# For those taking nardil: read this



## mr t (Jan 28, 2010)

First off I want to express again the need to *supplement with vitamin B6.* Nardil depletes it through some mechanism and can cause deficiency. without adequate b6 you cannot maintain adequate neurotransmiter synthesis including GABA. I take 50mg of it through b complex and then a separate 100mg capsule.
Ordered that from vitaminshoppe and it was very cheap.

If you have any questions about Nardil feel free to ask. More than willing to help

Also taking your nardil doses with food will reduce side effects such as hypotension. This will help you bump up your dosage faster.

I know it takes a while to work but hang in there. You will be amazed by the results.

I'm currently on 60 mg and have been for like 7 weeks.


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## mr t (Jan 28, 2010)

I'm bumping my own thread bc I have noticed many more people are starting nardil or considering it. This is important info for nardil users


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## shy-one (May 10, 2008)

I have also heard that too much vitamin B6 destroys nardil?

_Phenelzine has also been linked to vitamin B6 deficiency. It reacts with vitamin B6 via an unknown enzyme to form a biologically inert metabolite. Both phenelzine and vitamin B6 are rendered inactive upon this reaction occurring. For this reason, it is recommended to supplement with vitamin B6 while taking phenelzine. High doses of vitamin B6 may significantly lower phenelzine levels and subsequently inhibit its therapeutic benefits, however, and thus, excess quantities of vitamin B6 should be avoided. It may be advisable to dose them separately during opposite intervals of the day (e.g., take one, then take the other 12 hours later) to avoid interaction as much as possible._

http://wapedia.mobi/en/Phenelzine


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## shy-one (May 10, 2008)

I got some 100mg B6 tablets today. Does it matter what time of day you take them? 

I'm also wondering why you took a B complex, when only B6 is needed?


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## mr t (Jan 28, 2010)

shy-one said:


> I got some 100mg B6 tablets today. Does it matter what time of day you take them?
> 
> I'm also wondering why you took a B complex, when only B6 is needed?


B complex is just a good think to take in general. It reduces anxiety, improves energy and has many other benefits. Sometimes if wake up in the morning with an anxious feeling I take b complex and it removes anxiety in about 30 min. Plus taking tons of b6 can cause deficiency of b12 which is critical for mood.

I take my b complex and 100mg like an hour before I start taking nardil. I see that nardil article said to wait 12 hours apart so you could do that. I might keep taking my b complex in the morning bc it helps wake me up and take the 100mg later. You should find the b6 to relaxing. It is not a stimulating b vitamin.

Hope this helps. Feel free to message me with any other questions!


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## shy-one (May 10, 2008)

Has anyone else been taking b6 with nardil? If so did you notice if it boosted the effects?


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## Emile (Feb 3, 2010)

Parnate does this too. I had progressive peripheral neuropathy of one of the fingers on my left hand before I finally figured out what was happening, and supplemented B6, and it's begun to subside. It's a serious issue you want to consider if you're taking a MAOI.



shy-one said:


> Has anyone else been taking b6 with nardil? If so did you notice if it boosted the effects?


Initially, I noticed a huge boost in mood that I could put down to nothing but the B6, but then it subsided and my mood plateaued again. Then again I was worried about the neuropathy and was taking large doses of B6 (aware that too much can *cause* neuropathy), so maybe I nuked the Parnate.

I have no idea about the interaction and the Parnate in general just does not seem to be working - don't want to make it worse - so this tidbit of information is pissing me off royally. I think Mr T's regimen is the sweet spot.


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## CD700 (Apr 22, 2010)

Emile said:


> Parnate does this too. I had progressive peripheral neuropathy of one of the fingers on my left hand before I finally figured out what was happening, and supplemented B6, and it's begun to subside. It's a serious issue you want to consider if you're taking a MAOI.
> 
> Initially, I noticed a huge boost in mood that I could put down to nothing but the B6, but then it subsided and my mood plateaued again. Then again I was worried about the neuropathy and was taking large doses of B6 (aware that too much can *cause* neuropathy), so maybe I nuked the Parnate.
> 
> I have no idea about the interaction and the Parnate in general just does not seem to be working - don't want to make it worse - so this tidbit of information is pissing me off royally. I think Mr T's regimen is the sweet spot.


How long have you been on the Parnate and what dosage ?


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## linmeme (Apr 16, 2012)

*Vitamin B6 with Nardil*

I started taking Vit b6 with nardil taking opposite times of the day but i started to get agitated again especially when eating so I stopped I am on 30mg of nardil now take 15mg in morn after breakfast and 15mg after evening dinner but last couple of days have become very dizzy and an ache in bottom of back.Blood pressure is fine. If I start back on Vit B6 don't know when I should take it as not meant to take same time as nardil any suggestions and do u think this could help. I am going through the menopause which is adding to my problems but see Vit b6 is good for that to!!!


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## Arguablytheperfectman (May 21, 2012)

A few things i would like to add to this thread now that it's bumped anyway:

1st - Be very careful not to overdose B6, the dosages as mentioned in this thread (50 - 150mg) are WAY to high, even for nardil users. The required intake for a normal person is around 3mg. The recommended upper limit in most countries (except USA) is somewhere around 10 or 25mg.

2nd - There are multiple versions of B6, pyridoxine is the most used in supplements, but unfortunately this is not the active version of B6, it has to be converted first, a lot of people can not do this in an effective enough way. So B6 deficiency may still occur even if you supplement with pyridoxine.
The proper form of B6 you would want to supplement is Pyridoxal 5'-Phosphate. 

3rd - I would recommend against supplementing just one B vitamin, they work together in the body and need to be taken in a balanced way to not offset the krebs cycle. So far the only decent B complex supplements i have seen are those from Thorne Research, and perhaps also Jarrow Formulas B-Right (although high in B6, it is reasonably balanced otherwise).

Lastly, as has been said here before, do not take B6 around the time of taking nardil (1 or 2 hours before or after should do).

Ontopic: linmeme, if B6 agitates you, i would not take it everyday. It's supplementation with nardil is mainly recommended to avoid deficiency's in the long run (which will, cause nerve damage). Once you have settled down on a stable(ish) nardil dose, give b6 a run for it's money again. I dont thinks it's required to take it everyday anyway, maybe a few times a week will be good enough.

PS: Thanks for all the nardil advice mr t, im looking for a doctor that doesn't chicken out on me atm


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## robotaffliction (Jul 24, 2009)

shy-one said:


> I have also heard that too much vitamin B6 destroys nardil?
> 
> _Phenelzine has also been linked to vitamin B6 deficiency. It reacts with vitamin B6 via an unknown enzyme to form a biologically inert metabolite. Both phenelzine and vitamin B6 are rendered inactive upon this reaction occurring. For this reason, it is recommended to supplement with vitamin B6 while taking phenelzine. High doses of vitamin B6 may significantly lower phenelzine levels and subsequently inhibit its therapeutic benefits, however, and thus, excess quantities of vitamin B6 should be avoided. It may be advisable to dose them separately during opposite intervals of the day (e.g., take one, then take the other 12 hours later) to avoid interaction as much as possible._
> 
> http://wapedia.mobi/en/Phenelzine


GABA transaminase and Alanine transaminase (two targets of phenelzine or phenylethyidenehydrazine) are both enzymes that bind pyridoxal 5'-phosphate (PLP), a.k.a., a form of Vitamin B6, as their cofactor. I don't feel like the risk of B6 deficiency is very high with phenelzine but it can't hurt to supplement in reasonable amounts.

BTW - the time when dosing the two shouldn't make much of a difference, I'm guessing your GABA transaminase and alanine transaminases enzymes are close to saturated with PLP at any given moment.

and reference, http://www.rcsb.org/pdb/explore.do?structureId=1ohw


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## Arguablytheperfectman (May 21, 2012)

I don't think it's the use of B6 as a co-factor that leads to defficiency's

From wikipedia:


> Phenelzine has also been linked to vitamin B6 deficiency. It (or possibly its metabolites such as phenylethylidenehydrazine) reacts with vitamin B6 via an unknown enzyme to form a biologically inert metabolite. Both phenelzine and vitamin B6 are rendered inactive upon this reaction occurring. For this reason, it may be recommended to supplement with vitamin B6 while taking phenelzine.


And here the study that got it all started: http://www.ncbi.nlm.nih.gov/pubmed/7803366

So personally, i do recommend supplementing it. On the old dr-bob forum there are some long term nardil users who have reported nerve damage, but this of-course can have other causes.


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## robotaffliction (Jul 24, 2009)

Arguablytheperfectman said:


> I don't think it's the use of B6 as a co-factor that leads to defficiency's
> 
> From wikipedia:
> 
> ...


Well I've added it to wikipedia with citations and the moderators can check it out, I wrote most of that article anyway


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## viper1431 (Jun 6, 2012)

Wouldn't the easiest solution be to just go get a blood test for b6 levels rather than just suplementing for the sake of it ?
Is there anything to sugest this inert matabolite effects b6 level tests ?


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## ourwater (Jun 2, 2012)

viper1431 said:


> Wouldn't the easiest solution be to just go get a blood test for b6 levels rather than just suplementing for the sake of it ?
> Is there anything to sugest this inert matabolite effects b6 level tests ?





viper1431 said:


> Wouldn't the easiest solution be to just go get a blood test for b6 levels rather than just suplementing for the sake of it ?
> Is there anything to sugest this inert matabolite effects b6 level tests ?


They could risk hypervitaminosis if they take too much B6. B6 recommended daily allowance is 0.5 mg - children ages 1 to 3, 0.6 mg - ages 4 to 8 - 1 mg - ages 9 to 13. Infants - 7 to 12 0.3 mg, newborns up to 6 months - 0.1 mg. Males over ages 50 - 1.7 mg, - 1.5 mg.


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## ahmad (Jun 27, 2010)

I had been on nardil 105 mg for 7 years before two decades , none of doctors mentioned anything about vitamin B6, I am asking now is it possible that nardil made vitamin B6 difficincy for me and I dont know that?


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## robotaffliction (Jul 24, 2009)

I had carpal tunnel syndrome (a common symptom of B6 deficiency) as a result of B6 deficiency due to nardil. in addition, all the hydrazine-based drugs have this risk of B6 deficiency. you want to supplement with the pyridoxine form of B6 (which prevented toxicity from hydrazines) and not the pyridoxal form of B6 (which actually increased the toxicity from hydrazines), and not worry about B6 making phenelzine less effective because there has never been any evidence of that.

source:
http://www.sciencedirect.com/science/article/pii/0041008X60900077
and I have a doctorate in chemistry/pharmacology


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## upndownboi (Oct 7, 2010)

robotaffliction said:


> I had carpal tunnel syndrome (a common symptom of B6 deficiency) as a result of B6 deficiency due to nardil. in addition, all the hydrazine-based drugs have this risk of B6 deficiency. you want to supplement with the pyridoxine form of B6 (which prevented toxicity from hydrazines) and not the pyridoxal form of B6 (which actually increased the toxicity from hydrazines), and not worry about B6 making phenelzine less effective because there has never been any evidence of that.
> 
> source:
> http://www.sciencedirect.com/science/article/pii/0041008X60900077
> and I have a doctorate in chemistry/pharmacology


so you want the more common type of b6 supplement when taking nardil? not the 'active' p5p form?


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## robotaffliction (Jul 24, 2009)

upndownboi said:


> so you want the more common type of b6 supplement when taking nardil? not the 'active' p5p form?


I've been taking the pyridoxine hydrochloride, though there is also pyridoxine 5'-phosphate which is one oxidation step away from pyridoxal 5'-phosphate (PLP). since this regular pyridoxine is the one used in all the studies showing it's reduction of phenelzine and other hydrazine toxicity it seems good to me, and plus it's cheap


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## V1bzz (Feb 20, 2017)

I realise this is a really old thread but wondering if anyone has any advice about taking a B vit complex.

I have just purchased myself some after reading a few threads about it being a good thing to do to help stop me feeling like dog ****.

How much should one take?

Thanks for any replies


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## AtlantaPhobic (Oct 31, 2017)

I also would like recent advice on B6. I don't want to take anything I don't actually need. I take a daily multi and eat a nutritious diet.


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## SFC01 (Feb 10, 2016)

AtlantaPhobic said:


> I also would like recent advice on B6. I don't want to take anything I don't actually need. I take a daily multi and eat a nutritious diet.


Nah, you should be getting enough through your diet.

Not even sure you need it, I had **** diet the first 6 months or so on Nardil and it worked, since then, I`ve taken B6 occasionally, dont notice any difference.


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## AtlantaPhobic (Oct 31, 2017)

Thanks, that is kind of what I figured. My experience is the vast majority of supplements are useless / sometimes harmful. If Nardil truly needed B6 supplementation to work I feel like that would have been figured out by now and be the standard with an RX / all over the boards. 

Any thoughts on "The effective dosage is 1 mg/kg of body weight (i.e.; 1 mg of Nardil for every 2.2 pounds of body weight)". I'm 5'11" 200lbs about 15% to 18% body fat (not fat at 200lbs - I've been lifting eight years). This would indicate 90mg which I expect will cause lots of side effects. I'm at 60mg at 32 days or so. 

Also, dose timing? I've tried all before bed and all in the morning. I think I'm more anxious before it kicks in if I wait until the morning - could be placebo and I'm having issues with going down on propranolol.


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## SFC01 (Feb 10, 2016)

AtlantaPhobic said:


> Any thoughts on "The effective dosage is 1 mg/kg of body weight (i.e.; 1 mg of Nardil for every 2.2 pounds of body weight)". I'm 5'11" 200lbs about 15% to 18% body fat (not fat at 200lbs - I've been lifting eight years). This would indicate 90mg which I expect will cause lots of side effects. I'm at 60mg at 32 days or so.
> 
> Also, dose timing? I've tried all before bed and all in the morning. I think I'm more anxious before it kicks in if I wait until the morning - could be placebo and I'm having issues with going down on propranolol.


Not sure about the 1mg/kg thing, seems to have become fact somehow but I`ve always taken 75mg and I'm heavier than you but I`m fat haha, and its worked fine, have taken 90mg at times for a while but didnt notice much difference.

Dose timing, I`ve always taken it first thing and then 2/3PM.

As it worked really well and really quickly for me, I haven't really had to think about changing much with nardil.


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## AtlantaPhobic (Oct 31, 2017)

SFC01 said:


> Not sure about the 1mg/kg thing, seems to have become fact somehow but I`ve always taken 75mg and I'm heavier than you but I`m fat haha, and its worked fine, have taken 90mg at times for a while but didnt notice much difference.
> 
> Dose timing, I`ve always taken it first thing and then 2/3PM.
> 
> As it worked really well and really quickly for me, I haven't really had to think about changing much with nardil.


Thanks SFC01 - I appreciate that you hang around and answer questions even though you are doing well.

Saw my PDOC - I like that he willing to try things but I always feel like I know more about my particular meds and situation than him. He also seems freaked out if I talk about side effects so usually I keep the minor stuff out of the way. Dunno, hard to find a great doc - he is "acceptable" as he will work with me and RX Nardil. Did say we can try up to 90mg if needed but didn't seem to have much of a plan. He was just the guy I got my Klonopin from - didn't need to change much with that.

I'm going to stay patient on 60mg for four more weeks.


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## SFC01 (Feb 10, 2016)

AtlantaPhobic said:


> Thanks SFC01 - I appreciate that you hang around and answer questions even though you are doing well.
> 
> Saw my PDOC - I like that he willing to try things but I always feel like I know more about my particular meds and situation than him. He also seems freaked out if I talk about side effects so usually I keep the minor stuff out of the way. Dunno, hard to find a great doc - he is "acceptable" as he will work with me and RX Nardil. Did say we can try up to 90mg if needed but didn't seem to have much of a plan. He was just the guy I got my Klonopin from - didn't need to change much with that.
> 
> I'm going to stay patient on 60mg for four more weeks.


No prbs, happy to share my experience !!

The pdoc I used to see, who was very good, always used to tell me I knew more about a lot of meds than him - guess their job isn't necessarily reading pages and pages of internet forums and pubmed articles 

When I started nardil, I got good relief of symptoms @ 45mg after just a couple of weeks but not consistent. It was when I got up to 75mg that my mood improved to the point where it was good every day - and has stayed that way fortunately.


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## AtlantaPhobic (Oct 31, 2017)

Very true!

My mood is fine. I still have significant anxiety symptoms I would like not to have although I am much improved. Like any new med it is unknown how much more effective another 15mg would be or if giving 60mg more time will have an effect. 

From my obsessive reading and researching around it seems like most long term success stories are people who judged Nardil very slowly, gave it plenty of time to work, and really considered a dose increase. I've read many reports on here and other places of people who seem to misjudge and chase the hypomania feelings to higher doses much too fast and too soon.

Did you find a great difference in 60mg vs. 75mg or was it more of a tweak?


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## SFC01 (Feb 10, 2016)

AtlantaPhobic said:


> Very true!
> 
> Did you find a great difference in 60mg vs. 75mg or was it more of a tweak?


Yeah, it went from some anxiety/depression occasionally on 60mg to none at all at 75mg.

I did go up quite quickly from 60ng to 75mg, so who knows, if I had given 60mg a bit more time then maybe that would have been the perfect dose.


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## AtlantaPhobic (Oct 31, 2017)

SFC01 said:


> Yeah, it went from some anxiety/depression occasionally on 60mg to none at all at 75mg.
> 
> I did go up quite quickly from 60ng to 75mg, so who knows, if I had given 60mg a bit more time then maybe that would have been the perfect dose.


I will test it out and see if anything happens over a few weeks. I can deal with the anxiety at this level - it isn't great but it isn't horrible.


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## RCMC (Feb 5, 2017)

AtlantaPhobic said:


> Thanks, that is kind of what I figured. My experience is the vast majority of supplements are useless / sometimes harmful. If Nardil truly needed B6 supplementation to work I feel like that would have been figured out by now and be the standard with an RX / all over the boards.
> 
> Any thoughts on "The effective dosage is 1 mg/kg of body weight (i.e.; 1 mg of Nardil for every 2.2 pounds of body weight)". I'm 5'11" 200lbs about 15% to 18% body fat (not fat at 200lbs - I've been lifting eight years). This would indicate 90mg which I expect will cause lots of side effects. I'm at 60mg at 32 days or so.
> 
> Also, dose timing? I've tried all before bed and all in the morning. I think I'm more anxious before it kicks in if I wait until the morning - could be placebo and I'm having issues with going down on propranolol.


maybe heavier body contains larger and more cells and water which in turn need more Nardil to function?


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## AtlantaPhobic (Oct 31, 2017)

RCMC said:


> maybe heavier body contains larger and more cells and water which in turn need more Nardil to function?


That is what I was thinking and body weight certainly has an effect on other substances. Doesn't seem to be an evidence of this specifically with Nardil though.


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