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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by jonh kimble on October 14, 2004, at 15:01:48
I want to take Nardil again for my atypical depression/ avoidant personality/ social anxiety etc... Ive taken millions of ads in the past and they did nothing! I mean nothing! I also tried parnate and went up to 50 mgs for at least two weeks. It made me very dizzy when I stood up and generally really tired. I tried nardil too at 60mgs for about 2 weeks. Did nothing, but it seems to have the best track record for the above symptoms and maybe I just require higher doses than most? I really have no other good ideas for how to treat this. For example, in the past i took clono. at .5 mgs and it did nothing at all, but when I take 1 mg. its very noticable. Also many state that seroquel does something at 25 - 100 mg dose. I didnt feel ANYTHING till 900 mgs! So maybe just that 60 mgs didnt work doesnt mean it wont work at all? But the fact that I gave something so close as parnate such a good shot with no luck whatsoever makes me wonder. And it seems nardil responders always say things like, "the ssri's and/ or whatever ad helped a bit but nardil helped alot." Ive never heard anyone who had no effect from any other ad's especially something as similar as parnate, and then have nardil work. But I need to try it cause Im loosing it. Theres nothing else I can think of. Ill go to 300 mgs if I have too.
Thanks, Tom
Posted by King Vultan on October 14, 2004, at 16:55:10
In reply to Nardil, could it have been a dose dependant prob.?, posted by jonh kimble on October 14, 2004, at 15:01:48
> I want to take Nardil again for my atypical depression/ avoidant personality/ social anxiety etc... Ive taken millions of ads in the past and they did nothing! I mean nothing! I also tried parnate and went up to 50 mgs for at least two weeks. It made me very dizzy when I stood up and generally really tired. I tried nardil too at 60mgs for about 2 weeks. Did nothing, but it seems to have the best track record for the above symptoms and maybe I just require higher doses than most? I really have no other good ideas for how to treat this. For example, in the past i took clono. at .5 mgs and it did nothing at all, but when I take 1 mg. its very noticable. Also many state that seroquel does something at 25 - 100 mg dose. I didnt feel ANYTHING till 900 mgs! So maybe just that 60 mgs didnt work doesnt mean it wont work at all? But the fact that I gave something so close as parnate such a good shot with no luck whatsoever makes me wonder. And it seems nardil responders always say things like, "the ssri's and/ or whatever ad helped a bit but nardil helped alot." Ive never heard anyone who had no effect from any other ad's especially something as similar as parnate, and then have nardil work. But I need to try it cause Im loosing it. Theres nothing else I can think of. Ill go to 300 mgs if I have too.
>
> Thanks, Tom
The length of time on a medication is also critical. I know the MAOIs are supposed to be faster working for most people than regular ADs, but this is not always the case. I think 4 weeks at what should be a therapeutic dosage is an absolute bare minimum for a reasonable trial of an antidepressant, and 6-8 weeks is a better amount. There is a school of thought on Nardil and Parnate that the effective dosage is weight related; for Nardil, it is 1.0 mg/day per kg of body weight, and for Parnate, it is 0.7 mg/day per kg of body weight. For a 170 lb. person, for instance, this figures out to 170/2.2 = 77 mg/day or 5 or 6 x 15 mg pills of Nardil per day. For Parnate, it figures out to 170/2.2 x 0.7 = 54 mg or 5 or 6 x 10 mg pills per day of Parnate.Nardil is generally the worse of the two for causing dizziness, as the stimulant effect of Parnate tends to counterbalance the decrease in BP and heart rate from the MAOI effect. I have borderline high blood pressure and was only just able to tolerate Nardil, while 50 mg of Parnate really hasn't been a problem; although, it has lowered my BP into the middle of the normal range. Whatever you try, whether it be an MAOI or something else, do try to give the drug a long enough trial for it to accomplish its task. Downregulation of receptors can take weeks.
Todd
Posted by jonh kimble on October 16, 2004, at 21:09:41
In reply to Re: Nardil, could it have been a dose dependant prob.?, posted by King Vultan on October 14, 2004, at 16:55:10
Thanks. I hope to give it a shot starting Monday and Im gonna ask to go up to 90 mgs right away. Tom
Posted by King Vultan on October 17, 2004, at 0:57:27
In reply to Re: Nardil, could it have been a dose dependant prob.?, posted by jonh kimble on October 16, 2004, at 21:09:41
> Thanks. I hope to give it a shot starting Monday and Im gonna ask to go up to 90 mgs right away. Tom
The recommendation generally is to start at a lower dose and work your way up. If you were to start at 90 mg/day, you would have a high likelihood of getting blasted with severe insomnia. My pdoc uses the starting dosage that is in the PDR, which is 3 x 15 mg/day. This is then "increased to at least 60 mg per day at a fairly rapid pace consistent with patient tolerance. It may be necessary to increase dosage up to 90 mg/day to obtain sufficient MAO inhibition." I think I went to 75 mg/day after maybe three weeks at 60. I went to 90 mg/day after about the same amount of time on 75. If I had to do it over again, I think I would have stayed at 75 mg/day for a longer period of time, as this was the lowest dosage that gave me significant therapeutic effects.
Todd
This is the end of the thread.
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