid doxylamine succinate (25 mg/night) to counteract the insomnia. Other side effects that I experienced at start-up (but not after the medication kicked in) included lightheadedness and excessive daytime sleepiness.
Having read statements here on Psycho-Babble and on the Anxiety Community's Nardil discussion board suggesting that the "new" Nardil manufactured by Pfizer was less effective and less tolerable than its "old" counterpart for some patients because it lacked an enteric coating, I became curious as to whether or not the effectiveness of the Nardil that I was taking might be enhanced if I could just give it an enteric coating. So, that's exactly what I tried doing: I sought out to replicate Psycho-Babble member Michael Bell's approach to taking Nardil in enteric capsules. Michael Bell described his approach here:
http://www.dr-bob.org/babble/20050527/msgs/505052.html
http://www.dr-bob.org/babble/alter/20050510/msgs/506644.htmlAfter making the gradual transition from five film-coated tablets of the Australian Nardil (75 mg) per day to five partially homemade enteric capsules filled with the Australian Nardil (also 75 mg) per day, I experienced full remission from my depressive symptoms for about a month. I described the way that I felt during my period of remission in a previous Psycho-Babble post (http://www.dr-bob.org/babble/20060617/msgs/658844.html): "The response that I had was nothing like the euphoric hypomanic 'highs' that I had during my 'up' periods on Paxil. On the contrary, I felt *just right* in every way. Experiences that were supposed to make me feel good made me feel good, experiences that were supposed to make me feel sad made me feel sad. Likewise, tasks that were supposed to be simple were simple, and tasks that were supposed to be difficult were difficult. I experienced little to no insomnia, and for the first time ever, I did not struggle to get out of bed after a full night of sleep. I would just wake up as most people do."
In addition to achieving full remission on 75 mg/day of the Australian Nardil when I was taking it in the enteric capsules, I also noticed a reduction in side effects: the insomnia and excessive sweating became less pronounced, and the urinary retention and anorgasmia disappeared entirely.
Unfortunately, the full remission that I experienced with the enteric encapsulated version of the Australian Nardil lasted only a month. After I received a bottle of the Australian Nardil without any silica gel inside of it, the urinary retention and excessive sweating came back with a vengeance, and so did my depression. At that point, I had my pdoc prescribe me Pfizer's Nardil, which I also took in the enteric capsules. I could not tolerate Pfizer's version of the medication at 75 mg/day because of back pain, so I ended up taking 60 mg/day and experiencing something less than full remission (but still a healthy antidepressant response) for about another two months. You'd probably be interested in knowing that I didn't experience any anorgasmia during these two months. I eventually stopped taking Nardil after I received a batch from my pharmacy that sent me into a mad rage and felt dramatically different from any version of Nardil that I had taken up to that point.
So, I know that my story was complicated and involved a lot of twists and turns, but that was my experience with Nardil. To date, I still consider Nardil to be the most effective antidepressant that I've taken to date and the only one that brought me into full remission. Oh, how I miss those days and how I miss *just* having depression and being an MAOI responder.
But anyway, I hope that your experience with Nardil (assuming that you'll start taking it soon) turns out to be as positive as mine was without all of the complications. You deserve the wonderful results that Nardil can provide.
Tomatheus
Posted by Quintal on September 9, 2008, at 11:15:08
In reply to Re: Nardillians - lend me your ears » Quintal, posted by Phillipa on September 8, 2008, at 20:15:37
No, I'm still waiting to hear about Suboxone. I would stay on Lamictal and zopiclone - I find pleanty of sleep helps stave off psychosis.
Q
Posted by Quintal on September 9, 2008, at 12:05:01
In reply to Re: Nardillians - lend me your ears » Quintal, posted by Tomatheus on September 8, 2008, at 23:47:32
Thanks for posting such a detailed response Tom, this is just what I was looking for. Do you know which company makes the Australian Nardil? People have said they find it more effective than Pfitzer's new formula and a few have imported it into the US. The one I'd be getting is made by Concorde/Archimedes pharmaceuticals. I think it's supposed to be on a par with Pfitzer's original, but not many people here have taken it. Thanks for the enteric coating tip. Rumor has it that the British version has a hard shell like the Pfitzer original, so hopefully I won't need to do anything to it. I'm still not sure Nardil is absolutely necessary for me at this point, but your post was very encouraging. Did you respond to Parnate?
Thanks again for your post.
Q
Posted by Tomatheus on September 9, 2008, at 16:39:52
In reply to Re: Nardillians - lend me your ears » Tomatheus, posted by Quintal on September 9, 2008, at 12:05:01
Quintal,
Thank you for your post. The Australian Nardil is manufactured by Link Pharmaceuticals.
I did respond to Parnate, but only to a certain version of it and only on a long-term basis when I took it with SAMe. Basically, my first trial with Parnate came when my pdoc prescribed me GlaxoSmithKline's Parnate. I ended up staying on the Parnate that my pdoc prescribed to me for only about two weeks, going no higher than 20 mg/day. I noticed a stimulating effect on my first two days of taking Parnate, but nothing after that. What I could not tolerate at the time was the daytime sedation that the medication caused. I ended up sleeping through afternoon and evening classes that I was taking, and so I ended up discontinuing the Parnate prematurely so I could make it to my classes and pass them.
The next time that I tried Parnate, I tried the version manufactured by Goldshield for the U.K. Every time that I would start the medication or increase to a higher dose, I would notice a Nardil-like antidepressant effect that would last for about 3-4 days before I'd lose most of the antidepressant effect. The highest dose that I tried was 30 mg. I was able to get a partial-but-consistent antidepressant response from the medication when I took 20 mg of it with 150 mg of SAMe.
Tomatheus
Posted by Treehugger on September 11, 2008, at 1:32:54
In reply to Re: Nardillians - lend me your ears » Quintal, posted by Tomatheus on September 9, 2008, at 16:39:52
Q, hey! My memory is pathetic, but I will do my best. I used to be a musician, jazz, but I always had anxiety so I drank & took valium - started at 20, quit cold turkey when I was 30 - the valium & the music - the detox was pretty much Hell! - I am now 64 and the only relief I ever got from my Social Phobia (I have it Bad!) was about 10 or 12 years ago when I started Nardil (old version). After 6 weeks all of a sudden I just woke up a different person - I was on stage playing again & I wasn't nervous! I honestly don't even know how I got up there, I just changed - it was like a total miracle. I was on 60mg - I tried going back to 45 because of being really tired & drinking a lot of coffee in the afternoon to just be alert, but the good stuff started to disappear, so back to 60. I don't remember any other side effects. I can't even remember how long I took Nardil, 5 or 6 months maybe. I quit because of anorgasmia - I just didn't feel alive - I got my life back in one sense, but lost something that, at that time, I was not willing to let go of. I understand your saying it's a "Deal Breaker"! My desire for sex was great but erections would come & go, and it was extremely frustrating, especially since I had little trouble finding partners (new phenomena!!!) - along with being able to play music again, I seemed to become this kind of free communicator (I just said whatever I was thinking) and my life opened up to things I had never experienced as an extreme Social Phobic. I don't know what would have happened if I had kept taking it? I have two bottles of the new Pfizer stuff, but have never gotten up the courage to try it - just too much bad press out there. So now I am more depressed, anxious than when I started valium (my first med) 44 years ago - sometimes I think maybe my brain is fried after all the med trials. Nardil, hmmm? Tree
Posted by bulldog2 on September 11, 2008, at 9:01:58
In reply to Re: Nardillians - lend me your ears, posted by Treehugger on September 11, 2008, at 1:32:54
> Q, hey! My memory is pathetic, but I will do my best. I used to be a musician, jazz, but I always had anxiety so I drank & took valium - started at 20, quit cold turkey when I was 30 - the valium & the music - the detox was pretty much Hell! - I am now 64 and the only relief I ever got from my Social Phobia (I have it Bad!) was about 10 or 12 years ago when I started Nardil (old version). After 6 weeks all of a sudden I just woke up a different person - I was on stage playing again & I wasn't nervous! I honestly don't even know how I got up there, I just changed - it was like a total miracle. I was on 60mg - I tried going back to 45 because of being really tired & drinking a lot of coffee in the afternoon to just be alert, but the good stuff started to disappear, so back to 60. I don't remember any other side effects. I can't even remember how long I took Nardil, 5 or 6 months maybe. I quit because of anorgasmia - I just didn't feel alive - I got my life back in one sense, but lost something that, at that time, I was not willing to let go of. I understand your saying it's a "Deal Breaker"! My desire for sex was great but erections would come & go, and it was extremely frustrating, especially since I had little trouble finding partners (new phenomena!!!) - along with being able to play music again, I seemed to become this kind of free communicator (I just said whatever I was thinking) and my life opened up to things I had never experienced as an extreme Social Phobic. I don't know what would have happened if I had kept taking it? I have two bottles of the new Pfizer stuff, but have never gotten up the courage to try it - just too much bad press out there. So now I am more depressed, anxious than when I started valium (my first med) 44 years ago - sometimes I think maybe my brain is fried after all the med trials. Nardil, hmmm? Tree
Social phobia is very debilitating as i've had since my early 20's and I'm now 61. Seems like my life has revolved around avoiding social situations. Had no idea when I was younger that a med existed that would help with that.Now at my age i don't know if i could put up with the sides plus all the bad press about the new nardil. Heard parnate is good for that also with less sides.
Posted by bulldog2 on September 11, 2008, at 9:18:27
In reply to Re: Nardillians - lend me your ears, posted by bulldog2 on September 11, 2008, at 9:01:58
> > Q, hey! My memory is pathetic, but I will do my best. I used to be a musician, jazz, but I always had anxiety so I drank & took valium - started at 20, quit cold turkey when I was 30 - the valium & the music - the detox was pretty much Hell! - I am now 64 and the only relief I ever got from my Social Phobia (I have it Bad!) was about 10 or 12 years ago when I started Nardil (old version). After 6 weeks all of a sudden I just woke up a different person - I was on stage playing again & I wasn't nervous! I honestly don't even know how I got up there, I just changed - it was like a total miracle. I was on 60mg - I tried going back to 45 because of being really tired & drinking a lot of coffee in the afternoon to just be alert, but the good stuff started to disappear, so back to 60. I don't remember any other side effects. I can't even remember how long I took Nardil, 5 or 6 months maybe. I quit because of anorgasmia - I just didn't feel alive - I got my life back in one sense, but lost something that, at that time, I was not willing to let go of. I understand your saying it's a "Deal Breaker"! My desire for sex was great but erections would come & go, and it was extremely frustrating, especially since I had little trouble finding partners (new phenomena!!!) - along with being able to play music again, I seemed to become this kind of free communicator (I just said whatever I was thinking) and my life opened up to things I had never experienced as an extreme Social Phobic. I don't know what would have happened if I had kept taking it? I have two bottles of the new Pfizer stuff, but have never gotten up the courage to try it - just too much bad press out there. So now I am more depressed, anxious than when I started valium (my first med) 44 years ago - sometimes I think maybe my brain is fried after all the med trials. Nardil, hmmm? Tree
>
> Social phobia is very debilitating as i've had since my early 20's and I'm now 61. Seems like my life has revolved around avoiding social situations. Had no idea when I was younger that a med existed that would help with that.Now at my age i don't know if i could put up with the sides plus all the bad press about the new nardil. Heard parnate is good for that also with less sides.For me dealbreakers would be
1. weight gain
Also problem with dietary restrictions as I eat out a lot and hard to really know what is in food. Wouldn't want to be at a hotel somewhere and have an attack.
Posted by Quintal on September 11, 2008, at 9:25:32
In reply to Re: Nardillians - lend me your ears, posted by Treehugger on September 11, 2008, at 1:32:54
Thanks so much T. It's such a shame about the anorgasmia. I willing to put up with hypotension, constipation and all the rest of it, but not that! It was the same with Paxil.
>just woke up a different person - I was on stage playing again & I wasn't nervous!
Wow, I'd like some of that! I think I know what you mean. I feel like a bystander in life. As if I'm watching other people acting out the soap drama of their lives, while I don't have one (a life and a script).
>I seemed to become this kind of free communicator (I just said whatever I was thinking) and my life opened up to things I had never experienced as an extreme Social Phobic.
I'm really interested about this. I remember when I was on clonazepam I'd say things without thinking and looking back often they weren't really appropriate. I was a bit like a drunk and it is embarrassing to look back on. I'm a little wary that this might happen with Nardil as it has with other GABAergic drugs. Do you think Nardil really leads to better social functioning or just disinhibition? Opiates tend to have a very marked pro-social effect, but don't seem to cause as much social blundering as GABAergic drugs. I'm just wondering if Nardil might belong more to the opiate 'peace and love' kind of feeling or more the slighty more aggressive self-confidence that sometimes comes with benzos? What do you think? I wish we had a solution to the anorgasmia problem.
Q
Posted by Treehugger on September 11, 2008, at 12:23:28
In reply to Re: Nardillians - lend me your ears » Treehugger, posted by Quintal on September 11, 2008, at 9:25:32
Q - I am on Clonazepam now, & have been for about 5 years. Right now I have dropped from 1.5 to 1.25 - been about a week, and I feel worse of course. I have tried so many times to "kick it", but getting close one time .125 doesn't cut it. I speak my mind a little too much with C, I usually say that I need to turn on my edit switch. I think there is a difference in that respect between C & N - I don't know about being all warm and fuzzy & full of love - actually that just happens sometimes spontaneously & it is a trip. I would say the freedon I felt with Nardil was more of a positive thing than it is with Clonazepam. Actually I have thought for many years that my life would make a good movie (a downer, unless there is still that unlikely breakthru to come). It is very sad, I think, to have a lot of talent & not be able to use it - I have cried about it many times, even kind of as an observer of the CURSE. A therapist said to me once (if any bearing, it was a woman) that she would make the tradeoff, sex for my life as a musician. To me sex is much more complex than in the way, I believe, she was responding - she made it too simple. One can make love for sure without intercourse or orgasm, but it feels like there is something very natural in us that feels sad to be without the "whole enchilada" There are worse things, for sure. Like I said it is about feelin alive, to make love to someone you love & have it all work & that is beautiful. Anorgasmia, actually reduces it to the physical, trying so hard to make it happen. I don't need to feel insecure about anything else! If something like Tramadol would work like C in the good ways, and I could stay at a pretty steady dose - fxxx, I'm 64, what does it matter if I am addictied to an opiate - nothing could really be worse than the dead end of benzos, & the withdrawal!!!!!!!! If the old Nardil were to reappear, I would do it - I need to make music! Life is not always sweet. And HI to Liliths & Mjbogdanov if you are listening. Later, Tree
ps - (edit switch off)! To those who think benzos are not "addicting", use whatever words you want to make it feel better, but whether it comes from the street corner or the corner pharmacy, - if you have withdrawal "You Are Addicted"
Posted by Quintal on September 11, 2008, at 17:03:36
In reply to Re: Nardillians - lend me your ears » Quintal, posted by Treehugger on September 11, 2008, at 12:23:28
You seem fine to me Treehugger. You know the clonazepam years were the best of my life, I wish I could feel like that again. I never had so much enthusiasm for living! I think a lot of outgoing people don't have an edit switch anyway, they just say whatever they're thinking, and maybe they live a lot happier lives as a result! Maybe they just have a lot more GABA floating around? I think a lot of having an edit switch is the 'fear of negative evaluation' anyway, and often there's nothing really to be afraid of.
Q
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