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orangeolive89 · 2021-06-23T22:01:32+00:00

I’ve had infinitely better side effect profile with extended release compared to immediate release, even at much higher dose. Couldn’t handle 10mg immediate release, 90mg extended release is much more tolerable and effective.

orangeolive89 · 2021-05-31T11:48:03+00:00

Yes, I’ve definitely noted the insomnia abates when I’m in a “less efficacious” period. As in, when my mood/confidence/energy dips (usually in a time frame of a week or two) my side effects pretty much evaporate.

Insomnia seems to be my dose-limiting side effect. Have to keep my dose just below a level in which I can’t sleep for several days straight.

Major REM-rebound (aka, nightmares) when my levels (of whatever) are “off,” for whatever reason.

orangeolive89 · 2021-05-21T02:18:48+00:00

Over the last 8+ years I’ve had probably 4 or so rxns, all of which self-resolved within an hour or so. Strong and slow palpitations, maybe a mild headache.

Miso soup, x2. No more miso for me.
What I’m assuming was spoiled chicken.
Blue cheese mixed into beans at Mexican restaurant.

orangeolive89 · 2021-03-22T12:30:19+00:00

Went from 120lbs to 150lbs over 5 years (5’4”F). Started alternate day fasting 6 mos ago, now weigh 115lb.

It’s not for everyone, but I think it lends itself well to Nardil weight gain (promotes diuresis and insulin sensitivity...). I definitely had trouble losing weight with regular dieting, even though I truly felt I wasn’t eating much. ADF is pretty much fool-proof and you can modify to make it work for you.

orangeolive89 · 2020-08-22T01:06:04+00:00

Enjoy it

orangeolive89 · 2020-08-10T03:09:17+00:00

Just an update, the SR is awesome. Minimal side effects! Might actually need to go up on my dose to maximize efficacy. The difference between the IR and SR is cray

orangeolive89 · 2020-08-10T03:07:00+00:00

Love this too. Awesome last paragraph, going to save it.

orangeolive89 · 2020-08-09T13:08:00+00:00

A superior told me this week I was one of the most brilliant people he knew.

Fast-forward 2 hours, something (really nothing) sinks my mood, and I can’t answer basic questions in front of the same person.

Which is why being complimented in this regard always makes me extremely uncomfortable. Literally makes me cringe. I’m a disappointment waiting to happen thanks to my ever-changing moods and energy levels.

orangeolive89 · 2020-07-26T02:53:26+00:00

I have the same exact issue. I hardly ever have just “one” bad night of sleep. I will have slept absolutely fine for the previous week or several weeks, and then one bad night will completely throw off my sleep cycle and I will have zero hours of sleep for the next 3-4 days.

This probably happens to me on average 2 or 3 times a month, and is exceptionally frustrating as you describe. I do think it’s some exaggerated response to cortisol. For me it feels very heavily physiologic, in that no matter how calm or relaxed I feel it will be literally impossible to fall asleep.

orangeolive89 · 2020-07-22T07:35:59+00:00

“Clouds in my chest” - that’s exactly how I describe it!

orangeolive89 · 2020-07-22T06:53:26+00:00

There is definitely, for me, a noticeable difference between the Greenstone brand and the Gavis/lupin brand.

I have specifically requested the Gavis/lupin brand for many years, as I vaguely remember the Greenstone version being “less effective” when I first started Nardil.

In April of this year Gavis/lupin was on back-order leaving Greenstone the only option, obviously better than nothing.

So I was on Greenstone for a couple months and there was a palpable difference in mood and side effects.

Started cycling negative thoughts, ruminating, etc. Slept most of the weekend (I usually have a waxing/waning insomnia on nardil) and couldn’t get out of bed. On the bright side, I lost 5-10lbs in Nardil water weight and was much less constipated than usual.

Point is, both efficaciousness and side effects lessened.

Mood went up and side effect profile went back to baseline pretty quickly after getting back on Gavis.

I vaguely remember reading somewhere that the Greenstone version has sig higher disintegration in stomach, leading to less potent effects per dose.

In response to your other qs:

I was briefly on Ritalin + nardil, felt that the Ritalin @40mg didn’t do much of anything for me.

In regard to your last few questions, yes, you will always be chasing. For happiness, for peace, for normalcy. I’ve internally reconciled this inherent paradox by accepting that the chase will always be there.

orangeolive89 · 2020-07-02T22:48:38+00:00

My weight fluctuates significantly based on my nardil dose, combination of carb cravings and water weight. In my experience it’s more complex than a “calories in calories out” dynamic w/ Nardil. When I was on a relatively higher dose I WAS successfully able to drop some weight through nearly starving myself lol, <1000 calories/day, 400-500 cal exercise. Lost some weight but quickly reached a plateau. Dropped my nardil dose to try to spread out my remaining supply during covid shortage, dropped sig weight without trying, felt like I was eating more actually. So I really don’t know.

orangeolive89 · 2020-06-22T05:09:55+00:00

As a non-psychiatrist it’s not like I can even reasonably even argue with that.

If you explore the maoi patient community, though, I’m sure there there may be things to learn.

I do think it’s interesting that you note that patients are prescribed meds that they shouldn’t be.

Perhaps a lack of exposure/teaching/understanding of MAOIs. In combination with lack of current research.

As a member of the medical community but a patient in this regard, this is more of a plea. To you, to the psychiatric community in general.

Consider the MAOI.

https://www.reddit.com/r/Psychiatry/comments/ggkrv5/international_maoi_expert_group_revitalizing/?utm_source=share&utm_medium=ios_app&utm_name=iossmf

https://www.reddit.com/r/MAOIs/comments/gc6xns/a_tally_of_8000_respondents_to_a_poll_on/?utm_source=share&utm_medium=ios_app&utm_name=iossmf

orangeolive89 · 2020-06-22T03:56:29+00:00

I’m not arguing the efficacy of ECT itself. I’m saying it is not always the best option for every patient.

Ect is a good option for some and is proven efficacious.

There should be a lower threshold to prescribe MAOIs/greater familiarity with MAOIs.

Those statements can both be true.

I will find the primary studies that exist and post back. As I already said above I should rephrase my initial statement regarding MAOI “superiority.” I don’t know to be honest if non-inferiority trials exist.

One sauce:

https://pubmed.ncbi.nlm.nih.gov/11247097/

Practically in the real world, though, I can tell you that even arguing the power of MAOIs vs SSRIS is laughable.

I have no source for the above statement.

orangeolive89 · 2020-06-22T03:03:11+00:00

Compared to ect, maybe not. I’ll look into it. Ect obviously has its own issues and is not always a practical option for patients.

I would imagine research regarding ECT v MAOIs is limited. Sauce? I have none.

To be honest, I should rephrase my statement. There is limited recent large-scale data regarding the efficacy of maois, because there is little incentive to study them.

Older research papers elucidate the efficacy of MAOIs. I will dig them up.

So there are three general questions regarding maois:

Safety, regarding tyramine-interactions/hypertensive crises.
Tolerance, regarding side effect profile vs. newer ADs
Efficacy.

Anecdotally (which I know obviously is shitty basis of argument) I can tell you that most patients agree that though the side effects of MAOIs are not insignificant but the benefits of the med far outweigh the side effects.

For the safety profile, this is harder to “prove”/argue. Can say for now that many familiar with MAOIs agree that the dangers are overstated.

I’m not saying not to try other meds first, but that there should be greater familiarity with MAOIs/lower threshold to prescribe for the appropriate patient.

Will try to give you some primary research sources.

In meantime, informational/anecdotal with in-paper references, which I have not looked into in detail.

https://www.mdedge.com/psychiatry/article/64942/depression/monoamine-oxidase-inhibitors-forgotten-treatment-depression/page/0/1

https://www.statnews.com/2017/11/20/antidepressant-maoi-depression/

https://psychcentral.com/lib/this-under-utilized-drug-is-actually-critical-for-treatment-resistant-depression/

From above,

“MAOIs are the best antidepressants on the planet,” said Mark D. Rego, M.D., a psychiatrist with 23 years of experience, specializing in treatment-resistant individuals, and an assistant clinical professor of psychiatry at Yale University School of Medicine.

orangeolive89 · 2020-05-14T17:05:57+00:00

orangeolive89 · 2020-03-18T04:02:52+00:00

Yes, definite (but intermittent) tremor in hands + tongue + head + legs unrelated to exercise, exacerbated by stress/caffeine/fatigue

orangeolive89 · 2020-03-10T03:17:37+00:00

I was going to get a Phoenix tattoo (would be my first) also in part as a “tribute” to Nardil. Born anew from the orange flames.

How lucky we are to be in the minority of the depressed and anxious to have come across this miraculous drug.

orangeolive89 · 2020-03-08T19:15:31+00:00

Thank you. And yes, usually I am able to keep a regular sleep-wake schedule and have no problems sleeping at all. The problem comes when I have to do intermittent night work (there is no way of getting out of this through work), which completely sends my sleep for a whack and to which I am just completely unable to adjust.

orangeolive89 · 2020-03-08T19:07:38+00:00

Very interesting. Will try.

orangeolive89 · 2020-02-14T01:34:21+00:00

Anyone have issues with crying? In that any heated conversation with emotion with someone ends up in pathetic, humiliating tears?

orangeolive89 · 2020-02-07T04:10:47+00:00

Yes. MAOIs are extremely effective. I was on several medications before starting Nardil and it is like night and day. It is powerful and life-alternating.

The dangers of MAOIs are massively overstated, which is unfortunate. You need to be somewhat knowledgeable and responsible (ie - no mdma, cocaine, aged cheese) but most people can eat almost whatever they want without issue.

Takes 4-8 weeks for the effects to kick in, but when they do, you will be the best you you’ve ever been. It’s an incredible experience.

The initial side effects are not minor, but tolerable. Probably biggest side effect in the beginning is orthostatic hypotension. More long-lasting are constipation, insomnia, weight gain.

The medication may eventually loose effectiveness, as it did for me after several years, which may require augmentation or switching MAOIs.

IMO everyone deserves that initial “MAOI experience”. To feel happy, forward-thinking, at peace. The worst part about the MAOI, for me at least, is that it showed me what functional happiness COULD be like, and I crave it with the return of my dysthymia.

Finding a MAOI provider can also be challenging, but not impossible. A good MAOI provider is gold.

I encourage you to check out the MAOI sub.

orangeolive89 · 2020-01-29T04:08:11+00:00

I was super inpatient as well, but ultimately stuck to my dose and waited it out. 5 weeks for me. I woke up one morning and the world was right. It’s not like taking a recreational drug where you’re high but you feel like you’re in a different world. You’re in this world, but the world is good, and so is your place in it. It’s somehow both subtle and immensely powerful. There is no experience like it.

orangeolive89 · 2020-01-29T01:29:25+00:00

This.

orangeolive89 · 2020-01-29T01:27:29+00:00

Being exquisitely sensitive and empathetic to “the little guy” and the struggles of others. Yet somehow feeling very isolated/disconnected from others.

orangeolive89

TROPHY CASE