# My new psychiatrist recommends Trintellix over Nardil



## Captainmycaptain (Sep 23, 2012)

I met with a new psychiatrist today. Similar to my previous psychiatrist, he is not a huge fan of phenelzine. He did keep me on the 90 mg of Nardil like I had been taking, prescribed me 2mg a day of lorazepam a day to be taken when needed and at my request, switched my sleeping medication from Seroquel to 600 mg of a night of Neurontin. I have gained 22 pounds in six weeks on Seroquel. Seroquel also sometimes doesn't work for me when I take it several nights in a row. When I took Neurontin in the past for sleep, I recall it working quite well without all the side effects.

My new psychiatrist is a nice person and quite knowledgeable about medication. When I mentioned a couple of the most bothersome side effects of Nardil, including an inability to ejaculate as well as increased facial sweating, he felt strongly that I shouldn't have to put up with those side effects. He felt that some newer medications could be as effective if not more so than Nardil without all of the side effects. He said that Nardil acts on so many neurotransmitters instead of being more directed which causes all of the side effects and its inability to be combined with a huge laundry list of other meidcations. In particular, he spoke highly about a medication called Trintellix (vortioxetine) and said it would not give me as many side effects as Nardil. I don't plan to stop Nardil in the near future, but I was at least curious about Trintellix. Has anyone tried this as did you find it particularly effective?

By the way, getting Gavis manufactured Nardil, which IMO is far away the most effective version of Nardil, is getting more and more difficult to get. I went to the Costco near my house, and they switched over to Greenstone. I had to drive to another Costco that was quite far away to get Gavis Nardil. They have to order it and I will pick it up on Friday afternoon. For the past couple months, while in between psychiatrists and being low on Nardil, I had to use 60 mg of Archimedes Nardil which I got while overseas and 30 mg of Gavis Nardil. I will update on the difference in effectiveness or lack thereof between Gavis and Archimedes on a different Nardil thread a few days after making the switch.


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## SFC01 (Feb 10, 2016)

dont know much about trintellix but I would guess your psychiatrist is wrong - anything that I have read on it doesnt sound particularly great. and, if Gravis Nardil is better than Archimedes, then god knows how sky high my mood would be if I took gravis


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## Cassoulet94 (Apr 3, 2014)

Captainmycaptain said:


> I met with a new psychiatrist today. Similar to my previous psychiatrist, he is not a huge fan of phenelzine. He did keep me on the 90 mg of Nardil like I had been taking, prescribed me 2mg a day of lorazepam a day to be taken when needed and at my request, switched my sleeping medication from Seroquel to 600 mg of a night of Neurontin. I have gained 22 pounds in six weeks on Seroquel. Seroquel also sometimes doesn't work for me when I take it several nights in a row. When I took Neurontin in the past for sleep, I recall it working quite well without all the side effects.
> 
> My new psychiatrist is a nice person and quite knowledgeable about medication. When I mentioned a couple of the most bothersome side effects of Nardil, including an inability to ejaculate as well as increased facial sweating, he felt strongly that I shouldn't have to put up with those side effects. He felt that some newer medications could be as effective if not more so than Nardil without all of the side effects. He said that Nardil acts on so many neurotransmitters instead of being more directed which causes all of the side effects and its inability to be combined with a huge laundry list of other meidcations. In particular, he spoke highly about a medication called Trintellix (vortioxetine) and said it would not give me as many side effects as Nardil. I don't plan to stop Nardil in the near future, but I was at least curious about Trintellix. Has anyone tried this as did you find it particularly effective?
> 
> By the way, getting Gavis manufactured Nardil, which IMO is far away the most effective version of Nardil, is getting more and more difficult to get. I went to the Costco near my house, and they switched over to Greenstone. I had to drive to another Costco that was quite far away to get Gavis Nardil. They have to order it and I will pick it up on Friday afternoon. For the past couple months, while in between psychiatrists and being low on Nardil, I had to use 60 mg of Archimedes Nardil which I got while overseas and 30 mg of Gavis Nardil. I will update on the difference in effectiveness or lack thereof between Gavis and Archimedes on a different Nardil thread a few days after making the switch.


If you feel that nardil has more drawbacks than benefits then maybe you should stop, no need to insist just because it's supposed to be the best drug for SA. As for Trintellix, I don't know it but from what I saw it looks like one of these "new drugs" that big pharma regularly put on the market to keep making some good money thanks to the patent. It's ****ing expensive, its mechanism of action is not really different from a lot of other drugs and the studies show inconsistent efficacy. So honestly I don't think I would bother...


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## Captainmycaptain (Sep 23, 2012)

Cassoulet94 said:


> If you feel that nardil has more drawbacks than benefits then maybe you should stop, no need to insist just because it's supposed to be the best drug for SA. As for Trintellix, I don't know it but from what I saw it looks like one of these "new drugs" that big pharma regularly put on the market to keep making some good money thanks to the patent. It's ****ing expensive, its mechanism of action is not really different from a lot of other drugs and the studies show inconsistent efficacy. So honestly I don't think I would bother...


I never said that the side effects are worse than the gains of Nardil. The doctor was making more of the issue of side effects than I was. I take it all at night and can often ejaculate before taking it. It is impossible to ejaculate several hours after taking it. It's not a big deal to work my schedule around that. I asked the doctor about oxybutynin for sweating and he didn't think it would be a particularly good idea but was not succinct in explaining why. Dealing with facial sweating and having a two hour or so window to get the poison out is not the end of the world and certainly not a deal breaker for Nardil.


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## UltraShy (Nov 8, 2003)

Google Libby Zion. She is why they fear Nardil.:afr

The young Ms. Zion, who "genius" MDs killed by their incompetency (her rich parents argued "gross negligence" wanting them personally bankrupt & in prison). [Gross negligence is NOT covered by any malpractice policy.]

Most pdocs know next to nothing about MAOIs, with me -- having a background in investing -- literally knowing more than they do. I don't exaggerate. What the hell else can I say when a guy named one of the best docs in Milwaukee 4 times in a row, after 28 years in practice as a pdoc, has to look up Parnate in a god damn reference book!

If you really want to have some fun, play "stump the pharmacist." I asked a young lady who clearly was a recent grad of pharmacology school if she could ID tranylcypromine or phenelzine (Parnate or Nardil). Despite my hints, I won that game, which demonstrates most vividly how woefully ignorant the medical community is regarding MAOIs.


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## UltraShy (Nov 8, 2003)

As for the anorgasmia of Nardil, I won't deny that is indeed an issue.

Of course, SSRIs ARE anti-orgasm pills! If some poor fella suffering from premature ejaculation goes to his doc seeking treatment, he will be going how with a script for Paxil and it will most definitely cure his problem.

I tend to assume every guy in the porn industry is on a combo of Paxil -- to avoid the "money shot" for as long as possible as demanded by the director, along with Cialis -- for a performance enhancing duo. That or every dude in porn just magically suffers from retarded ejaculation, taking a full 15 minutes to orgasm, so his female partner can have a let's-do-it-till-we're-sore-gasm.


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## Cassoulet94 (Apr 3, 2014)

Captainmycaptain said:


> I never said that the side effects are worse than the gains of Nardil. The doctor was making more of the issue of side effects than I was. I take it all at night and can often ejaculate before taking it. It is impossible to ejaculate several hours after taking it. It's not a big deal to work my schedule around that. I asked the doctor about oxybutynin for sweating and he didn't think it would be a particularly good idea but was not succinct in explaining why. Dealing with facial sweating and having a two hour or so window to get the poison out is not the end of the world and certainly not a deal breaker for Nardil.


Then you're lucky and obviously there is not point in changing for something that does not seem very efficient, however nice is your doc.


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## DarkHoarse (May 17, 2017)

Captainmycaptain said:


> I met with a new psychiatrist today. Similar to my previous psychiatrist, he is not a huge fan of phenelzine. He did keep me on the 90 mg of Nardil like I had been taking, prescribed me 2mg a day of lorazepam a day to be taken when needed and at my request, switched my sleeping medication from Seroquel to 600 mg of a night of Neurontin. I have gained 22 pounds in six weeks on Seroquel. Seroquel also sometimes doesn't work for me when I take it several nights in a row. When I took Neurontin in the past for sleep, I recall it working quite well without all the side effects.
> 
> My new psychiatrist is a nice person and quite knowledgeable about medication. When I mentioned a couple of the most bothersome side effects of Nardil, including an inability to ejaculate as well as increased facial sweating, he felt strongly that I shouldn't have to put up with those side effects. He felt that some newer medications could be as effective if not more so than Nardil without all of the side effects. He said that Nardil acts on so many neurotransmitters instead of being more directed which causes all of the side effects and its inability to be combined with a huge laundry list of other meidcations. In particular, he spoke highly about a medication called Trintellix (vortioxetine) and said it would not give me as many side effects as Nardil. I don't plan to stop Nardil in the near future, but I was at least curious about Trintellix. Has anyone tried this as did you find it particularly effective?
> 
> By the way, getting Gavis manufactured Nardil, which IMO is far away the most effective version of Nardil, is getting more and more difficult to get. I went to the Costco near my house, and they switched over to Greenstone. I had to drive to another Costco that was quite far away to get Gavis Nardil. They have to order it and I will pick it up on Friday afternoon. For the past couple months, while in between psychiatrists and being low on Nardil, I had to use 60 mg of Archimedes Nardil which I got while overseas and 30 mg of Gavis Nardil. I will update on the difference in effectiveness or lack thereof between Gavis and Archimedes on a different Nardil thread a few days after making the switch.


I can tell you about Trintellix; I was on it for around a month before stopping my first time around, and then 4 months the second time. It's a serotonin modulator and stimulator that is pretty new. When I first went on it; I actually did feel some relief of my depressive symptoms and a bit of relief from my GAD as well, but not too much. The thing was, that I had a very strange side effect. I had muscle aches and pains after maybe a week or two of taking the medication, and the more I took it the worse it got. Eventually I just stopped taking it altogether. The inability to orgasm side effect I found to be particularly bad on this med as well; more so than while on SSRI's such as Zoloft, Prozac, or Lexapro, for example. The reason why I gave it a second trial was because my doc insisted on it, reasoning it was literally the only medication at the time I responded to at all and wanted to see if the side effects would decrease over time. I agreed, but the side effects multiplied over time instead. Eventually it got so bad my wrist began aching as a result of brushing my teeth in the morning, haha.

But hey, that's just my experience, and apparently its a very rare side effect (I tend to get those). You might respond well to it, who knows. I would say though that its probably worth staying on the Nardil; I myself am trying desperately to get it prescribed to me at the moment with no luck as of yet, and strongly believe side effects within reason are worth persisting through if the medication actually works well. If Nardil is a life saver for you, I'd say don't agree to start another medication as doctors are so unwilling to prescribe it you may not get another script for it if you switch meds, who knows.


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## jaiho (Feb 14, 2015)

I disagree that SSRIs are anti orgasm pills. Perhaps on their own.
MAOIs completely castrate my sexuality, and there's no drug you can add to resolve it with them. SSRis though, you can add buspirone or nortriptyline & all my sexual function is completely normal.

All this is extremely individual anyway, a person i talked to had tried sky high doses of Parnate didn't respond, and they went back to SNRI + Augment and gained remission.

I suggest listening to your psychiatrist if you're not happy with Nardil. They can add things onto the Trintellix to make it more effective, and you'll probably still have less side effects.


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## Gillman fan (Sep 24, 2016)

My doctor was also enthusiastic about Trintillex, for a few months. It can provide a much much faster response than SSRIs, which is generally a good sign. But after the strong start it tends to be underwhelming, just another SSRI. Modulator and stimulator pfft. That is marketing. 

I don't want to write a long technical post, but all these drugs that just hit the market LOOK really good. It is only when they have been around longer that their drawbacks and side effects become fully known. Almost every doctor I have known gets a smile on their face when they think they have the latest and greatest for me.

The whole thing about targeting specific receptors is marketing b*ll****. Pharma likes to paint a pretty picture where psychiatrists have some super detailed understanding of how the brain works. Psychiatrists like to think that they have the same precise and detailed knowledge of doctors in other fields. A heart surgeon makes the tiniest incision with their scalpel, in exactly the right spot, and cures the illness.

The reality is that individuals vary so much that all of this "precision" means very little. Psychiatry is as close to voodoo as it is to heart surgery. Trial and error is how things ultimately work. In the real world, most people get the best results from an older medication like an MAOI. 

Captain - good job dropping that stupid antipsychotic. The funny thing is the pharma company that patented it has paid fines, not just in the billions, but in the DOUBLE DIGITS of billions, for marketing the drug as a cure all remedy - anxiolytic! Sleep med! Antidepressant! It doesn't matter because doctors love reading shiny pamphlets and prescribing new drugs.


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## Dylan2 (Jun 3, 2012)

I found Trintellix very effective for my depression but only somewhat helpful for my social anxiety disorder. Standard sexual side effects.

Edit: I spent around 14 months on it. See my recent post for why I might be discontinuing, at least temporarily.


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## Nardan (May 10, 2017)

I was on Brintellix for about 9 months a year and a half or so ago. It was initially great for my depression but it was also clearly bad for my anxiety symptoms to the extent it was clearly hurting more than helping. The anxiety late night binge-ing had me put on a bunch of weight. Hopefully it is better for others taking it.


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## Tandorini (May 12, 2017)

Tried 20 mg Brintellix for three months. Didn't work for me. Didn't get too many side effects, and the few there were passed in a couple of weeks or so. Never heard of anyone having weight gain on it either. (So my point is - if the doc insists, at least it won't be a painful experiene, trying it out for a few months, except for the fact that other possible treatment will be delayed).

They say Brintellix has a lot less sexual side effects that then old SSRIs. I've heard of lots of people switching from escitalopram til Brintellix because of that.


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## Shai Hulud (Feb 8, 2017)

I've taken both. Vortioxetine is bull****. It's basically an SSRI, with an huge advertisement department behind it, making it "multimodal". Try if you can pulse Nardil... Will take some time to adjust. I take it every 2nd day, no problems with anorgasmia anymore!


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## Shai Hulud (Feb 8, 2017)

BTW, I also had the sweating problem, only worse. 
Pulsing doses helped. More importantly, methylation support (Methyl-B12, Methyl TH folate) helped me degrade excessive histamine. 
If you still want to go the pharmacy way: There's a Canadian pharmacy selling cosmetic pads with glycopyrrolate


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## Captainmycaptain (Sep 23, 2012)

I just recalled that my psychiatrist wants me to see an endocrinologist if I want to get on a medication like oxybutynin for excessive facial sweating. In addition, he wants me to start seeing a therapist. Even with medical insurance, I would have to drop 45 dollars at least four times a month. My job pays minimum wage, so after car insurance payments, medical insurance payments, credit card bills, food, gasoline, etc. I would be saving no money and probably be in the red. It also would be a problem at my workplace having to work my frequent doctor and therapist visits with my schedule. 

Thanks for the tips and recommendations Shai Hulud.


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## SFC01 (Feb 10, 2016)

Captainmycaptain said:


> I just recalled that my psychiatrist wants me to see an endocrinologist if I want to get on a medication like oxybutynin for excessive facial sweating.


Have you tried the industrial strength anti perspirants you can get a script for ? I used to get facial sweating a lot when I took imipramine and the doc gave me some of this. It works well, you put in on everynight for a couple of weeks and then drop to down once/twice a week.


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## Captainmycaptain (Sep 23, 2012)

SFC01 said:


> Have you tried the industrial strength anti perspirants you can get a script for ? I used to get facial sweating a lot when I took imipramine and the doc gave me some of this. It works well, you put in on everynight for a couple of weeks and then drop to down once/twice a week.


Do you recall the name of the industrial strength prescription antiperspirant that you took? Were you told that it could be used on the face? I have used OTC deodorants on my face and they haven't worked at all. I also think that putting an antiperspirant on one's face could lead to acne, but I'm not sure. The only OTC antiperspirant that I had some success with was Sweat Block. It controlled sweating on my forehead quite a bit, but it was quite expensive. There is also a lotion I found on amazon.com called "Neat Feat 3B Face Saver Antiperspirant Gel for Facial Perspiration and Shine" https://www.amazon.com/dp/B00B5N1QFY/_encoding=UTF8?coliid=I39XVVV2KFPR88&colid=A9L46YMKDRY&th=1. The reviews are a bit mixed. Some people say it is a god send for facial sweating and other say it doesn't work. I may at least give it a try.


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## SFC01 (Feb 10, 2016)

Captainmycaptain said:


> Do you recall the name of the industrial strength prescription antiperspirant that you took? Were you told that it could be used on the face?


Think it was dryclor and assume it was ok for the face as that was issue I had told the doctor about - cant remember any rashes or anything like that but it did sting and itch a bit - nothing too bad though. It did work well for me.

Like I said, supposed to use it every night for 2 weeks and then only a couple times a week after that but if I remember correctly it worked after a couple of days.


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## UKguy (Sep 30, 2013)

I guess you are seeing the same doctor as me... or at least one who went to the same drug company sponsored training event.

Brintellix seems to be the latest thing. With SSRIs a big deal was made of the fact they are 'selective' and 'clean' drugs (which is BS btw many have drug-drug interactions and plenty of side effects that only became apparent after decades in use)... now the lastest wheeze is 'multi modal'... oh please why don't they just **** off and come back when they actually develop a drug that works, rather than bombarding us with marketing guff dressed up as science. 


Also anything that has no side effects (e.g. Moclobemide) probably has no benefit either.


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## Captainmycaptain (Sep 23, 2012)

SFC01 said:


> Think it was dryclor and assume it was ok for the face as that was issue I had told the doctor about - cant remember any rashes or anything like that but it did sting and itch a bit - nothing too bad though. It did work well for me.
> 
> Like I said, supposed to use it every night for 2 weeks and then only a couple times a week after that but if I remember correctly it worked after a couple of days.


I just searched google, and Driclor is OTC, at least in the United States. It's quite expensive, but I'll consider trying it.


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