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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by mantus on January 19, 2011, at 11:19:00
Hello,
I wanted to update my Nardil trial, mainly because I have now developed insomnia (no other noticeable side effects except maybe a little dry mouth). My doctor gave me ambien 10mg which I tried for about 5-6 days with no luck. The past 2 nights I have decided not to use it because it wasn't working anyway (still no sleep). I have also decided to increase my dose of Nardil from 60mgs to 75mgs, even though I am dealing with the current insomnia problems. I have a few questions in general but specifically for people that have tried or are currently taking Nardil. 1. What is your opinion of my raising the dose to 75mgs after being on Nardil at 45mgs for a month and 60mg for about 3 weeks even though I now can't sleep? And how long would you suggest I stay on 75 before making any further decisions on dosage? 2. What did you do to augment the insomnia? Did you decide to take some sort of sleeping aid or just try to push through in hopes that the insomnia would subside? 3. How do you take your nardil dosage? (once a day or broken up into individual doses and if so what times) 4. Any suggestions on a sleep aid that is as non-addictive in nature as possible, yet still works? Also, I have been considering some sort of leave from work to allow more time for the Nardil to show more benefits, and in an atmosphere where sleep isn't as necessary until I can fix this problem. But I'm scared that if I do this I will just isolate myself at home too much, which I also know is not the best idea. As many suggestions or opinions on any of these topics as possible would be greatly appreciated.
Thank You,
Mantus
Posted by gardenergirl on January 19, 2011, at 12:24:38
In reply to Insomnia/Nardil Issues, posted by mantus on January 19, 2011, at 11:19:00
Nardil insomnia is awful. I had good luck for a long time with Ambien. I'm sorry it didn't work for you. One thing I noticed with it is that I had to take the Ambien on an empty stomach. If I'd eaten anything within a couple of hours of bedtime, it didn't work nearly as well.
I suspect that going up on Nardil will only increase the insomnia, but maybe not.
Sorry I can't help more.
gg
Posted by mantus on January 19, 2011, at 20:34:13
In reply to Re: Insomnia/Nardil Issues » mantus, posted by gardenergirl on January 19, 2011, at 12:24:38
Gg,
Are you still on Nardil? And if so how well did it work on your anxiety/depression? What dosage did you use? How long till you noticed at significant difference? And did the insomnia eventually go away?
Thanks,
Mantus
Posted by gardenergirl on January 19, 2011, at 20:44:32
In reply to Re: Insomnia/Nardil Issues » gardenergirl, posted by mantus on January 19, 2011, at 20:34:13
No, I had to go off of it for some surgery, and I decided not to go back on it again. I take 60 mg Cymbalta now.
It worked fairly well, probably better than anything else I've taken. I took 60 mg. I noticed an almost immediate effect, though at first it was almost too mood-elevating--almost euphoria.The insomnia never went away but it was mostly manageable at 60 mg. After awhile, it seemed that Ambien was pooping out. I had tried Ambien CR before, but I didn't like the hung-over/depressed feeling I had the next day. I also tried Lunesta, but I experienced that bad taste side effect that nothing relieved, so I stopped that.
When I tried 75 mg Nardil and got increased insomnia and agitation, my pdoc recommended Gabatril (I think?), though that didn't help me.
Do you split up your dose?
gg
Posted by jedi on January 19, 2011, at 23:09:44
In reply to Re: Insomnia/Nardil Issues » gardenergirl, posted by mantus on January 19, 2011, at 20:34:13
> Gg,
>
> Are you still on Nardil? And if so how well did it work on your anxiety/depression? What dosage did you use? How long till you noticed at significant difference? And did the insomnia eventually go away?
>
> Thanks,
>
> MantusMantus,
I've been on Nardil for most of the past 12 years so thought I would put my two cents in. I have always had some degree of insomnia from the medication. At first I was on trazodone, but this med tends to leave me hungover even at low dosages. I've taken clonazepam(Klonopin) for years-currently taking .5mg nightly, cutting down from 2mg. I've also taken low dose Seroquel for Nardil induced insomnia. As little as 12.5mg daily would knock me right out. This is another med that you have to watch out for that morning hangover effect. I am really sensitive to the meds that affect histamine receptors. This has been lucky for me with Nardil insomnia. I currently take 50mg of Benadryl nightly and it will always make me tired. Some people react differently to the meds that affect histamine receptors, so your mileage may vary.I take Nardil for treatment resistant atypical depression and social anxiety. It works very well for both. I am left with a residual level of dysthymia even with Nardil up to 90mg. Diagnosed with double depression. The effective dosage of Nardil for me is between 60 and 90mg. I am currently taking 75mg after being on 60mg for many months.
I have discontinued Nardil at least a half dozen times over the past 12 years. Each time, within a few months, the major depression has returned. This can be a dangerous strategy since sometimes it can be hard to find a MD who will prescribe the MAOIs. I keep trying to quit because of the major side effects of weight gain and delayed orgasm. But now, with all of the failed attempts at quitting the medication, I have resigned myself to being a lifer. This can be tough, since my insurance only covers generic meds and Nardil is not available in generic. At least in the US.
When I first started taking Nardil, I gained over 100 pounds in the first couple of years. It really affects carbohydrate cravings if you lean in that direction. I have finally gotten a handle on this through exercise and a modified low carb diet and have lost about 80% of the weight I gained. At my lowest effective dosage of 60mg the delayed orgasm is under control. As my dosage gets towards 90mg, that side effect is more of a problem. The insomnia is always with me but controlled mainly with the histamine receptor medications. I have never been able to get a good MAO inhibition at 45mg of Nardil. I wish I could get that dosage to work, since it also produces no side effects.
Good luck with Nardil. It is the "Bomb" when everything else fails for atypical depression and social anxiety.
Be Well,
Jedi
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