# Nardil Log, last time giving this MAOI a shot



## gilmourr (Nov 17, 2011)

Started on Wednesday, taken it for 4 days now.

Haven't realized any side effects as of yet.

Just feel like my mood and anxiety has become worse since going off Zoloft, which I expected. I expect my mood an anxiety to pick up by day 7-10 and then for some real results by day 30.

Considering how I still have brain zaps and withdrawal feelings, I'm guessing Nardil hasn't begun doing anything yet.

Probably will give this last trial 40 days. If there's any marginal improvement I'll extend the duration of the trial.


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## yourfavestoner (Jan 14, 2010)

Good luck sir. Hope this works out for you. Keep us posted. 

I find it interesting that 45 mg has worked out well for you but going up to 60/75 put you into the gutter. Is that frequent with Nardil?


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## metamorphosis (Dec 18, 2008)

Nardil is a notoriously hard drug to manage as far as titration and timing are concerned. The fact that he is on his second or third run- sorry I forgot- can make interactions that more complicated. I mean there are many that top off at 75-90 mg a day than titrate down for maintenance periods until they have symptoms that require a titrate back up. Basically keeping the plasma levels in different states to deal with what symptoms may crop up.


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## yourfavestoner (Jan 14, 2010)

metamorphosis said:


> Nardil is a notoriously hard drug to manage as far as titration and timing are concerned. The fact that he is on his second or third run- sorry I forgot- can make interactions that more complicated. I mean there are many that top off at 75-90 mg a day than titrate down for maintenance periods until they have symptoms that require a titrate back up. Basically keeping the plasma levels in different states to deal with what symptoms may crop up.


This is actually gilmour's fourth Nardil trial.


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## gilmourr (Nov 17, 2011)

Fourth and final trial if it doesn't work. Then I can put this drug into a far off distant corner, never to be touched again.

And then I can choose between my left over selection! Zoloft (with augment), Luvox, amitryptiline, nortryptiline, clomipramine, imipramine, moclobemide, viibryd, (those would be the base drug)

and abilify, gabapentin, pregabalin, olanzapine as augmenters


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## metamorphosis (Dec 18, 2008)

gilmourr said:


> Fourth and final trial if it doesn't work. Then I can put this drug into a far off distant corner, never to be touched again.
> 
> And then I can choose between my left over selection! Zoloft (with augment), Luvox, amitryptiline, nortryptiline, clomipramine, imipramine, moclobemide, viibryd, (those would be the base drug)
> 
> and abilify, gabapentin, pregabalin, olanzapine as augmenters


So, 12 more including augmentors, this experimental strategy could take up the med. section for yrs. I'm joking. Like MFS, I am the most fascinated to read the MAOI diaries. 'Cause unlike other psychotropics, things change hr to hr day to day. Sorta like a House episode.
All this being said I want you to have a good run. I have had a go with parnate but couldn't stay upright with early side effects. Actually more like major insomnia, that left me seeing faces peering at me, in the rocks at Red Rocks.
Main question- What is your plan this time? And how will it different from the other times w.o. using the vit. B6 toxicity issue? How much time will you give it this time?


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## gilmourr (Nov 17, 2011)

metamorphosis said:


> So, 12 more including augmentors, this experimental strategy could take up the med. section for yrs. I'm joking. Like MFS, I am the most fascinated to read the MAOI diaries. 'Cause unlike other psychotropics, things change hr to hr day to day. Sorta like a House episode.
> All this being said I want you to have a good run. I have had a go with parnate but couldn't stay upright with early side effects. Actually more like major insomnia, that left me seeing faces peering at me, in the rocks at Red Rocks.
> Main question- What is your plan this time? And how will it different from the other times w.o. using the vit. B6 toxicity issue? How much time will you give it this time?


Well, the first two times I used, it worked exceptionally well (it probably would've put me in remission if I didn't fiddle with it and stayed on it longer than 40-50 days.

The 2nd time it was amazing, but I was only on it for like 60 days I think, and it maxes out around days 70-90. So the first thing is if it's going well, don't question it's efficacy until 90 days are up.

It will be different because last time I went from Nardil to Nardil which has been shown to deactivate the GABA function of Nardil when you go off a MAOI to MAOI. (Journal). This time I went from Zoloft to Nardil, so no issue there.

I'm taking no B6 at all because Nardil worked the first two times when I took no B6 and journals show that even though it depletes levels, it shouldn't be a big deal.

Finally, I know not to go past 45 mg because I get mood swings and side effects i can't tolerate long term.

So plan is, take Nardil for 40-50 days, if it shows progress, keep on it till day 90. If nothing after 40-50 days, gonna just stop it and try something else.

If everything goes according to plan and I feel superb by day 90 I will decide whether an augment should be added. It will probably be pregabalin if I have a lot of residual anxiety, olanzapine (low dose) if I have residual depression, lithium if the drug works but I get strange shivers again (would shiver and be cold for no reason, which I'm 99% sure is because of it being strong on NE. Lithium lowers NE levels I'm fairly sure.

EDIT: A good sign so far is that when I dose I feel sleepy after. This was exactly like the first two times I went on it. First three weeks includes a lot of napping.


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## basuraeuropea (Jul 25, 2012)

gilmourr said:


> Well, the first two times I used, it worked exceptionally well (it probably would've put me in remission if I didn't fiddle with it and stayed on it longer than 40-50 days.
> 
> The 2nd time it was amazing, but I was only on it for like 60 days I think, and it maxes out around days 70-90. So the first thing is if it's going well, don't question it's efficacy until 90 days are up.
> 
> ...


you state that 'last time i (you) went from nardil to nardil'. do you mean that you went from nardil to parnate as you state something about switching from maoi to maoi?


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## gilmourr (Nov 17, 2011)

No, it's a bit confusing. I went from 45 mg to 60 mg to try and get a better effect. Didn't work, it made me actually lose the anti depressant effect and made me even more depressed. So after 30 days of that bull**** I was like.. **** this I'm going back to 45 mg. That didn't work, so I went OFF it completely, let the MAO enzymes regenerate and then went back on 45 mg of Nardil. 

That didn't work either. But also I've read you can't go off a MAOI and back on it that quickly or else the GABA effect is basically negligible. Also my B6 levels were 5 times over the limit and apparently B6 destroys Nardil so there's that too.

Just a big mess last time. It either works or it doesn't this time.


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## basuraeuropea (Jul 25, 2012)

gilmourr said:


> No, it's a bit confusing. I went from 45 mg to 60 mg to try and get a better effect. Didn't work, it made me actually lose the anti depressant effect and made me even more depressed. So after 30 days of that bull**** I was like.. **** this I'm going back to 45 mg. That didn't work, so I went OFF it completely, let the MAO enzymes regenerate and then went back on 45 mg of Nardil.
> 
> That didn't work either. But also I've read you can't go off a MAOI and back on it that quickly or else the GABA effect is basically negligible. Also my B6 levels were 5 times over the limit and apparently B6 destroys Nardil so there's that too.
> 
> Just a big mess last time. It either works or it doesn't this time.


ah, gotcha. i hope it works out well for you this time around. best of luck!


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## ChopSuey (Nov 5, 2012)

gilmourr said:


> But also I've read you can't go off a MAOI and back on it that quickly or else the GABA effect is basically negligible.


This sounds rather odd. Do you remember where you read this?

The GABA mechanism of Nardil has never done anything good for me, it just sedates me to the point that i want to sleep. Has zero benefits for my SA. Forces me to take my dose before bedtime.


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## metamorphosis (Dec 18, 2008)

ChopSuey said:


> This sounds rather odd. Do you remember where you read this?
> 
> The GABA mechanism of Nardil has never done anything good for me, it just sedates me to the point that i want to sleep. Has zero benefits for my SA. Forces me to take my dose before bedtime.


Are you on Nardil now? And if so, for how long and has it been effective? If so, how bad have your side effects been?


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## ChopSuey (Nov 5, 2012)

metamorphosis said:


> Are you on Nardil now? And if so, for how long and has it been effective? If so, how bad have your side effects been?


It's been effective since the 7-8th week, currently been using it for 3 months. Oh, I probably hit the jackpot with side effects. Most of them are gone though;

Tremors
Dizziness
Fatigue
Paresthesia
Sedation
Dry Mouth
Bloating
Minor Weight Gain
Major constipation
Hypotension
Orthostatic hypotension
Syncope
Sexual dysfunction
Blurry vision
Myoclonic jerks everytime closing eyes/during sleep
Waking up a few times during the night, but usually it's easy to go back to sleep.
Minor cardiac dysrythmia
Urinary retention


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## metamorphosis (Dec 18, 2008)

ChopSuey said:


> It's been effective since the 7-8th week, currently been using it for 3 months. Oh, I probably hit the jackpot with side effects. Most of them are gone though;
> 
> Tremors
> Dizziness
> ...


Your side effects ++++
How many have subsided/disappeared and how many are you still dealing with? It must be proving to put your SA (other) symptoms into strong remission to deal with that list!


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## gilmourr (Nov 17, 2011)

ChopSuey said:


> It's been effective since the 7-8th week, currently been using it for 3 months. Oh, I probably hit the jackpot with side effects. Most of them are gone though;
> 
> Tremors
> Dizziness
> ...


That's a lot... are you on like 90 mg?

45 mg treats me fairly well. Myoclonic jerks start after using 60 mg or more.


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## gilmourr (Nov 17, 2011)

ChopSuey said:


> This sounds rather odd. Do you remember where you read this?
> 
> The GABA mechanism of Nardil has never done anything good for me, it just sedates me to the point that i want to sleep. Has zero benefits for my SA. Forces me to take my dose before bedtime.


Page 207, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1188458/

elevation of GABA can be dramatically reduced when pretreating rats with a MAOI.

Also notice that Nardil is very strong on NE and moderately on dopamine from the table below. Must be why the Zoloft apathy usually goes away and I feel energetic and motivated.

Usually am super cold from strong NE medications, hopefully it doesn't get that bad.

And the tiredness is a *****. But it 100% goes away. Mine took about a month and a half to fully go away.


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## gilmourr (Nov 17, 2011)

basuraeuropea said:


> ah, gotcha. i hope it works out well for you this time around. best of luck!


tyty!

Looking forward to day 12 when I stop dreaming and start waking up at 7 AM. Best feeling ever.

Still having a lot of extremity coldness which happens when I stop drugs (Zoloft). I think last time it took 12-15 days for the temperature to get back to a normal level.


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## ChopSuey (Nov 5, 2012)

metamorphosis said:


> Your side effects ++++
> How many have subsided/disappeared and how many are you still dealing with? It must be proving to put your SA (other) symptoms into strong remission to deal with that list!


The three most troublesome side effects I'm still having is hypotension, orthostatic hypotension and constipation. But it's getting better. And if the depression and/or SA is disabling enough, then personally i stop caring about what temporary side effects i may get. Getting relief from my symptoms is much more important, side effects usually abate anyhow.


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## ChopSuey (Nov 5, 2012)

gilmourr said:


> Page 207, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1188458/
> 
> elevation of GABA can be dramatically reduced when pretreating rats with a MAOI.
> 
> ...


I started on 75mg and stayed there for a couple of weeks, since then I've been experimenting with the dosage. I am hopeful that Nardil will work for you again, but if it does not, would you be willing to try 75-90mg? Side effects will probably be difficult, but surely they'll slowly disappear. And you might be left with a potent therapeutic response.

I also find it strange that distributors of Nardil sometimes only mention that it increases serotonin and norepinephrine in their prescribing/patient information leaflet despite that dopamine is also increased by quite a bit.


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## gilmourr (Nov 17, 2011)

ChopSuey said:


> I started on 75mg and stayed there for a couple of weeks, since then I've been experimenting with the dosage. I am hopeful that Nardil will work for you again, but if it does not, would you be willing to try 75-90mg? Side effects will probably be difficult, but surely they'll slowly disappear. And you might be left with a potent therapeutic response.
> 
> I also find it strange that distributors of Nardil sometimes only mention that it increases serotonin and norepinephrine in their prescribing/patient information leaflet despite that dopamine is also increased by quite a bit.


No, been at 75 mg, didn't work. Not going any higher than 45 mg. Maybe the action on dopamine receptors is what causes myoclonic jerks.


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## metamorphosis (Dec 18, 2008)

gilmourr said:


> No, been at 75 mg, didn't work. Not going any higher than 45 mg. Maybe the action on dopamine receptors is what causes myoclonic jerks.


Hey, if it doesn't work on this go around, would you be willing to try Parnate? Maybe with a little polypharmacy for GABA and perhaps sleep difficulties?
Also, are you still in the flush out period? Let's get this on the road!!!


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## metamorphosis (Dec 18, 2008)

Pregabalin or gabapentin, of course there are the benzos. None of these are contraindicated. Also, exercising till you drop!


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## metamorphosis (Dec 18, 2008)

mike93271 said:


> Oh I was hoping for something non-addictive, I've tried pregabalin/gabapentin and they built up tolerance quick.
> 
> I was thinking tiagabine could be an option but haven't heard many experiences on it... in theory a GABA reuptake inhibitor should be great...


I've used Gabatril with success. I know others that have no response but that would be a decent option. It could possibly work. Pregabalin owns gabapentin and actually coming off of gabapentin is harder. These meds can always be cycled. Pregabalin will cause tolerance issues and make you eat yourself out of house and home. That might be a good balance if Parnate causes weight loss as a side effect. But a break of up to a week every month on pregabalin should slow tolerance issues. I know first hand once off of it; You can start it again w.o. tolerance issues lingering.


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## viper1431 (Jun 6, 2012)

Good luck. I'm on my 5th or 6th "last go" of nardil 
Although it's lasted a couple years now thankfully as I finally got a hold of controlling it properly. Took a lot of goes though and many times where the doc has said no more trying nardil.


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## metamorphosis (Dec 18, 2008)

viper1431 said:


> Good luck. I'm on my 5th or 6th "last go" of nardil
> 
> My pdoc said that after I finally talked him into trying Parnate.
> Within 3 weeks the side effects were killing me, No Sleep. Zombified. I stopped it. After that he said no more talk of MAOIs. I see him Tues., so I will bring them up again;p If only we had a med with the combination of Parnate's more manageable side effects and Nardil's great success with SA! There is one still in clinical testing I believe. It's mentioned on psychotropics.com


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## bazinga (Jun 9, 2010)

Is gabatril good for anxiety?


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## yourfavestoner (Jan 14, 2010)

metamorphosis said:


> viper1431 said:
> 
> 
> > Good luck. I'm on my 5th or 6th "last go" of nardil
> ...


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## viper1431 (Jun 6, 2012)

haha dunno. It was after my second hopistal stay though from severe hypotension/bradychardia so a bit more serious than most ssri side effects. I'm careful now though not to let it get to the stage of dropping my BP that much.


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## gilmourr (Nov 17, 2011)

Day 8.

Very happy as to how Nardil 45 mg is going so far.

I feel that sedated calmness after dosing which is a good sign that I'm responding to the GABAergic function of Nardil.

My body temperature is doing well considering last time I was on Nardil I almost froze to death (knock on wood).

The Zoloft apathy is dissipating and I'm feeling like I want to do stuff again. This is probably remnants of Zoloft + start up effects of Nardil, but all in all, very happy how things are going (knock on wood a second time).

Looking forward to day 12 since that's when my sleep cycle changes and I begin waking up at 7 AM and stop dreaming.

I have not needed to take seroquel either for sleep and the start up nausea is just beginning to go away (it was pretty bad). Minor orthostatic hypotension. I expect more in a weeks time.


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## crossfadex (May 17, 2008)

I've been on Nardil for 3.5 months and have no benefit from the drug. I went as high as 90mg as well. I know Nardil is a tricky drug to master.
Would you recommend getting off of it for a few days/weeks/whatever and restarting it and staying at 45mg? I had zero side effects at 45mg but once I decided to jump to 60mg I got the weight gain, sexual sides, urin retention, nardil farts and the jerks when falling asleep. Those are the only SEs I've experienced but I've heard the postural hypotention means the drug is being effective at inhibiting MAO, but I never experienced this side effect even at 90mg.

Dammit, I really wanted this drug to work for me. However, I also really want to try Parnate.


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## shy-one (May 10, 2008)

gilmourr said:


> Day 8.
> 
> Very happy as to how Nardil 45 mg is going so far.
> 
> I feel that sedated calmness after dosing which is a good sign that I'm responding to the GABAergic function of Nardil.


Yep, I remember after first starting nardil I noticed a mild sedation effect, felt almost a bit like a benzo.

However, this only lasted maybe 1-2 weeks, so I think it was more of a side effect than the real deal of hitting GABA.


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## gilmourr (Nov 17, 2011)

crossfadex said:


> I've been on Nardil for 3.5 months and have no benefit from the drug. I went as high as 90mg as well. I know Nardil is a tricky drug to master.
> Would you recommend getting off of it for a few days/weeks/whatever and restarting it and staying at 45mg? I had zero side effects at 45mg but once I decided to jump to 60mg I got the weight gain, sexual sides, urin retention, nardil farts and the jerks when falling asleep. Those are the only SEs I've experienced but I've heard the postural hypotention means the drug is being effective at inhibiting MAO, but I never experienced this side effect even at 90mg.
> 
> Dammit, I really wanted this drug to work for me. However, I also really want to try Parnate.


3.5 months of being on 90 mg? How long exactly were you on EACH level of dosage for? I've noticed with all of my trials that you really shouldn't fiddle with it at all. Changing dosages messes up the road to recovery.

I definitely would not recommend going off and back on after reading literature about going off a MAOI or pretreating with a MAOI and then going on a MAOI may impact the GABA effect of Phenelzine--which I think is a huge contributor to it's success as a drug.

I have also heard about orthostatic hypotension being an indicator or precursor to Nardil working...though I'm not really sure about whether this is true.

If it were me, I'd give 45/60/75 mg each 30 days. You will 100% notice some difference after 30 days...usually it's much earlier.

Also, more side effects does not equal a better effect. The first time I tried Nardil I was on 45 mg for 2 weeks, then I went to 60 mg in the 3rd week and 75 mg in the 4th week. Then I stayed on it for 7 weeks in total and after myoclonic jerks, extreme constipation, hyperreflexia, insomnia, urinary retention and no effect I gave up.

For some reason I tried it again 6 months later. But at a dose of 45 mg. It magically worked at this dosage. I tried 60 mg and it made me depressed again along with side effects. I have no ****ing idea why 60/75 mg makes me more depressed and adds to more negative effects, it just does.

45 mg works for me. I can't really give you much advice either than realize that just because it doesn't work at a higher dose doesn't mean that it won't work at a lower dose. Give it a shot maybe at 30/45/60/75/90 each. It's crazy frustrating, but I assure you that Nardil is worth it if you get the effect.


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## gilmourr (Nov 17, 2011)

shy-one said:


> Yep, I remember after first starting nardil I noticed a mild sedation effect, felt almost a bit like a benzo.
> 
> However, this only lasted maybe 1-2 weeks, so I think it was more of a side effect than the real deal of hitting GABA.


I'd agree with this. I usually don't feel that post dosing sedation in the 3rd or 4th week or any week beyond that.

Excited to see how I feel by day 70-90. I'm going to really have a tough decision about adding pregabalin if it's working well, but I feel that I might only get 80% of the way again just like last time.


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## gilmourr (Nov 17, 2011)

Day 12?

Cold intolerance is much better again, I think I just have some off days adjusting to Nardil. I don't drink much coffee to help with this also.

Today I woke up very depressed out of the blue, felt awful, head was cloudy, felt like ripping my heart out of my chest, though I think it's because last two nights I went out and drank a lot, + Nardil lowers B6 naturally, so with loads of alcohol and Nardil, it probably depleted my vitamin/minerals/amino acids to make me feel like ****. B6 is super important for synthesizing serotonin and other AD chemicals so it makes sense to me.

I drank a bunch of vitamin shakes/ate some really nutritious stuff all day and I'm feeling like I'm beginning to level out. It was very different starting in the morning. So yeah, I think I'm going to stay away from drinking, or at least make sure I balance drinking with loads of nutritious stuff after/before hand.

And this is not placebo or whatever, I've been free of depression since Zoloft kicked in like 3 months ago. This has been my first majorly depressed day since then. Wasn't hung over at all, just felt like death/depressed. Besides that, since my last post, things have remained awesome. Doing well and expecting improvement each week. Only side effects are tiredness/memory issues at times


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## gilmourr (Nov 17, 2011)

Day 16

Body temperature fine (seemingly), motivation/interest is up, not many side effects yet (though I think constipation is starting). And I'm definitely much more tired during the day (expected).

Anyways, I don't really expect Nardil to do much until between day 30-40, which is usually when it becomes really noticeable.

Right now my anxiety feels good, though I know my mood is slipping (compared to Zoloft+ seroquel). I think it might be because Zoloft and seroquel are a fairly potent combo on serotonin, so that probably explains that.

I KNOW that zoloft is better than Nardil at keeping me not depressed (only problem is Zoloft makes me feel really flat, unlike Nardil).

Anyways, I was thinking of something to add to Nardil once I hit that 70-90 day mark (hopefully, or maybe sooner). I probably want something that binds well to 5HT2A as an antagonist and something with partial 5HT1A agonism and some decent H1 antagonism. I can't add seroquel because combined with Nardil it gives me worse NE side effects.

So atm I'm thinking between Abilify (not sure what dose), Pregabalin (though this might not be a good idea if I want help with mood), low dose Zyprexa (though it's very unselective, gives me unwanted D2,D3 antagonism), Trimipramine (good for sleep, and a number of other things, though I can't find the receptor profile for this drug). Geodon is a bit of a mystery to me (don't know much about it).

*TL;DR: Appreciate any words from the community. Basically I think Nardil will be awesome on my anxiety by the time it levels out but my mood will need an augmenter. SO ADVISE! *


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## CD700 (Apr 22, 2010)

gilmourr we have Borderline personality disorder 
That's why none of these crappy anti-depressants pills do anything


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## crossfadex (May 17, 2008)

gilmourr said:


> 3.5 months of being on 90 mg? How long exactly were you on EACH level of dosage for? I've noticed with all of my trials that you really shouldn't fiddle with it at all. Changing dosages messes up the road to recovery.
> 
> I definitely would not recommend going off and back on after reading literature about going off a MAOI or pretreating with a MAOI and then going on a MAOI may impact the GABA effect of Phenelzine--which I think is a huge contributor to it's success as a drug.
> 
> ...


I was at 45mg for only a few weeks I think. Then I boosted to 60mg for like 6 weeks. After that, I increased it to 90mg but only for 2 weeks because of limited supply of the drug since my pdoc wanted me to stay at 45mg. So, now I've been back down to 45mg since I have 118 pills left and I see him at the end of the month. My pdoc gave me tons of refills for some reason lol. I want to bring up Parnate.

I had no side effects for the first 1.5 months. Then my increase from 45 to 60mg hit me with quite a bit of side effects. I don't know why, but I never received orthostatic hypotension, constipation and a few others that are very common. 90mg felt exactly like 60mg. The difference from 45mg to 60mg is pretty big.

So, technically my % of MAO inhibition *isn't* the amount received by the 45mg? Its higher than 45mg right now, even though I'm currently at 45mg? MAO will start regenerating till it reaches the amount inhibited by 45mg or will MAO stay inhibited at its current level (given that I was at 90mg for a few weeks)?
So, if I were to get off of the drug for a few weeks and start again, there's actually a chance it might work this time??


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## shy-one (May 10, 2008)

gilmourr said:


> 3.5 months of being on 90 mg? How long exactly were you on EACH level of dosage for? I've noticed with all of my trials that you really shouldn't fiddle with it at all. Changing dosages messes up the road to recovery.
> 
> I definitely would not recommend going off and back on after reading literature about going off a MAOI or pretreating with a MAOI and then going on a MAOI may impact the GABA effect of Phenelzine--which I think is a huge contributor to it's success as a drug.
> 
> ...


You sound like me... 45mg was just right for me. At 60mg the hypotension and insomnia was just too severe. The 1mg/1kg rule is a myth, some people just need more nardil than others, but I don't think this is mass related.

Oh god I am looking forward to the constipation again... I have terrible IBS-D and nardil is the only med that has ever fixed that.


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## gilmourr (Nov 17, 2011)

crossfadex said:


> I was at 45mg for only a few weeks I think. Then I boosted to 60mg for like 6 weeks. After that, I increased it to 90mg but only for 2 weeks because of limited supply of the drug since my pdoc wanted me to stay at 45mg. So, now I've been back down to 45mg since I have 118 pills left and I see him at the end of the month. My pdoc gave me tons of refills for some reason lol. I want to bring up Parnate.
> 
> I had no side effects for the first 1.5 months. Then my increase from 45 to 60mg hit me with quite a bit of side effects. I don't know why, but I never received orthostatic hypotension, constipation and a few others that are very common. 90mg felt exactly like 60mg. The difference from 45mg to 60mg is pretty big.
> 
> ...


I went from 60 mg to 45 mg and waited for a month. The side effects I received from 60 mg never went away.

When you lower the dose, MAO enzymes begin to regenerate. I'm guessing it's an exponential regeneration rate (since whenever I go off Nardil I'm fine for like a week, sometimes even 2, then it hits me HARD).

MAO should regenerate properly if you drop down to 30 mg and then go back up to 45 mg. But make sure a sufficient amount of time has passed. I think it takes 2.5 days to exit your system and then it should take about 2-3 weeks (I'd do 3 weeks) for MAO to regenerate. So 3- 3.5 weeks. Then back to 45 mg if you think that's your dose you need. I'm not saying it's the dose you need because I have no idea and in my case it worked once so I know. And then what sucks is that technically it takes between 70-90 days for Nardil to REALLY max out. It's about the average based on people that have had near remission on this forum. But it will start to work much earlier.

Don't go off it and back on it, it didn't work for me. And there's literature to show that going from MAO inhibitor back to MAO inhibitor can mess up the efficacy of the GABA function of Nardil.

EDIT: If for whatever reason you become suicidal or way worse off than before, stop Nardil and use some past med to stabilize yourself. Don't make Nardil your holy grail. It takes a while for it to REALLY kick in and most people can't be psychotically depressed when waiting for it to kick in. The only reason I can do it while being severely depressed is that it brings me from severe to moderate in about 5 days somehow, then I can weather the rest of the days at moderate usually.


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## gilmourr (Nov 17, 2011)

shy-one said:


> You sound like me... 45mg was just right for me. At 60mg the hypotension and insomnia was just too severe. The 1mg/1kg rule is a myth, some people just need more nardil than others, but I don't think this is mass related.
> 
> Oh god I am looking forward to the constipation again... I have terrible IBS-D and nardil is the only med that has ever fixed that.


Insomnia is still pretty bad on 45 mg. That's about the only side effect. I would take seroquel, but I think it's potent effect on elevating NE will **** with me. I just don't want to chance it...

I'm stuck on the fence about whether I should add trimipramine or abilify before 7 weeks. Nardil conquers any anxiety I have for the most part I believe, but it never gets rid of all my depression. Just not sure if I should wait for my anxiety to feel amazing first.


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## shy-one (May 10, 2008)

gilmourr said:


> Insomnia is still pretty bad on 45 mg. That's about the only side effect. I would take seroquel, but I think it's potent effect on elevating NE will **** with me. I just don't want to chance it...
> 
> I'm stuck on the fence about whether I should add trimipramine or abilify before 7 weeks. Nardil conquers any anxiety I have for the most part I believe, but it never gets rid of all my depression. Just not sure if I should wait for my anxiety to feel amazing first.


Have you tried taking fish oil with nardil? As I was taping off I started on fish oil and felt pretty good towards the end. I think the fish oil may have boosted the AD effects of nardil as it also has an effect on dopamine. Many people report that they were even able to lower their dose of their antidepressant when combining it with fish oil.

I would suggest trying at least 1000mg of EPA a day.


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## shy-one (May 10, 2008)

gilmourr said:


> No, been at 75 mg, didn't work. Not going any higher than 45 mg. Maybe the action on dopamine receptors is what causes myoclonic jerks.


I also suffered myoclonic jerks on nardil as I drifted off to sleep. Sometimes they were so powerful my whole body would spasm causing me to wake up.

My girlfriend always used to say it looked like I was "dancing" as I fell asleep. Apparently I also used to grind my teeth a lot during the night.


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## ChopSuey (Nov 5, 2012)

Trazodone works like a charm when having difficulties to sleep due to MAOIs.


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## gilmourr (Nov 17, 2011)

shy-one said:


> Have you tried taking fish oil with nardil? As I was taping off I started on fish oil and felt pretty good towards the end. I think the fish oil may have boosted the AD effects of nardil as it also has an effect on dopamine. Many people report that they were even able to lower their dose of their antidepressant when combining it with fish oil.
> 
> I would suggest trying at least 1000mg of EPA a day.


Yep! But I need to get back to you about the dose...


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## gilmourr (Nov 17, 2011)

ChopSuey said:


> Trazodone works like a charm when having difficulties to sleep due to MAOIs.


Took trazadone once, never again, lol. Maybe I'm weird but my ears were ringing, I felt my heart pounding like mad and I could do anything but sleep, it actually kept me up.


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## crossfadex (May 17, 2008)

gilmourr said:


> Insomnia is still pretty bad on 45 mg. That's about the only side effect. I would take seroquel, but I think it's potent effect on elevating NE will **** with me. I just don't want to chance it...
> 
> I'm stuck on the fence about whether I should add trimipramine or abilify before 7 weeks. Nardil conquers any anxiety I have for the most part I believe, but it never gets rid of all my depression. Just not sure if I should wait for my anxiety to feel amazing first.


Ugh. Even at 90mg I have no orthostatic hypotension or insomnia (or constipation) with this drug. It doesnt feel like Im taking the same drug as those here, who seem to praise this drug as the gold standard. I've felt no relief =/ and gained 14 pounds in 2 months blahh.


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## gilmourr (Nov 17, 2011)

jameslp3230 said:


> Jeez then why take Nardil in the first place. I thought Nardil was this mega eliminator of the most extreme depression. If I can get away with zoloft and some other augment then why do it?


Because Nardil makes me feel interested/motivated and better overall. It reduces anxiety much better than zoloft does.

Zoloft kills the depression and it never makes me have suicidal thoughts, though I just don't want to do any work/anything productive. Going out is a chore.

Zoloft + something else may counteract this though.

Also, Nardil works on depression, just not to the point at which Zoloft does. It's still a fairly strong med I would say.


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## gilmourr (Nov 17, 2011)

crossfadex said:


> Ugh. Even at 90mg I have no orthostatic hypotension or insomnia (or constipation) with this drug. It doesnt feel like Im taking the same drug as those here, who seem to praise this drug as the gold standard. I've felt no relief =/ and gained 14 pounds in 2 months blahh.


90 mg and you've been on it for 2 months and no side effects (or barely any?). Maybe you should double check that you're getting the right medication, lol.


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## shy-one (May 10, 2008)

gilmourr said:


> Because Nardil makes me feel interested/motivated and better overall. It reduces anxiety much better than zoloft does.


Agreed. Nardil is excellent for increasing motivation. It even made me move to the other side of the world!


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## gilmourr (Nov 17, 2011)

shy-one said:


> Agreed. Nardil is excellent for increasing motivation. It even made me move to the other side of the world!


.

I think I'm getting the same reaction as last time which is great. Around day 18 or so I get complete knots in my stomach and by day 30 or so it usually goes away and is replaced with a completely chill and anxiolytic feeling.

It's around day 18 I think and I've definitely felt it all day today.

Do you also feel more anxious before it levels out?


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## gilmourr (Nov 17, 2011)

jameslp3230 said:


> Maybe you're right though I do definitely need motivation... still confused about a crappy SSRI beating it depression wise though, lol...


SSRI's aren't crappy. They just serve another purpose. They're selective as opposed to Nardil, which inhibits MAO enzymes so that a **** tonne of different monoamines are increasing or being released into the synapse.

SSRI's have done a lot of good.


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## CD700 (Apr 22, 2010)

SSRI are junk poo
It's placebo pill


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## gilmourr (Nov 17, 2011)

mike93271 said:


> I'd have to agree they are like sugar pills to me...
> 
> I'm not even getting any effects from Nardil after like 5 weeks or something but from the reviews I've seen everywhere there's no way I would go through this with Nardil if it was going to be like zoloft (lol).
> 
> Going to cancel Nardil and fill a script for zoloft asap, lol


You've never tried Zoloft? What's your diagnosis? Nardil increases levels of serotonin just like Zoloft so it basically is doing something similar, it's just way more unselective by hitting things like GABA, NE, D as well along with possibly other monoamines.

Anyways, cut down on drinking lately. Nardil keeps me in this mild-moderate depressed zone, which is okay I guess since it's not severe. My anxiety feels quite good at this point.

I'm so confused about whether I should add abilify or olanzapine. I know that Nardil alone won't get my mood to a spot I'm happy with, but it does with anxiety. I figured that I might wait until my anxiety is at a really great place first (which is usually 6 weeks) before adding abilify... but I'm starting to not see the point. I need something to add to Nardil definitely for mood + sleep.

I don't see many people having success with high dose abilify (nor do I think I need it)--so 2-5 mg might help. I think if Abilify can create a net increase in SERT, net decrease in NE and keep dopamine at decent levels it might work out well. Also it has an anti-histamine part to it.

I'd appreciate an opinion of whether you'd wait for Nardil to max out at 7-9 weeks and then add abilify, or add abilify now since I have an idea of how well Nardil works at 7 weeks.


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## shy-one (May 10, 2008)

mike93271 said:


> I'd have to agree they are like sugar pills to me...
> 
> I'm not even getting any effects from Nardil after like 5 weeks or something but from the reviews I've seen everywhere there's no way I would go through this with Nardil if it was going to be like zoloft (lol).
> 
> Going to cancel Nardil and fill a script for zoloft asap, lol


DO NOT GIVE UP ON NARDIL YET!!! 5 weeks is nothing, it took 8 weeks to kick in for me. It could just be around the corner! I would say give it up to 10 weeks just to make sure.


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## gilmourr (Nov 17, 2011)

jameslp3230 said:


> I had exactly that. 45mg and it wasn't working though that was at the start, then switched to 60mg and I wanted to kill myself.


I have a really obscure hypothesis that sometimes too much NE reuptake inhibition can lead to this. I believe cymbalta is another very strong NE reuptake inhibitor and I had the same if not worse effect.

I believe that increased release of NE in some people will help. Though I believe a good amount of people have some sort of agitated depression where moderate to potent NRI's do NOT help. I know that another person who had remission with nardil, oioioi was unable to tolerate NRI's I THINK.

That being said, I believe NE has it's place. You just need a balance of SERT, and I think Nardil actually becomes way more potent on the NE side as you get higher in dose.



jameslp3230 said:


> I just went off Nardil 5 days ago. So if I wait 3 weeks, I still can't go back on Nardil? You mean ever?


I don't mean ever, but I know that I had to use another antidepressant (zoloft) before going back on. You can try it, but a journal I found makes an argument that the GABA-T inhibition effect may not function properly if you go off or from an MAOI to MAOI.


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## gilmourr (Nov 17, 2011)

jameslp3230 said:


> If it's all out of my system in a month or two then surely that would be enough? Or do I have to go on Lithium or something first?


To me it makes more sense that you start on lithium. You probably want your mood to balance out first before adding/trialing nardil again.


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## gilmourr (Nov 17, 2011)

Check in. (I think I posted a few days back and I said 18 or 20 days...I actually counted and it's day 18[more for myself])

- Sleeping is weird (up too late, not up in the morning)
- Still dreaming vividly
- Mood keeps going back and forth (taking no B6 currently, or any other meds)
- Anxiety seems to be doing well. Silver lining?


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## gilmourr (Nov 17, 2011)

Got a B6 serum test today. So now I will know what my levels are with nardil affecting it. With that being said, I've started using 2mg of B6 a day with some other vitamins. Fairly small B complex, it's not too over the top. Maybe I'll notice a big effect from taking the complex with Nardil as it depletes B6 greatly.

I've noticed an increase in peripheral limb coldness and clamminess since I started which kinda blows--Though, I'm glad I don't have those weird shivers like last time. I think it's still because Nardil is too strong on NE for me, which is why I want to get on something with GABA or additional SERT effect.

Somehow even though I'm depressed I'm actually able to get some work done. But definitely a large increase in suicidal thoughts since going off zoloft. 

I've cut back on alcohol drastically as well since my anxiety feels fine.


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## gilmourr (Nov 17, 2011)

Today was the first day I got that Nardil wake up effect. It's basically like 7-8 am in the morning I just shoot up completely awake instead of sleeping until 1 pm.

This B complex might be causing some mild nausea, I'll see how it goes throughout the week..

Trying to think of a way to beat this clammy/cold peripheral hand thing that is being caused by Nardil. It's annoying since it's giving off inaccurate body language. Usually when you have clammy hands/cold hands it's because your nervous, but they are always like this atm since I started Nardil. It's especially weird during the summer to have cold hands haha.


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## gilmourr (Nov 17, 2011)

I seem to have had no moderate-severe swings lately, it's getting better if anything.

My insomnia seems to be getting worse. Still having awful amounts of coldness in my hands.

Thinking about a round of rTMS..


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## shy-one (May 10, 2008)

jameslp3230 said:


> Do you think this is going to work for you? Is all the Nardil stuff worth it e.g. insomnia?
> 
> Do you think if you could get to therapeutic response and take 15mg a day just to maintain, the insomnia would go?
> 
> Your dreaming is odd, I didn't have any dreams, on Nardil withdrawal now these past weeks I've had vivid nightmares.


While the insomnia is a downright pain, IMO it is worth it to be almost completely free from depression, anxiety and have lots of motivation.

It is possible that you could get by on a low dose, but probably only if combined with something, eg fish oil.


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## gilmourr (Nov 17, 2011)

jameslp3230 said:


> Do you think this is going to work for you? Is all the Nardil stuff worth it e.g. insomnia?
> 
> Do you think if you could get to therapeutic response and take 15mg a day just to maintain, the insomnia would go?
> 
> Your dreaming is odd, I didn't have any dreams, on Nardil withdrawal now these past weeks I've had vivid nightmares.


I agree. It is weird. Last night I dreamt about fighting 2 people which felt like it went on for hours on end. I was trying to make it to my elementary school classroom on the 3rd floor from the basement. On the way they kept throwing basketballs at me and tackling me. I finally made it to the room but when I woke up I felt like ****.

And I don't know. Last time I had little hope (the time it worked) and then I felt pretty damn good. I know that I need to add something else for poor sleep quality and to cover the mild depression. But I would say this has a strong chance of wiping out my anxiety.

And yes it's worth it for insomnia ONLY if I can get a med to manage the insomnia. If I stay up till 5 AM still, it's not worth it imo, since I have Zoloft.


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## gilmourr (Nov 17, 2011)

shy-one said:


> While the insomnia is a downright pain, IMO it is worth it to be almost completely free from depression, anxiety and have lots of motivation.
> 
> It is possible that you could get by on a low dose, but probably only if combined with something, eg fish oil.


Those 3 things are ideal. I definitely then can find something for the insomnia.

Zoloft was like that except only half on the anxiety, and 0 motivation but with good sleep.

I can always go back to Zoloft and something else. Maybe nortryptiline or wellbutrin, or gabapentin/pregabalin


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## shy-one (May 10, 2008)

gilmourr said:


> And yes it's worth it for insomnia ONLY if I can get a med to manage the insomnia. If I stay up till 5 AM still, it's not worth it imo, since I have Zoloft.


What med are you taking for the insomnia? I am taking benzo's but obviously can't take this every day.


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## gilmourr (Nov 17, 2011)

shy-one said:


> What med are you taking for the insomnia? I am taking benzo's but obviously can't take this every day.


Since I don't have anything atm (well I kinda do but I can't use seroquel or it ****s up nardil with too much NET inhibition, remeron naw as well) I have to use unisom or clonazepam. Unisom doesn't work well at all, it's very inconsistent and leaves a huge hangover feeling. Clonazepam is much better.

Day 25, I feel that the B6 supplement is definitely helping the med be consistent with an anxiolytic and it also helps my mood. Very useful whenever I go out and have a few beers as I feel much less depressed the next day.

Insomnia bad, no constipation atm, waking up late, feeling a bit more motivated, still cold peripherals. Basically it's felt like the same since I've started except a slight increase in mood. I'm working out to help with my mood as well.


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## shy-one (May 10, 2008)

Unisom is a bad idea if you suffer from hypotension on nardil. It is actually a muscle relaxant and it will make you likely to collapse even more. I once collapsed at hit my head on the bathroom sink from a combo of unisom + hypotension on nardil. 

Yeah antipsychotics made me feel worse also. Made me dizzy which again is bad when combined with hypotension. 

I pretty much have to put up with the insomnia and treat myself to benzos for a good sleep a few nights a week.


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## gilmourr (Nov 17, 2011)

shy-one said:


> Unisom is a bad idea if you suffer from hypotension on nardil. It is actually a muscle relaxant and it will make you likely to collapse even more. I once collapsed at hit my head on the bathroom sink from a combo of unisom + hypotension on nardil.
> 
> Yeah antipsychotics made me feel worse also. Made me dizzy which again is bad when combined with hypotension.
> 
> I pretty much have to put up with the insomnia and treat myself to benzos for a good sleep a few nights a week.


I'm actually a bit disappointed that I've had no orthostatic hypotension (or hardly any, I've experienced a VERY small bit this time). Many people look of it as an indicator or precursor for efficacy. But whatever, less side effects are better. I just hope that it steps up it's game between day 40-70.

Right now I forgot to say I'm also kind of snappy and irritated. I don't feel as laid back and feel super stubborn and truculent. Not a big fan of snapping at people but it's difficult at the moment to apologize or contain my aggression at times. E.g. (people not giving me space to get out of the subway, slow waitresses, dumb people, people who like ****ty things or into their own ****ty ways) I just have quite a few peeves atm.


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## Jawi96 (May 15, 2012)

I'd be more worried if you felt no better but already had the standing up dizziness thing. I know what it's called. When I stabilized on 45mg, it's effectiveness time would only last me about 6 hours a day, and ONLY when it was working would I have the standing up blood rushy thing. at night, when it wouldnt work anymore, I had unlimited freedom. Freedom to stand where ever I wanted, when ever I wanted. Freedom from the oppressive ways of orthostatic hypotension

I don't know if other people get this but my Nardil worked (after 1 1/2 months) overnight. I just.. woke up happy. before that, it just helped me get rid of those pesky healthy bowel movements and gave me insomnia (and hypersomnia above 60mg)

hope I helped. I lost my train of thought quite a few times in this post


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## shy-one (May 10, 2008)

Jawi96 said:


> I'd be more worried if you felt no better but already had the standing up dizziness thing. I know what it's called. When I stabilized on 45mg, it's effectiveness time would only last me about 6 hours a day, and ONLY when it was working would I have the standing up blood rushy thing. at night, when it wouldnt work anymore, I had unlimited freedom. Freedom to stand where ever I wanted, when ever I wanted. Freedom from the oppressive ways of orthostatic hypotension
> 
> I don't know if other people get this but my Nardil worked (after 1 1/2 months) overnight. I just.. woke up happy. before that, it just helped me get rid of those pesky health bowel movements and gave me insomnia (and hypersomnia above 60mg)
> 
> hope I helped. I lost my train of thought quite a few times in this post


Yes it is very common that a lot of people report it "kicking in overnight". For me it was the anxiety that was gone first, so I think it must have had an effect on GABA before dopamine. I literally felt less anxious after waking up one day and was talking a lot more at work, even cracking jokes etc. About 2 weeks later the antidepressant effect really kicked in and at times I was close to euphoric (but only mildly).

I take it you also suffer from IBS-D? Nardil is excellent for that... it is better than any medication I have tried that is actually intended for digestive problems!


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## metamorphosis (Dec 18, 2008)

ChopSuey said:


> Trazodone works like a charm when having difficulties to sleep due to MAOIs.


lol, and..... I don't know, maybe a very trained and intelligent
psychopharmacologist. Instead of using the scattergun approach of picking more meds. creating a cocktail without even realizing what effect the combinations may be doing to the different regions of the brain. This concerning all of the NT issues being tossed around. You must have a very open minded pdoc, gilmourr. Concerning what meds. shall we add to the soup next, also, a pretty indecisive one.


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## metamorphosis (Dec 18, 2008)

blakeyz said:


> SSRI are junk poo
> It's placebo pill


If they were placebos than people wouldn't have about 60-80% sexual dysfunction. Also, experience frontal lobe apathy, which subsides with discontinuation. Call them crap, if you want but not sugar pills.


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## metamorphosis (Dec 18, 2008)

shy-one said:


> Unisom is a bad idea if you suffer from hypotension on nardil. It is actually a muscle relaxant and it will make you likely to collapse even more. I once collapsed at hit my head on the bathroom sink from a combo of unisom + hypotension on nardil.
> 
> Yeah antipsychotics made me feel worse also. Made me dizzy which again is bad when combined with hypotension.
> 
> I pretty much have to put up with the insomnia and treat myself to benzos for a good sleep a few nights a week.


 And maybe regular, daily amounts of exercise and sun with reduced simple sugars and caffeine might help.:idea


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## gilmourr (Nov 17, 2011)

metamorphosis said:


> lol, and..... I don't know, maybe a very trained and intelligent
> psychopharmacologist. Instead of using the scattergun approach of picking more meds. creating a cocktail without even realizing what effect the combinations may be doing to the different regions of the brain. This concerning all of the NT issues being tossed around. You must have a very open minded pdoc, gilmourr. Concerning what meds. shall we add to the soup next, also, a pretty indecisive one.


I did not understand one word of that post or how it related to what you replied to. I also don't have a very open minded pdoc, I'm just on Nardil. Open minded to med combos that is.


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## No Limit (Dec 6, 2005)

jameslp3230 said:


> Hmm I am concerned with the insomnia. Does that kick in according to %MAO inhibition? I found it was OK to get to sleep but slept about 2-3 hours in the end, stuff like Seroquel (really the best med for keeping me asleep tbh) didn't stand a chance against it.
> 
> Does insomnia ever go away? e.g. has anyone reduced their dose to a very low level so that it goes away, but therapeutic effects are still there?


 The insomnia never went away for me. The best medication I took to counteract it though was Trazodone.


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## gilmourr (Nov 17, 2011)

jameslp3230 said:


> Hmm I am concerned with the insomnia. Does that kick in according to %MAO inhibition? I found it was OK to get to sleep but slept about 2-3 hours in the end, stuff like Seroquel (really the best med for keeping me asleep tbh) didn't stand a chance against it.
> 
> Does insomnia ever go away? e.g. has anyone reduced their dose to a very low level so that it goes away, but therapeutic effects are still there?


It might go away. Wait and see. DAY 29.


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## shy-one (May 10, 2008)

jameslp3230 said:


> Hmm I am concerned with the insomnia. Does that kick in according to %MAO inhibition? I found it was OK to get to sleep but slept about 2-3 hours in the end, stuff like Seroquel (really the best med for keeping me asleep tbh) didn't stand a chance against it.
> 
> Does insomnia ever go away? e.g. has anyone reduced their dose to a very low level so that it goes away, but therapeutic effects are still there?


Insomnia never goes away completely, but it does get better. At the start I was getting about 2 hours sleep, a few months later I was getting about 5 - 6 hours which is as good as it gets. I just took nitrazepam a few nights a week.


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## viper1431 (Jun 6, 2012)

5 hours here too, i'm currently on 60mg. I am taking about 5-10mg of Seroquel though to help drift off, basically biting the tiniest crumb of the edge of the tablet.
I havn't tried it in a while but in the past I used to take another 15mg as soon as I woke up and i'd soon fall back to sleep to end up with a nice 8 hours or so. Otherwise if i'm still desperate for a few hours extra I use Xanax. But generally even with little sleep I wake up feeling really energized since I take the nardil before bed


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## gilmourr (Nov 17, 2011)

So normally I take 2 pills at 12 pm and 1 more at 3-4 pm.

Yesterday I just took 3 pills together later at about 7 pm instead of separating them to possibly deal with the insomnia. For some reason, today I've felt a sudden drop in my mood that I haven't felt in about a week and a half, 2 weeks.

I guess I'll just elbow my way through it, but any reason this could inhibit more MAO than usual? I wouldn't think so since it's later..but I know that if I get near a higher level of MAO inhibition I get depressed.

Or is it just an unusual swing most likely that will probably resolve? I have avoided alcohol all week and on weekends I drink hardly anything.

Also started getting more frequent shivering today for no reason (which correlates to too much NE release). 

If I wanted to use lithium to help with the synthesis of SERT and reduction of NE it might help greatly. Is there a minimum amount of lithium you must use?

EDIT: Also just took a mg of Klonopin an hour ago and the shivers have pretty much stopped and I'm warm. I'm fairly certain benzos reduce the neurotransmission of NE and other NT's. Or they're just sedating in general. Maybe Gabapentin or pregabalin might be a good add on? 

I NEED A WAY TO GET DOWN MY NE LEVELS. I want my own prescription pad.


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## shy-one (May 10, 2008)

gilmourr said:


> So normally I take 2 pills at 12 pm and 1 more at 3-4 pm.
> 
> Yesterday I just took 3 pills together later at about 7 pm instead of separating them to possibly deal with the insomnia. For some reason, today I've felt a sudden drop in my mood that I haven't felt in about a week and a half, 2 weeks.


Did taking it all at once help with the insomnia at all?


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## viper1431 (Jun 6, 2012)

Not sure about the min amount of lithium to effect NE greatly but while on Zoloft I had no usual ssri side effects and after adding the smallest dose of lithium (200 or 250mg I think the tablets were) it caused the usual side effects I get with high serotonin like sexual dysfunction and loss of appetite.


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## gilmourr (Nov 17, 2011)

shy-one said:


> Did taking it all at once help with the insomnia at all?


No, exactly the same, 5 am I fall asleep.


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## gilmourr (Nov 17, 2011)

viper1431 said:


> Not sure about the min amount of lithium to effect NE greatly but while on Zoloft I had no usual ssri side effects and after adding the smallest dose of lithium (200 or 250mg I think the tablets were) it caused the usual side effects I get with high serotonin like sexual dysfunction and loss of appetite.


usually you eat more the higher your serotonin levels are. Weird.

Lithium might help with my insomnia and help with my NE issue. Could be very good.

It might also make me completely zonked though...


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## gilmourr (Nov 17, 2011)

Day 31?

Nardil definitely affects prolactin or something that is causing me to have a change in my chest. Male breasts are not cool. 

My back is ****ing killing. Upper back. No idea if it's a side effect. I doubt it. It probably is just the fact that I've been not exercising enough and my back is really weak from sitting a lot. Going out on weekends isn't enough exercise haha.

Insomnia till 5 AM.

My anxiety is okay, but seriously, it isn't that much better than zoloft. Depression is still worse than zoloft.

I'm losing weight AGAIN. This suppresses my appetite. Another sign that it's more of a stimulant for me...

I'm constantly thinking that this might be the wrong move and that I've wasted another 70 days  But at least I'll know for sure that Nardil will never work for me in 39 more days...

I really, really, really hope I get into a state of being able to function. 

CMON NARDIL YOU ****ING *****.


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## riptide991 (Feb 1, 2012)

gilmourr said:


> Day 31?
> 
> Nardil definitely affects prolactin or something that is causing me to have a change in my chest. Male breasts are not cool.
> 
> ...


Have you at all given antipsychotics combined with an antidepressant a thought? I mean they are great for sleep, they are great for anxiety, and typically really powerful. I was a little put off by olanzapine because of the scary stuff that could happen, but man I am so happy I gave it a chance.

Olanzapine/Effexor/propranolol have destroyed my anxiety and anhedonia completely.


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## gilmourr (Nov 17, 2011)

kehcorpz said:


> Have you at all given antipsychotics combined with an antidepressant a thought? I mean they are great for sleep, they are great for anxiety, and typically really powerful. I was a little put off by olanzapine because of the scary stuff that could happen, but man I am so happy I gave it a chance.
> 
> Olanzapine/Effexor/propranolol have destroyed my anxiety and anhedonia completely.


Guess I forgot to save my post. Yeah I've thought of olanzapine and abilify. Waiting to see what Nardil can do up till day 70 though before I go augmenting. Currently on day 32. It works fairly well minus the major insomnia + weight loss + slight cognitive decline (always happens, memory). And it might be causing back pain, though I have no idea about this last one (****ing bad upper back pain).

Olanzapine doesn't seem that scary tbh (do you mean the diabetes risk?). I don't think it works with zoloft because zoloft already makes me apathetic. Or do you think it might work? I was thinking abilify would be better if zoloft gets rid of all my depression but leaves me completely "anhedonic." I think that's when you really just don't have any motivation/happiness in anything right? Though it kicks my depressions ***.

If Nardil doesn't work I guess it'll either be zoloft + augment or something completely new... though I've only not tried effexor/imipramine and clomipramine.


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## gilmourr (Nov 17, 2011)

Got doxepin! But I don't want to try it since I don't want anything to mess with nardil until day 70. Kinda stupid even though it really has no effect on NET or SERT, but you never know with these crazy drugs!

Lets hope it obliterates my insomnia!


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## Plopperton (Nov 27, 2010)

It actually caused weight loss for you? Damnit... I was very happy with my results at 90 but I'm back at 45 cause I gained almost 30 pounds. Is 45 a good dose to "reset" at, or should I drop it to 15? I did cold turkey from 90g for 4 days and those were the coldest, loneliest days I've felt in a while, maybe ever.

I pretty much had every side effect on the list, at 90 for a month is when the insomnia became easier to deal with- but I had trouble staying asleep rather than falling. I'm cheering you on!


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## gilmourr (Nov 17, 2011)

Plopperton said:


> It actually caused weight loss for you? Damnit... I was very happy with my results at 90 but I'm back at 45 cause I gained almost 30 pounds. Is 45 a good dose to "reset" at, or should I drop it to 15? I did cold turkey from 90g for 4 days and those were the coldest, loneliest days I've felt in a while, maybe ever.
> 
> I pretty much had every side effect on the list, at 90 for a month is when the insomnia became easier to deal with- but I had trouble staying asleep rather than falling. I'm cheering you on!


YES IT DID! From 185 to 169 pounds. And I'm very tall.

90 mg I would agree = insomnia is easier but sleep is less. WHenever I go higher, I get to bed earlier but I sleep for 3-5 hours. Which is nice if it didn't come with like 10 more side effects.

I can't try doxepin till day 70 though since I don't want ANYTHING to add to or screw up Nardil.

Thanks also plopperton. My mood actually feels fairly good almost even great as of the last few days. It's wild.


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## riptide991 (Feb 1, 2012)

gilmourr said:


> Guess I forgot to save my post. Yeah I've thought of olanzapine and abilify. Waiting to see what Nardil can do up till day 70 though before I go augmenting. Currently on day 32. It works fairly well minus the major insomnia + weight loss + slight cognitive decline (always happens, memory). And it might be causing back pain, though I have no idea about this last one (****ing bad upper back pain).
> 
> Olanzapine doesn't seem that scary tbh (do you mean the diabetes risk?). I don't think it works with zoloft because zoloft already makes me apathetic. Or do you think it might work? I was thinking abilify would be better if zoloft gets rid of all my depression but leaves me completely "anhedonic." I think that's when you really just don't have any motivation/happiness in anything right? Though it kicks my depressions ***.
> 
> If Nardil doesn't work I guess it'll either be zoloft + augment or something completely new... though I've only not tried effexor/imipramine and clomipramine.


Yah, I know my blood sugar levels were pretty low when I got my tests back. Reference range is 3.6 - 6.0 and I had 2.3. I'll be getting these tests every few months, hopefully next one is better hehe. Although I did increase to 7.5mg.


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## gilmourr (Nov 17, 2011)

My hands are no longer freezing even with coffee, they're dry, I feel good, though I have energy dips, my mood feels stable, I enjoy things, I'm feeling REALLY GOOD!

KNOCK ON WOOD. 

Please Nardil, no weird surprises in the next 40 days and PLEASE Nardil, don't let this back pain be caused by you. I can't live with this back pain if it's chronic from Nardil.

Please let it be an upper back sprain or a herniated thoracic disc or ANYTHING else. I'd even take a tumor. Tumors are easier to get rid of than find a medication that works.

Advil, oxycodone, tylenol 3 w/codeiene all do not work.

Muscle relaxants kind of work but they put me to sleep, so I'm not sure if it did anything.


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## shy-one (May 10, 2008)

Congrats man, hopefully the Nardil is starting to work for you.


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## Jawi96 (May 15, 2012)

gilmourr said:


> My hands are no longer freezing even with coffee, they're dry, I feel good, though I have energy dips, my mood feels stable, I enjoy things, I'm feeling REALLY GOOD!
> 
> KNOCK ON WOOD.
> 
> ...


and you better write me back this time, nardil!


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## gilmourr (Nov 17, 2011)

shy-one said:


> Congrats man, hopefully the Nardil is starting to work for you.


I'm telling you, I think you and I are going to get our **** back together from this drug man.


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## gilmourr (Nov 17, 2011)

Seems like I've finally developed some constipation issues.

My shivers are becoming chronic and my body temperature is frequently cold.

The medicine is working well atm, but the shivers/body temperature is a huge issue. They become a MAJOR problem when it's winter or below 10 degrees celsius even. 

This is always the hardest side effect to control... but I still think it's NET inhibition.

Any guesses to anything else?


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## shy-one (May 10, 2008)

gilmourr said:


> Seems like I've finally developed some constipation issues.
> 
> My shivers are becoming chronic and my body temperature is frequently cold.
> 
> ...


Excellent to hear about the constipation, hopefully it won't be much longer for me then.

As I said in the other thread, I also felt MUCH colder on nardil when I first started on it, but this went away after some months.


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## gilmourr (Nov 17, 2011)

How bad was it though, because I don't mind the coldness that much or the cold peripherals, but having shivers or chills every like 5-10 seconds is awful.

And I think it's also ****ing up my mood, I feel pissed off, frustrated and overall not as good as 5-7 days ago.

I am at day 37, I don't know if I want to ride out this awful feeling though for 33 more days until day 70 and just wish that it goes away. I think I can make it to day 45 or 50, but...we'll see how out of control it gets.

Regardless, I'm going to try and pick up clonidine.


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## viper1431 (Jun 6, 2012)

Yeaah clonidine would be the best go, it has the effect you want quite fast, hence why it's been used in the past for blood tests where they take blood then give you clonidine and a few hours later test to make sure levels such as NE have decreased.

I had a look at lithium just before, there seems to be some debate on the amount needed, early tests showed the amount needed in rats to decrease ne would equal close to toxic dose in humans, however a later study showed the dose needed may be slightly lower than the first study.

The cold thing is interesting because I have the opposite effect, it makes me feel warmer which is why I've just uped my dose to help cope with the current freezing weather. Don't need a heater on when on nardil.


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## gilmourr (Nov 17, 2011)

To the usual followers, basal, shy, keh, viper, meta, and others

Could you let me know what you would do if you were in my situation?

1. (Day 37) Wait another 30+ days see if the chills/coldness goes away. Is there any logic behind there being a possibility of it going away? I don't understand the whole feedback loops idea well enough, though I haven't read much about it.

2. Take clonidine at a safe dose to lower NE hopefully. The only problem with this is that the NE might be part of Nardil working... though if the chills don't go away... I can't stay on this med.

** My vote goes to clonidine since I think last time I waited until day 49 and they didn't go away. Granted it was 60 mg and not 45 mg. It was worse also.


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## CD700 (Apr 22, 2010)

I always felt it was the lower BP that was making me cold
Nothing better then a hot shower on Parnate
I skimmed over the last few posts .... I'm lazy and full of apathy but what is NE ? Norepinephrine ? I took Anafranil while i was on Parnate and was still cold as mofo


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## gilmourr (Nov 17, 2011)

blakeyz said:


> I always felt it was the lower BP that was making me cold
> Nothing better then a hot shower on Parnate
> I skimmed over the last few posts .... I'm lazy and full of apathy but what is NE ? Norepinephrine ? I took Anafranil while i was on Parnate and was still cold as mofo


well that's an awful combo, could've been mild SS or too much NE. Parnate is super strong on NE. Anafranil is strong on SERT and moderate on NE


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## CD700 (Apr 22, 2010)

woops 
I meant nortriptyline
I taken so many of these useless drugs


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## gilmourr (Nov 17, 2011)

blakeyz said:


> woops
> I meant nortriptyline
> I taken so many of these useless drugs


even worse, nortryptiline + parnate = mass NE, no idea how you didn't get adrenergic storm. Unless you were on 30 mg or less of Parnate


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## CD700 (Apr 22, 2010)

MAOI and TCA like Nortyp are perfectly safe to combine. No chance of SS


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## gilmourr (Nov 17, 2011)

blakeyz said:


> MAOI and TCA like Nortyp are perfectly safe to combine. No chance of SS


adrenergic storm is different, it's too much NE. Nortryp and parnate are fine regarding SS. Only imip or clomip are SS risky with MAOI's


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## CD700 (Apr 22, 2010)

How you figure that ? Its a re-uptake inhibitor.


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## gilmourr (Nov 17, 2011)

blakeyz said:


> How you figure that ? Its a re-uptake inhibitor.


I figure that Parnate is stronger than PEA on NE according to the journal I read "Insights into the Mechanisms of Action of the MAO
Inhibitors Phenelzine and Tranylcypromine: A Review"

Along with Nortryptiline which antagonizes a1 receptors you'll probably have more NE binding with a2 receptors which raise cathecholamine levels if I'm correct.

I'm also not quite sure how powerful nortryptiline is on NE reuptake inhibition but I figure with it's name being derived from NE that it probably is potent enough.

All that norepinephrine can cause adrenergic storm.

Surprisingly though I believe that it's almost impossible to have a tyramine related hypertensive crisis on nortryptiline and a MAOI because of some sort of combination that makes it difficult for tyramine to reach the CNS. It was in another journal which I forget where it is exactly. It was also very recent, 2006 I believe.


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## gilmourr (Nov 17, 2011)

Anyways, last night not very fun. The most depressed I've been since I started Nardil. I still feel cold, wearing sweaters and sweat pants in summer. Sheesh.

People are probably afk atm so I'll just grab clonidine. I don't expect Nardil to change it's levels of NE based on a longer trial period. It's either this or lowering the dose to 30 mg. That actually might be a good idea..

But first clonidine.


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## shy-one (May 10, 2008)

I would give it another month or so and see if it gets better. I remember feeling really cold when I first started on nardil as well. Possibly due to lower blood pressure?

However this did get better after a while.


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## gilmourr (Nov 17, 2011)

Day 38. After 3 days of hell I'm less depressed and less irritated and angry. No idea why. I can't do a month more if I'm shivering since it turns me into a crazy off the handle nut. Plus when I went down this road on 60 mg it got worse.... I know on 45 last time it was leveling out real well by day 40. I just see no possible way that my levels of cathecholamines will decrease just by waiting. They stay the same. Or go higher. That's the point of the med.

Also had to take 2 mg and alcohol to keep from raging yesterday


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## riptide991 (Feb 1, 2012)

Dejavu? 

Anyways, you could try propranolol, it's a non-selective beta blocker and indirect a1 agonist. You just have to make sure your blood pressure doesn't go too low since you're on Nardil too. Anyways, most doctors give it out easily.


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## gilmourr (Nov 17, 2011)

kehcorpz said:


> Dejavu?
> 
> Anyways, you could try propranolol, it's a non-selective beta blocker and indirect a1 agonist. You just have to make sure your blood pressure doesn't go too low since you're on Nardil too. Anyways, most doctors give it out easily.


Went with clonidine, took two doses of 0.1 mg each. We'll see how it works after a bit of time. It's making me sleepy at least so I can go to bed!

EDIT: So the problem with Nardil insomnia might be completely noradrenaline related..after taking 0.1 of clonidine I went to sleep at 12:30, up at 9 AM, feel well rested completely.

But these things always seem to facking do weird stuff in the long haul. So far I'm only noticing dry mouth.


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## gilmourr (Nov 17, 2011)

40 days in, another mood swing later in the day (possibly when clonidine wore off since I took only 0.05 mg this morning instead of 0.1 mg).

I'm going to start taking B6 again since the 2mg of B6 seemed to be during my most upbeat moments on nardil (anxiolytic effect and anti-depressant).

My sex drive is being obliterated this past week since the mood swings began.

1) Can Nardil work at 30 mg? Is it more serotonergic at lower doses? I guess that would mean that MAO oxidase targets serotonin with greater affinity than NE if that's true. Maybe another way of looking at it is...if I were to OD on MAOI Nardil would serotonin syndrome occur first or adrenergic storm? If it's SS then possibly I can lower it. OBVIOUSLY there's a reason why it's so good between days like 18-30 and then it starts to diminish. 

2) How quickly does clonidine lower NE levels in the CNS? Is it basically after it reaches steady state @ 2.5 days?

EDIT: On a side note, I haven't once had the least amount of claminess or sweaty hands since starting Clonidine. It never was that big of an issue, it was mild and every once in a while moderate, but now it's non existent.


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## gilmourr (Nov 17, 2011)

jameslp3230 said:


> Much of this is caused by NE but not all of it by any means. For example, if there were separate versions of MAO for 5HT and NE and Nardil inhibited only 5HT version of the enzyme, resulting in higher 5HT levels, you would still be experiencing a LOT of the worsening anxiety/agitation and worsening depression. It just wouldn't be as bad, it would still be pretty bad though. You seem to be sort of preoccupied with NE when that's by no means all of it. Nardil affects so many monoamines that it's impossible to pinpoint just one.


Not sure why you might think that if it was selective for SERT that I would have the same outcome. The reason I'm preoccupied with NE is that shivers/coldness, mood swings/suicidal swings are a NE side effect because they happened on Parnate and Cymbalta and although it's not close to being a perfect guess it seems pretty accurate given that I've never had it on any SERT based specific meds alone. Also, I'm not trying to pinpoint one with my MAOI, but if I can use the MAOI and then reverse certain levels of monoamines at certain receptors using add on antagonists/agonists.



> As difficult as it is at the moment, if there is any way for you to stick with Nardil, keep at it. You've only got once chance. I regret that I was not capable of sticking with it but the pain/agitation was so great that it was a danger to myself and induced mild psychosis. You're basically in the business of waiting for your brain to make the adaptive changes both in terms of receptor downregulation and many other downstream effects which are not fully understood yet. Also try to maintain a good diet, lots of protein, omega 3/6/9, vitamins/minerals - changes in brain structure aren't easy.


Agreed. It is difficult. I'm trying to stick with it and I will probably until the mood swings turn into 24/7 suicidal thoughts which would not be a good sign. I really want to reach 70 days. I'm taking 2 vitamin drinks a day with everything in them (except amino acids, which I'm getting from my diet though I'm much less hungry because Nardil is stimulating and reduces hunger).



> Forget about targeting NE specifically, what you need to do in the meantime is reduce brain activity by any means. This means:
> 
> (for agitation)
> stopping clonidine
> ...


I was thinking about this, though I'd only use benzos or codeine to help get me through this stage. I think you're saying about the clonidine that if I use it to reduce catecholamines that my brain won't get used to the raised NE. Regardless, it's not inhibiting all NE, only part, so if I see this start to work by day 70, I can come off clonidine and let my brain get used to the full amount.

Atm I've been using benzos though for the agitation and swings.



> I've investigated the initial difficulties for many people in beginning a MAOI following my own difficulties. I found that for me, codeine had the most profound impact on mood but benzos/baclofen for GABA A/B combined with it got me through the worst times. Unfortunately at the time I was not equipped with high enough amounts to sustain myself through the 'pain' period.
> 
> Going on Lithium before this would have helped immensely, even at a low dose.
> 
> It's worth noting that while you may or may not be Bipolar as per strict ICD/DSM criteria, there is in fact a unipolar-bipolar *spectrum* rather than a simple yes/no answer. Your sensitivity in particular to NE suggests a clinically significant presence on the Bipolar spectrum. This does not mean as per strict diagnostic criteria you would be classified as clear-cut Bipolar depressed as opposed to unipolar, however it is an indicator that you may well respond to medication as if Bipolar, e.g. Lithium, or if your depression is much more prominent Lamotrigine. At the very least, it could suggest that you should always be on Lithium when initiating powerful antidepressants, since ADs have a very significant danger of accelerating the course of your illness, such that bipolarity may not fully appear as per diagnostic criteria now, but you may find that antidepressant monotherapy i.e. without Lithium, in some cases Valproate, may lead to such a clear-cut diagnosis within a few years. Not saying 100% this is what will happen to you/is happening, but it's quite a serious prospect worth investigating.


I definitely agree with the analysis of some type of bipolar sensitivity as it does exist within my family fairly close. Also medications like cymbalta,parnate and nardil have all caused good (parnate, excellent) at first but later would cause mood swings and/or suicidal thoughts.

Though then again, most people feel good going on meds that affect dopamine. It could easily just be a quick antidepressant response from that and then back to my unipolar depression.

I like the idea of lithium, but I'm worried that it will turn me into a complete moron. I do still hope to get back to my academics/work (which I'll need decent level of memory/cognitive function for)

Thanks for the reply and hopefully you can respond to some of my thoughts

EDIT: BTW I still respond to Nardil at points. When I feel good I'm motivated, playing music, want to go out (which was like the whole weeks 3-5). Now I seem to get them right once my swings end, then I'm like


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## gilmourr (Nov 17, 2011)

On my phone so I can't type much until later. But when my depression started 2 years ago I was majorly depressed for 4 months before I got on my first partially good ssri. Never did I once feeL hypomanic or even energetic at all. I was dead. I may have been agitated and I definitely didn't sleep ever.


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## gilmourr (Nov 17, 2011)

jameslp3230 said:


> I didn't say the same outcome at all, no way. NE is indeed a big part of it, and bipolar folks are well known to be sensitive to it and have it precipitate mania. However there are reasons beyond NE alone. The reason I mention an uncomfortable reaction even without the NE is because Nardil is just so damn powerful with regard to increases in monoamines, same with Parnate, it's a much bigger deal than just 5HT reuptake inhibition.





> It's unfortunate that people have to go through suicidal thoughts to start an antidepressant, it shouldn't be this way. That's a strong indicator of bipolar diathesis again. And yeah, on Nardil I couldn't eat anything. I didn't know what all these people were talking about, weight gain on Nardil. I think our brain chemistry is more similar and I am Bipolar II. Possibly the f*king severely depressed type, like you, to warrant Nardil I am guessing.


Couldn't it be a number of things like increased SERT inhibition would lead to more serotonin in the synapse, possibly landing in 5HT-2A receptors which are like suicidal aren't they? Pretty sure 5HT-2A antagonists are like antisuicidals.



> Codeine was by far the most helpful thing for me. Stick to codeine because there are interactions with others. However I only realized this after the fact, for example, I took some small amount of codeine and it was the only thing that relieved any of the hell to a significant degree, but by the time that happened I was just beat with the psychological beatdown I received, exhaustion from psychosis etc. If I were ever dumb enough to go on Nardil again, I would be prepared. I would go on Lithium beforehand with an eye to increasing the Lithium if the Nardil got really bad, and I would prepare myself with all the inhibitory stuff needed to get me through it. Benzos alone aren't enough for the hell Nardil can give a bipolar brain without Lithium. First, because they can stop some agitation but they can't stop it all (codeine can finish it off as well as baclofen on the side) and also benzos don't raise mood. The problem isn't just the agitation (i.e. hypomanic) symptoms, it is the suicidal depression. Codeine can lift you up from that. Baclofen at 20mg is really underrated, I get tubs of 10mg x 100 tabs from united pharmacies and they're cheap as chips, they're kind of soft tablets and they dissolve under your tongue, pack quite a punch.
> 
> Yes the clonidine could be doing more harm than good, it's not good to screw around with things like that as your brain might not know whether it's coming or going.


I'm QUITE certain it stops the shivers completely though, I feel no shivers and it makes my hands completely dry. Shivers are really annoying and hard to deal with every 10-20 seconds.



> Hasn't a doctor diagnosed you with Bipolar disorder or at least being on the Bipolar spectrum i.e. to be treated medically as if Bipolar, with regards to you depression?
> 
> Bipolar depression can look deceptively unipolar. It is not euphoria-depression-euphoria-depression etc. Hypomania/Mania is not categorized as something that requires euphoric mood, in the latest DSM 5 update this month. The manic end of the spectrum simply reflects 'activity levels' e.g. hyperactivity/instability. So you can have very low mood (i.e. on Nardil) and be hypomanic at the same time (e.g. severe agitation, racing thoughts, severe insomnia etc.) Just because you might not have the hypomania in the presence of euphoric mood does not disqualify you from Bipolar diathesis.
> 
> ...


No because I've always been adamant that I'm not BP and I made it clear I have no hypomania or mania. I definitely have never been manic. I don't think I've even been hypomanic. I don't know. I just stay up till 4-5 am on nardil, 2 am if on Zoloft which is like normal for me, I'm not agitated normally, I do have hyperness though at times and I do talk quite fast when I'm on stimulating drugs since I feel like I'm just freaking brilliant. I also am narcissistic...

Just looking on wiki now...

Grandiosity
Decreased need for sleep
Increased talkativeness
Racing thoughts
Distractibility
Overactivity, especially in goal-directed areas
Psychomotor agitation
Excessive participation in risky behaviors, such as hypersexuality

I'm narcasstic even when depressed, I am FOR SURE 100% never wanting to go to bed early, I have increased talkativeness except when I'm in a major depression, I am easily distracted which is why in uni I always went to the library because any sound of music I want to dance to or TV I lose my train of thought. I always need to be at the lib to do work.

Just clicked on psychomotor..."In more severe cases, the motions may become harmful to the individual, such as ripping, tearing or chewing at the skin around one's fingernails or lips to the point of bleeding."

Only one I don't have is like racing thoughts when I'm normal

If that's the case for bipolar 2, there's a good chance I could be. I just wonder if lithium causes an insanely amount of side effects.


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## CD700 (Apr 22, 2010)

lol 
Hang in there buddy


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## ChopSuey (Nov 5, 2012)

jameslp3230 said:


> AD 'poop out' as a whole is 60% in BP patients and only 20% in unipolars.


Where did you get these statistics from?


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## gilmourr (Nov 17, 2011)

jameslp3230 said:


> It's not always a black or white deal. It's a spectrum. Some people can begin responding as if unipolar only to be tipped across to the dark side by aggressive antidepressant monotherapy, which is known to accelerate BP illness.
> 
> Half the people diagnosed with major depression then end up being diagnosed as BP, usually BPII. The problem is it takes an average 10 years for that to happen, and by that time many patients' brains have deteriorated to the point of no return.
> 
> ...


Yeah I'm going to stop using clonidine, but I'm rather certain my shivering will come back (or it might've been the B6 as I added both at the same time, we'll see).

I am definitely not in hell, I'm only in moderate-severe swings like for a 4-5 hours every other day or something.

So I stop the clonidine, I'm going to wait until day 70 or try to at least to see if it works alone (maybe I am just unipolar depressed, these things are really vague). I don't even have an appointment until then, so I shall keep on the 45 mg. If by day 70 it doesn't work, I'm going to go down to 30 mg and see if it's just too much at 45 mg since it was working for a solid 2.5 weeks.

I think 45 mg is okay, but I get the shivers and mood swings when I take the med so I think it's when I take the med and phenelethylmine gets produced that it makes me a bit crazy since it has a half life of 10-15 mins which is why I might feel ****ty right after taking it.

Anyways, I think the end result might be something like 30 mg of Nardil + 300-500 mg of lithium carbonate.

And Zoloft was super tolerable, I had no side effects except apathy and disinterest just saying

EDIT: I tried lamictal, it was working on my depression relatively fast but it made my throat close up so that I could hardly breathe :/ Lithium or depakote are the only other mood stabilizers correct?

EDIT: Also, it's a bit confusing as to why cymbalta gave me suicidal thoughts and parnate didn't when parnate would exacerbate BP2 much more. Parnate just made me hypothermic, 10 times worse than nardil and made me depressed, but I wasn't having racing suicidal thoughts 24/7. That was only on cymbalta. On parnate and nardil I just sometimes have death thoughts , depressing suicidal thoughts but nowhere near cymbalta. Cymbalta was the only drug I thought I might kill myself on tbh.


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## gilmourr (Nov 17, 2011)

Lol that's jokes about the removal of my amygdala thread.

Anyways day 43 on the orange shtuff.

Since separating my doses I haven't had a severe mood swing in 4 days I believe, which is good. I think taking it all at once is bad because of the PEA thing, but we will never know will we?  We just know that it so far has made a difference.

I stopped the clonidine I think 2-3 days ago and I'm feeling fine atm with the shivers, though I noticed I had 20 minutes of them this morning after taking my first dose of the day

I'm relying on clonazepam way too much for sleep these days. I take 1 mg to get to bed almost every day or maybe 5 days/week.

One thing I'm concerned about is that I don't feel too motivated or able to concentrate for long periods of time. It might just be that I've been away from work for some time. At least I don't have any apathy!

*TL;DR: Anxiety is still incredibly diminished, mood swings have lessened, mild depression still remains/though it sometimes feels like moderate. I also am having a really tough time concentrating/motivating myself + sleep. Actually now that I think of it, more of the concentration issues are from like zoning out.

Maybe seroquel (at a dose that doesn't hit D2) and abilify that hits D2 might work.. I'm thinking 100 mg of seroquel, 2-5 mg of abilify.*


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## viper1431 (Jun 6, 2012)

Insonmia was quite bad for me with abilify, don't think I could mix it with nardil insomnia. Not sure if it's common for it to cause insomnia.
Have u always been on benzos along with nardil? I noticed the other week when I took flunitrazepam to get some extended sleep that it made me feel strangely cold.


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## gilmourr (Nov 17, 2011)

viper1431 said:


> Insonmia was quite bad for me with abilify, don't think I could mix it with nardil insomnia. Not sure if it's common for it to cause insomnia.
> Have u always been on benzos along with nardil? I noticed the other week when I took flunitrazepam to get some extended sleep that it made me feel strangely cold.


I just always have benzos and take them whenever needed, though I don't take much, it's usually 0.5 - 1 mg.

I was planning on taking abilify in the morning to like wake me up with the D2 agonism

seroquel is also very potent when it comes to putting me to sleep. So I'm sure I won't have trouble sleeping


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## riptide991 (Feb 1, 2012)

You could try olanzapine for sleep. It would also block 5-ht2a which you were mentioning.

I can't do benzos or Nardil as anything Gaba related tends to be bad for my anhedonia.


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## gilmourr (Nov 17, 2011)

kehcorpz said:


> You could try olanzapine for sleep. It would also block 5-ht2a which you were mentioning.
> 
> I can't do benzos or Nardil as anything Gaba related tends to be bad for my anhedonia.


Issues I have with olanzapine and nardil are D2 antagonism and the muscarinic antagonism. Not a big fan of developing lactating man boobs or become more unmotivated which might happen with D2 blockade.

It feels like it's more useful as someone with psychosis or mania, I'm not even sure how it works on your anhedonia.

Is there any evidence that antagonizing D2 receptors can help cognitive functioning/motivation? Because right now I'd take being able to concentrate and more motivation over mood. But then again, it might be my mood that's causing it right?  Tricky game. I'll probably give it a whirl as it seems like I'll be adding something to Nardil (lithium or seroquel or abilify or olanzapine).

Mind giving me a bit more of a detailed explanation keh about why olanzapine might be better than seroquel, abilify or lithium for 1. mood stabilization 2. not reducing my energy/cognitive function or motivation any more than it is


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## riptide991 (Feb 1, 2012)

Well first of all olanzapine increases dopamine in the PFC which is important. It also increases dopamine at d1 receptors which account for neuron growth as well as mediate D2 receptors. Olanzapine has a low record of any of the side effects you mention. It is the next best thing to clozapine. Clozapine you probably wouldn't be able to get but this is the master of helping motivation/interests.

Anyways, it's not as simple as you make it seem by antagonizing dopamine. By this logic this should not be helping my anhedonia yet it has a track record of doing so. It Is also known for helping memory and other cognitive functioning. Clozapine even moreso. In fact, antagonizing dopamine is more likely to cause upregulation which clozapine/olanzapine have shown to do. Also depending on the dose you may be antagonizing only the presynaptic autoreceptors.

Olanzapine is actually used for bi-polar so that about answers your mood swings question.

Olanzapine also increases allopregnanolone which is an important neurosteroid and acts as a gaba-a agonist.



> Olanzapine increases in vivo dopamine and norepinephrine release in rat prefrontal cortex, nucleus accumbens and striatum
> 
> http://link.springer.com/article/10.1007/s002130050551





> Olanzapine increases allopregnanolone in the rat cerebral cortex
> 
> http://www.sciencedirect.com/science/article/pii/S0006322399003054





> Differential effects of haloperidol, clozapine and olanzapine on learning and memory functions in mice
> 
> ...
> Thus, their effects on this issue were investigated in the present studies by using one-way step-through passive avoidance task and Morris water maze as models of learning and memory. The results showed that olanzapine did not affect acquisition, consolidation or retrieval process in step-through test. Moreover, *it improved spatial learning function in mice in Morris water maze task*.
> ...


Anyways, there's hundreds of studies on olanzapine. It's a good drug. To be honest I never wanted to try it because I tried to play arm-chair scientist and discredit drugs based on pharmacology. I'm so glad my doctor convinced me as it has been a savior to me.

You should be doing trial and error of drugs until you find one that works and stay on it. Instead you're wasting your time with Nardil because it worked at one point. And when things are going bad you repeat the same process you did while you were on it previously, obsessing over how to fix it. If you're concerned about cognitive function then nardil isn't exactly a winner there as I can drop tonnes of studies showing it's bad for cognitive function/memory. Just try stuff and if it doesn't work then it doesn't work, move on try something else. These drugs have so many mechanisms that you can ask all the questions you want online but in reality only trying it will give you the truth.


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## gilmourr (Nov 17, 2011)

kehcorpz said:


> Well first of all olanzapine increases dopamine in the PFC which is important. It also increases dopamine at d1 receptors which account for neuron growth as well as mediate D2 receptors. Olanzapine has a low record of any of the side effects you mention. It is the next best thing to clozapine. Clozapine you probably wouldn't be able to get but this is the master of helping motivation/interests.
> 
> Anyways, it's not as simple as you make it seem by antagonizing dopamine. By this logic this should not be helping my anhedonia yet it has a track record of doing so. It Is also known for helping memory and other cognitive functioning. Clozapine even moreso. In fact, antagonizing dopamine is more likely to cause upregulation which clozapine/olanzapine have shown to do. Also depending on the dose you may be antagonizing only the presynaptic autoreceptors.
> 
> ...


You can't discredit nardil entirely. It basically manages my anxiety better than any drug I've ever tried. That in itself is amazing. I've also never tried the same thing, last time I was on 60 mg which is completely different.

I'll consider olanzapine. What dose would you use for infrequent mood swings? And how long until you noticed a change? I'm still not going to add anything until 70 days are up since on average nardil kicks in then fully-- on average.


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## odspot (Sep 1, 2009)

kind of interesting reading through this last page, especially the stuff about NE sensitivity gilmourr ..

I have the exact same problem, anything that touches NE (stimulants, Strattera, Parnate, Nardil) makes my mood way more labile and exacerbate suicidal thinking, which has made most things that have helped to some degree intolerable. what complicates this is I have ADDi, severe OCD and atypical depression. TCAs are bad too .. low-dose nortriptyline, amitriptyline all make me more anxious/sensitive (especially clomipramine, which was the worst in terms of agitation)

only thing that brought me out of a disabling 5 year depression AND fixed ADD was Parnate, but it did nothing for anxiety/agitation at doses up to 60mg (wasn't allowed to try higher). what was also weird is that I got the best response - a kind of inner warmth and desire to do things - at night, whereas daytime I was just coldly motivated. benzos have a paradoxical effect on me, so were of no use and I had to come off it, which sucked .. I was on about Nardil 4 years prior to that, but found the insomnia too wearying and gave up sooner.

but my depression sx. have changed over the years - morphing from anergia and brain fog to this later feeling of adrenaline-coursing-through-me 24/7 which was so unbearable, and brought until control by (individually) Lexapro, Neurontin and Depakote -- though none ever hit the core depression the way Parnate managed to at night.

i've wondered if based on your guys' back-and-forth it isn't some weird OCD/ADD/BP mix (my Aunt on dad's side has Bipolar). problem is last psychiatrist who is the only one who acknowledged lifelong ADD - which seems to run RIFE in my immediate family but went ignored because of my IQ - didn't think I had any BP issues. new one was willing to go higher with Parnate to see if it would be more calming, but is a Bipolar specialist and doesn't think I have BP or ADD (based on one brief meeting .. he never offered much explanation). anyway, I had a stomach infection and was feeling agitation on Parnate at 40mg so he just pulled me off last week, saying it probably wouldn't be much help.

I feel kind of lost .. OCD treatments (SSRIs, APs) induce sub-parkinsonian like symptoms in me, like akathisia and restless legs, and in the case of SSRIs make ADD crippling. the more activating SSRIs (Zoloft, Prozac) induce insomnia that doesn't remit, even after remaining on them.

stimulants cause mood lability, worsen OCD and rendered ineffective by addition of an SSRI.

anyway, sorry this is so long and disorganized. I feel like I've basically covered every med without luck and have disintegrated from a gifted, once-bright adolescent into a cripplingly anxious, suicidally depressed, untreatable mess. curiously pretty much the *only* things that haven't been tried are Lithium and Lamictal, with or without a stim/SSRI ..


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## gilmourr (Nov 17, 2011)

odspot said:


> kind of interesting reading through this last page, especially the stuff about NE sensitivity gilmourr ..
> 
> I have the exact same problem, anything that touches NE (stimulants, Strattera, Parnate, Nardil) makes my mood way more labile and exacerbate suicidal thinking, which has made most things that have helped to some degree intolerable. what complicates this is I have ADDi, severe OCD and atypical depression. TCAs are bad too .. low-dose nortriptyline, amitriptyline all make me more anxious/sensitive (especially clomipramine, which was the worst in terms of agitation)
> 
> ...


Lol, that post was a bit all over the place. I'll try to respond to it the best I can.

So you have severe OCD/ADD and atypical depression. So I'm assuming you're not hyper/super energetic since you didn't say ADHD. Assuming you're not psychotic so BP1 probably ruled out. Not sure if you're BP2 as besides the crippling anxiety/suicidal deppression and ADD you didn't talk about other symptoms--or I don't think you did.

Amitryptiline is weird (not really serotonergic, I just recently read a journal that said that along with trimipramine and doxepin would all be reclassified as antihistamines rather than AD's as they don't seem to hit SERT or 5HT well at all). Clomipramine is super serotonergic though, however I'm not sure how long you were on each of these drugs. It may have just been a 6 week increase in anxiety before normalizing.

Basically you just kind of summarized to me that drugs that affect SERT/NE/D all suck for you, which are essentially the monoamines that treat these issues...

Have you checked your thyroid, celiac disease, vitamin deficiencies? (truehope vitamins are the only I know of that authentically work for mental illnesses as a family member treated 6 years of BP2 with it). Tumor, B12 deficiency? hyper/hyp parathyroidism? hormones (prolactin)?

Sounds like maybe something like Parnate + Lamictal or lithium might help. Stick to what works and try and augment it. Parnate + seroquel maybe to get help with sleep and antagonize 5HT2A receptors (usually helps with death/suicidal thoughts). If SSRI's work, you can treat insomnia for sure with ambien, benzos, doxepin, trimipramine, seroquel, olanzapine, so many choices.

I'd advise go making a thread of your own, only list meds you've been on for 6 weeks + (without adjusting the dose) and your symptoms. There's gotta be something wrong here.

***BTW, no way am I OCD, I can maybe see OCPD mild'ish, maybe BP2 (but that still is a bit iffy). I think MDD + panic attacks, mild agoraphobia is pretty close to what I have, which is also my diagnosis.*


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## odspot (Sep 1, 2009)

sorry didn't mean to hijack .. was mainly the NE thing that stuck out, which i hadn't really seen anyone mention before. if you like i can delete my post and start a new thread; yeah it is especially frazzled, though suffering from severe lack of sleep deprival (acute parnate withdrawal) at the mo' ..


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## gilmourr (Nov 17, 2011)

odspot said:


> sorry didn't mean to hijack .. was mainly the NE thing that stuck out, which i hadn't really seen anyone mention before. if you like i can delete my post and start a new thread; yeah it is especially frazzled, though suffering from severe lack of sleep deprival (acute parnate withdrawal) at the mo' ..


Lol, there's 100% no need for me to delete your post. I don't mind anyone commenting whatever a few times but some replies seem like they can throw off an entire thread which is why I said that for your complicated case.

I really suggest you summarize your whole deal in a thread since users on this forum can be really helpful with regard to medications.

For a person who has OCD, I'm assuming that a lot of NE can't be great as it would make the mind race... though I'm not quite sure, I've only seen fMRI's of a brain, which in part looks like a lit up christmas tree.

EDIT: Also going to use this post to test out whether 45 mg again all at once causes cold intolerance and shivers as I've been dividing the doses since I've found it works much better. Just testing it to make sure.


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## odspot (Sep 1, 2009)

jameslp3230 said:


> That's my life story in a nutshell...
> 
> Why do our brains do this to us... why...
> 
> ...


sorry to hear that jameslp. it's nice to hear from people who can relate, even if it's a miserable situation. David Foster Wallace is a personal hero .. one quote of his I think about a lot is that radical "acceptance" of your situation -- which is avowed a lot today w/ buddhist influences in psychology -- is mostly about tiredness and defeat, rather than some great liberating force ..

low-dose amitriptyline was 25-50mg. Anyway, I won't say anymore here about my situation as I don't wanna derail Gilmourr's thread, but I will create my own perhaps like he suggested


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## gilmourr (Nov 17, 2011)

jameslp3230 said:


> That's my life story in a nutshell...
> 
> Why do our brains do this to us... why...
> 
> ...


I'll get the name of it tomorrow. I don't have it on me and I can't seem to find it atm.


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## gilmourr (Nov 17, 2011)

45 or 46 days in I don't believe I have any more shivers or cold intolerance even when I take it all at once, which is good news.

It still is a potent anxiolytic. For the past week I stopped using my 2mg B6 supplement because I thought it was causing me nausea but I'm fairly sure it was the vitamin/meal replacement shakes I was drinking as it always happened 30 minutes after them. So I stopped those and am resuming my 2 mg of B6.

Every 3 days I'm still getting very harsh suicidally depressed/severe depressed swings for about 8 hours. They usually happen at night.

To counter this lovely issue I started to use 25 mg again of seroquel to get me to sleep (surely enough it works). Next day though it aggravates my cold intolerance moderately and induces mild shivers, so I'm going to need to wait until I can get something like 100 mg or 150 so that it hits alpha1 receptors and 5HT to possibly counteract the strong NET inhibition of norquetiapine.

It's either something like 100-200 mg of seroquel or 2.5-5 mg of olanzapine I'll be adding next. Then I was thinking if I have any cognitive issues/concentration issues left 2 mg of abilify might make it all come together. *Any commentary on the med stuff from the regulars as to dosage or any other info?*

** I'm still going to get you that journal for whoever asked for it.


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## riptide991 (Feb 1, 2012)

gilmourr said:


> I'll consider olanzapine. What dose would you use for infrequent mood swings? And how long until you noticed a change? I'm still not going to add anything until 70 days are up since on average nardil kicks in then fully-- on average.


Well for bipolar I believe they use 5-10mg. I know "A sense of purpose" was on 5mg for his bipolar diagnosis. Funny part which I just realized today is that zyprexa has a really strong affinity for 5-ht2c, which could explain the increase in dopamine but also the insane hunger hehe.

serotonin 5-HT2C: 10


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## gilmourr (Nov 17, 2011)

kehcorpz said:


> Well for bipolar I believe they use 5-10mg. I know "A sense of purpose" was on 5mg for his bipolar diagnosis. Funny part which I just realized today is that zyprexa has a really strong affinity for 5-ht2c, which could explain the increase in dopamine but also the insane hunger hehe.
> 
> serotonin 5-HT2C: 10


How have you been with being able to concentrate/work at that dose? I feel like 10 mg might be too much. I don't even know If I'm bp, I just have severe mood swings for hours every 2,3,4 days. I need to ask my psych what bipolar 2 really is or if I'm in that area.

EDIT: BTW I'm going to try more seroquel tonight. I'm thinking the low dose is too energizing with the NET inhibition. Keh, do you think that more seroquel might help the NET inhibition issue? Possibly like how clonidine lowered my levels of NE by antagonizing alpha 1 receptors at a higher dose there might be more NE flowing into alpha 2 which might inhibit some NE.

I have enough seroquel to test it out tonight and for the next few days, so I was thinking 75 or 100 mg.


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## A Sense of Purpose (May 8, 2011)

kehcorpz said:


> Well for bipolar I believe they use 5-10mg. I know "A sense of purpose" was on 5mg for his bipolar diagnosis: 10


Indeed as my dosage was then changed to 30mg for hypomania.
Overall Olanzapine has been fantastic to me, aside from the tiniest amount of weight gain.

Also, libido and satisfaction appear to be uninterrupted which is a pleasant surprise.

Once i go to the gym again large means ==> muscles


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## gilmourr (Nov 17, 2011)

So seroquel @ 75 mg seemed to incredibly take away my mood swing.

I'm looking at the binding affinities and seroquel's active metabolite norquetiapine is tight with 5HT2A antagonism which might explain why I felt so damn good today. It's honestly the best I've felt since the mood swings started about 2.5 weeks ago.

**This may also be why remeron is so amazing for me as well for depression (because of it's 5HT2A antagonism) as I've only had 3 pills to work..zoloft, nardil and remeron on depression**

The drawback is the NET inhibition causes the chills/shivers and cold intolerance. Plus it might not be the smartest idea to further raise levels of norepinephrine... if I have underlying undiagnosed bipolar 2.

1) Does anyone know when seroquel begins to have diminishing returns on NET inhibition or NE reuptake inhibition? Is it's effect almost topped at 25-75 mg? Because I might raise the dose.. it might have anti NE properties at higher doses when it becomes a mood stabilizer.. or at least that would make sense since it's a bipolar medication.

ATM I'm looking for 5HT2A antagonists I can use that won't **** with my Nardil too much. Abilify/Zyprexa.. etc. Basically items that have histamine 1 value to put me to sleep but also the 5HT2A antagonism.. and NO NET INHIBITION.

****Also now I'm a bit unsure whether the mood swings are caused more by the increase in NET or by nardil releasing 5HT everywhere including 5HT2A receptors causing the suicidal thought/severe depression swings.*


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## riptide991 (Feb 1, 2012)

I actually started taking mirtazapine, it's only my 2nd day but today I was slightly irritable. I'm hoping this goes away. James as someone who is bipolar is it common to get irritable with adrenergic drugs? I was doing so well with olanzapine/propranolol and Effexor. I never felt irritable, 0 anxiety, however, motivation is a bit low as dragging myself to the gym isn't as easy as it used to be. I added the mirtazapine to test but man I rather have no motivation than feel that irritable sort of state.


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## riptide991 (Feb 1, 2012)

Today I'm not feeling irritable like yesterday. I even had a coffee and doing fine. This is the first coffee I had in months, and man it feels good heh.


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## gilmourr (Nov 17, 2011)

kehcorpz said:


> Today I'm not feeling irritable like yesterday. I even had a coffee and doing fine. This is the first coffee I had in months, and man it feels good heh.


Coffee always makes things better  Mirtazapine should make you feel more chill though I figure than irritated/angry in the average person.

I kinda figured that Olanzapine might cause some motivational issues (gym) sooner or later, though it really could be any of the 3 drugs you have there.

BTW, Keh, do you know anything about 5HT2A and seroquel? I'm finding a lot of mixed information on the affinity of seroquel on 5HT2A. Some sites say it has a low affinity, while others say higher and that it's after histamine and alpha 1. I'm trying to take enough so it actually antagonizes that receptor...help?


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## riptide991 (Feb 1, 2012)

gilmourr said:


> Coffee always makes things better  Mirtazapine should make you feel more chill though I figure than irritated/angry in the average person.
> 
> I kinda figured that Olanzapine might cause some motivational issues (gym) sooner or later, though it really could be any of the 3 drugs you have there.
> 
> BTW, Keh, do you know anything about 5HT2A and seroquel? I'm finding a lot of mixed information on the affinity of seroquel on 5HT2A. Some sites say it has a low affinity, while others say higher and that it's after histamine and alpha 1. I'm trying to take enough so it actually antagonizes that receptor...help?


The metabolite has high affinity for 5-ht2a, but you can never be sure how much of it gets converted. You'd probably need a decent average dose to be sure you're hitting it but then you would be getting too much norepinephrine action. Seroquel is too dependent on individual chemistry. It's kind of like bupropion which the active drug is great for dopamine but it gets converted to a form that has completely different sites of action.

None of the actual drugs im taking are causing motivational issues. My problem has always been anhedonia/motivation issues, thus far the drugs have fixed my anhedonia problem, but motivation still remains lower than I would like. This is why I added the mirtazapine. And man I was pretty motivated after the coffee, but of course there's the coffee tolerance issue. I used to drink coffee like crazy and once you get used to it, you need it just to stay normal.


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## gilmourr (Nov 17, 2011)

kehcorpz said:


> The metabolite has high affinity for 5-ht2a, but you can never be sure how much of it gets converted. You'd probably need a decent average dose to be sure you're hitting it but then you would be getting too much norepinephrine action. Seroquel is too dependent on individual chemistry. It's kind of like bupropion which the active drug is great for dopamine but it gets converted to a form that has completely different sites of action.
> 
> None of the actual drugs im taking are causing motivational issues. My problem has always been anhedonia/motivation issues, thus far the drugs have fixed my anhedonia problem, but motivation still remains lower than I would like. This is why I added the mirtazapine. And man I was pretty motivated after the coffee, but of course there's the coffee tolerance issue. I used to drink coffee like crazy and once you get used to it, you need it just to stay normal.


Yeah, seroquel has such a large range that it's difficult to know how much is reasonable for something specific like that. And I also agree about the NET inhibition which is why I'm skeptical about going higher. I know that there are diminishing returns on it, but I think they don't begin to really diminish until you get to much higher doses. I think it's because it's so sedating that it was constructed with NET inhibition--maybe.

I still find that olanzapine fixing anhedonia is wicked crazy.

It feels so good once you keep getting closer and closer to being in a mild/asymptomatic place.


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## gilmourr (Nov 17, 2011)

So 50 days in... I'm a little rattled by the fact that my mood would probably be swinging between severe and okay without the addition of seroquel. With seroquel my mood just feels low in general now. It is better surprisingly.

Anyways, I was going to do 70 days at 45 mg, but it seems that everyone who achieved remission/major recovery around that point was not experiencing the worsening effect up until day 70. It seems like Nardil continues to get worse as the days go by.

So I'm dropping down to 30 mg, giving it 2-3 weeks to regenerate the enzymes and maybe with less NET inhibition I might be better off. It worked at a point... so maybe I'm a very slow metabolizer.

Anyways, max of another 21 days to see some improvement or I'm either going to go back to Zoloft (no side effects, remission of depression just severe apathy and lack of motivation) and augment the hell out of it or monotherapy it with clomipramine. Unless my psych wants to do lithium with Nardil quickly before going to a new approach. 

All in all, I feel like **** depressive wise and need to get some relief from this soon. **** depression.


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## metamorphosis (Dec 18, 2008)

kehcorpz said:


> Today I'm not feeling irritable like yesterday. I even had a coffee and doing fine. This is the first coffee I had in months, and man it feels good heh.


*An ode to coffee*:

"Should I kill myself, or have a cup of coffee?" 
― Albert Camus

"It is inhumane, in my opinion, to force people who have a genuine medical need for coffee to wait in line behind people who apparently view it as some kind of recreational activity." 
― Dave Barry

"I don't really like coffee, she said, but I don't really like it when my head hits my desk when I fall asleep either. " 
― Brian Andreas

"I'd rather take coffee than compliments just now." 
― Louisa May Alcott

"I told the waitress I wanted some coffee. She asked if I wanted leaded of unleaded, so I had to leave the restaurant, because I quit drinking gasoline years ago." 
― Jarod Kintz

"The powers of a man's mind are directly proportioned to the quantity of coffee he drinks." 
― James Mackintosh






























"I put instant 
coffee in a microwave oven and almost went back in time."- Steven Wright
:hyper + :cup=  +







=


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## riptide991 (Feb 1, 2012)

lol


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## gilmourr (Nov 17, 2011)

Imagine if you needed a prescription to get a cup of coffee...


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## metamorphosis (Dec 18, 2008)

gilmourr said:


> Imagine if you needed a prescription to get a cup of coffee...


Lulz, then we would have 10 threads on here a day about how to score a caffeine script instead of benzo scripts!


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## yourfavestoner (Jan 14, 2010)

This is really intriguing - I'ma need to be schooled on my pharmacology. 75/90 mg increases NE more? What of serotonin and dopamine? I remember you've said too much NE increases your depression gilmourr.


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## gilmourr (Nov 17, 2011)

yourfavestoner said:


> This is really intriguing - I'ma need to be schooled on my pharmacology. 75/90 mg increases NE more? What of serotonin and dopamine? I remember you've said too much NE increases your depression gilmourr.


Well it definitely increases level of NE the higher you go with nardil dosing, but whether it increases more proportionally compared to SERT for every dose raise is a question I would like to know.

And yeah, well kinda, I said that NE increases mood swings and suicidal thoughts/ideations. It doesn't just make me feel severely depressed, it swings between low and severely low.


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## viper1431 (Jun 6, 2012)

gilmourr said:


> Well it definitely increases level of NE the higher you go with nardil dosing, but whether it increases more proportionally compared to SERT for every dose raise is a question I would like to know.
> 
> And yeah, well kinda, I said that NE increases mood swings and suicidal thoughts/ideations. It doesn't just make me feel severely depressed, it swings between low and severely low.


I'm not sure if this is the most recent post, something is being weird right now on the forum for me. However just thinking about this i would say NE would increase at greater rates than SE with dose increses due to one of nardil's metabolites being PEA which releases NE and dopamine, so that's going to be extra to the normal NE increasing effect of nardil through MAOI inhibition.


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## adamaus (Mar 24, 2013)

does nardil kill sex drive and does anyone know of any stimulant type anti depressants that counter act the effects to increase your libido?


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## gilmourr (Nov 17, 2011)

adamaus said:


> does nardil kill sex drive and does anyone know of any stimulant type anti depressants that counter act the effects to increase your libido?


I only know personally that it causes slight ED and major anorgasmia at higher doses. No libido issues


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## ChopSuey (Nov 5, 2012)

adamaus said:


> does nardil kill sex drive and does anyone know of any stimulant type anti depressants that counter act the effects to increase your libido?


Some people tend to use Wellbutrin or random psychostimulant to counter the libido effects.


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## riptide991 (Feb 1, 2012)

gilmourr said:


> Went with clonidine, took two doses of 0.1 mg each. We'll see how it works after a bit of time. It's making me sleepy at least so I can go to bed!
> 
> EDIT: So the problem with Nardil insomnia might be completely noradrenaline related..after taking 0.1 of clonidine I went to sleep at 12:30, up at 9 AM, feel well rested completely.
> 
> But these things always seem to facking do weird stuff in the long haul. So far I'm only noticing dry mouth.


Propranolol is the shiat cuz you still get the benefit of norepinephrine and focus that it provides through other receptors but you don't get the bad physical effects. Like I drink a butt load of coffee and im so focused but not anxious or jittery at all! I love this stuff!


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## riptide991 (Feb 1, 2012)

asfd is this thread broken? keeps saying my post is the last one but I don't see it.


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## adamaus (Mar 24, 2013)

why does my post keep getting deleted? I will ask again. Does Nardil kill your sex drive?


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## gilmourr (Nov 17, 2011)

Is my thread broken? I can't see the last page anymore


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## riptide991 (Feb 1, 2012)

Thread fixed!


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## gilmourr (Nov 17, 2011)

Lol, NARDIL LOG FINISHED.

Up next, Zoloft + Gabapentin + Abilify

Going to work my *** off to get Zoloft to work to get me in a functional state, if this doesn't work I'll probably give amitrip a round before trying ECT or DBS if there's a possibility I can get into one. Though I'm not sure I would be included since technically one AD (zoloft) can take away my major depression though it leaves me with moderate anhedonia or dysthymia or whatever makes you feel like you don't want to work/music basically sucks and everything is just kind of dull. Replaces suicidal thoughts with just being flat.


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## CD700 (Apr 22, 2010)

Those s/e for zoloft sounds like my depression
Don't want to do anything, nothing is enjoyable...
zoloft help your depression by giving you depression ? :S


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## yourfavestoner (Jan 14, 2010)

blakeyz said:


> Those s/e for zoloft sounds like my depression
> Don't want to do anything, nothing is enjoyable...
> zoloft help your depression by giving you depression ? :S


Well it at least dumps away the suicidal thoughts for gilmourr. That's substantial, though the ahedonia would suck ****ing dick.

Did you feel like you wanted to do the deed on Nardil or did it just make you think about it gilmourr?


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## gilmourr (Nov 17, 2011)

yourfavestoner said:


> Well it at least dumps away the suicidal thoughts for gilmourr. That's substantial, though the ahedonia would suck ****ing dick.
> 
> Did you feel like you wanted to do the deed on Nardil or did it just make you think about it gilmourr?


I'm not even sure if Nardil causes it after 40-50 days in or whether it just poops out and my old endogenous depression comes back in. But it causes suicidal thoughts almost all the time once it begins to poop out.

The good thing is once I go off it completely I actually feel a bit better for 2 weeks. Once 14 days hits being off of it, I crash like a mother ****ing boeing plane. It's ridiculous even worse, which is basically me unmedicated which is hell. It really is what I would define as hell. If I was always in THAT state I probably would've killed myself by now, or at least tried

I survived about 3 months of that somehow, basically up 24 hours a day just sitting up staring at a wall or out walking around my neighbourhood until morning because sometimes I couldn't be inside at night. It's almost like it made it worse. During the 90 days before I went on medication I would literally just wander my neighbourhood between 1-6 AM. Would frequently pool hop alone since the cold water would for a second snap me out of it.


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## adamaus (Mar 24, 2013)

does nardil kill your sex drive


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## crossfadex (May 17, 2008)

adamaus said:


> does nardil kill your sex drive


it doesn't completely kill it, no. At least, not as bad as Paxil did to me. It does lessen it by quite a big degree and, coupled with the practically complete inorgasmia, it doesn't seem worth it a lot of the times to even bother with sexual stuff. The inorgasmia does hugely lessen after quite some time on the drug but the sex drive still won't be as high as if you weren't on Nardil.

If Nardil is providing benefit, I'd highly suggest to push through the months of crappy sexual side effects. If not, try Parnate as it is said to not have the sexual side effects Nardil has and is a bit more activating. I just got off Nardil because I got nothing but weight and sexual side effects from it..pretty much the only 2 side effects (plus a bit of urine retention and farting fits) I got and received no positive benefit from the drug.

The perception on these forums seem to be that Nardil has a higher rate of efficacy. But after reading so many posts and through my experience, Nardil certainly doesn't work for everyone like I once foolishly believed. It may or may not work for you, it works in mysterious ways. It may work for you once, poop out and then never work again. It might not work for you the first time but it could the second time. Personally, I think Parnate might be better.


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## riptide991 (Feb 1, 2012)

gilmourr said:


> Lol, NARDIL LOG FINISHED.
> 
> Up next, Zoloft + Gabapentin + Abilify
> 
> Going to work my *** off to get Zoloft to work to get me in a functional state, if this doesn't work I'll probably give amitrip a round before trying ECT or DBS if there's a possibility I can get into one. Though I'm not sure I would be included since technically one AD (zoloft) can take away my major depression though it leaves me with moderate anhedonia or dysthymia or whatever makes you feel like you don't want to work/music basically sucks and everything is just kind of dull. Replaces suicidal thoughts with just being flat.


Clomipramine alone would destroy all 3 of those. And most people on askapatient notice it working within a week to 2 weeks.
Just saying.


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## gilmourr (Nov 17, 2011)

Maybe somewhere down the line.

I like Zoloft because I literally have no side effects except vivid dreams. The anhedonia/dysthymia stuff might just be from residual major depression, I don't know. 

It also doesn't affect my cognitive state like TCA's might because of mACh action. Zoloft seems like the smartest move atm if I'm focused on getting better by the fall.


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## riptide991 (Feb 1, 2012)

Did you read the reviews from patients that I posted in the other thread? A lot of them have tried many SSRIs and while some of the side effects like dry mouth are high, they do mention that they do not get the apathy and cognition problems like they did with SSRIs.

Anyways, it's obviously your decision, I was just nudging you 

I will be getting my clomipramine on June 29th. Will update when I do. Most of the reviews I read saw results within a week to 2 weeks so that's something for me to look forward to if I get any additional benefit from it.


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## gilmourr (Nov 17, 2011)

kehcorpz said:


> Did you read the reviews from patients that I posted in the other thread? A lot of them have tried many SSRIs and while some of the side effects like dry mouth are high, they do mention that they do not get the apathy and cognition problems like they did with SSRIs.
> 
> Anyways, it's obviously your decision, I was just nudging you
> 
> I will be getting my clomipramine on June 29th. Will update when I do. Most of the reviews I read saw results within a week to 2 weeks so that's something for me to look forward to if I get any additional benefit from it.


Yep, I read all of the reviews. I'm certain that because clomipramine isn't just a sole SRI that it doesn't cause as bad apathy issues as zoloft, which is why I'm thinking about abilify or nortryptiline to augment Zoloft with since one can affect dopamine while the other is a moderately potent NRI I believe (hopefully zoloft provides enough SRI to ward off bad NRI symptoms).

But yeah, let me know how it goes, TCA's do seem to work faster than SSRI's. Usually 2 weeks like you said and you'll notice something


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## riptide991 (Feb 1, 2012)

I would go with Zoloft + nortryptiline. This is similar to clomipramine in action. Clomipramine and Zoloft are very close in their SERT action. The thing is, if you get the abilify restlessness you may not enjoy that at all. I had it, it was pretty brutal at times, although it did get me off my *** to the gym. But If you want to sit down and read or do something that requires relaxation, it can drive you nuts.


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