Social Anxiety Support Forum banner

Nardil

103K views 243 replies 63 participants last post by  D'avjo 
#1 ·
Nardil - The Gold Standard for treatment of Social Anxiety

Nardil - The Gold Standard for treatment of Social Anxiety

I have been getting many question's about Nardil so I thought I would write a guide to getting and using this wonder drug

Is Nardil for me?
If you have have trialed various other treatments such as SSRI's, SNRI's TCA, etc. And you have tried CBT with no or minimal result.
If your Social anxiety is long standing and causing you significant distress
If your mature, responsible and prepared to make lifestyle changes such as limiting or ceasing alcohol and recreational drug use.
Then Nardil could well be the drug of choice for you

How do I get Nardil?
Doctors these days are very litigation conscious and risk adverse. Nardil is a medication with the potential for serious and deadly reactions and as such doctors are inclined to trial you on every drug under the sun before even considering a irreversible MAOI such as Nardil if at all. Many people have had great difficulty convincing their Doctor to give them Nardil for exactly these reasons so I will give you an outline of how to obtain a prescription

(1)

Approach your Doctor and lay it all on the table.

Tell them of all the treatments that you have tried and have failed. Do your research and speak about Nardil with authority, speak about your knowledge of medication and food interactions and give them some examples. Stay calm, If your acting highly distressed they are unlikely to prescribe it. What is likely will happen is that your doctor will want to trial you on yet another SSRI. You need to be prepared to compromise and negotiate. Ask your doctor if you trial it and it fails again would they be prepared to prescribe it. They are likely to give you a "we'll see" response. This is not good enough, Doctors will keep you going round and round for years if you will let them. Below I have listed the various things you need to discuss with your doctor. Such as:

How your life is currently severely restricted because of your SA

Your previous drug trials and failures

The amount of time it takes to start a new drug, wait for it to take effectiveness and then to taper off and wait for it to wash out again. This can be at least 4 months, most likely 6 months.

If your Doctor gives you an agreement that you can trial Nardil after trying one more drug, it may be reasonable to go with that. If however your doctor hums and ha's or refuses to give you a commitment, I suggest you find a new Doctor because that simply is not good enough. Doctors have an ethical and professional obligation to provide you with adequate treatment and if they are not providing that then you need to look elsewhere.

(2)
Scam it

Approach a Doctor that you have never seen before, tell them that you are from interstate or far out of the area. You need to tell them that you are visiting the area and forgot your medication and that you need a script. Say your on 3 tablets per day which is the starting dose. Most doctors won't ask too many questions and will give you a script for a limited supply. A good plan is to go to a late night medical centre so that they are unable to make a call to the fictitious Doctor who put you on the medication. Once you obtain the script and if you really understand all the indications and contraindications you may start taking them. I then advise you to find a new Doctor within 2 weeks and be up front about what you did. Tell them about your distress and desperation and that you are not in the habit of deceiving doctors. Tell them about how much better you are feeling (and you most likely will be) and ask if they can they manage your care or refer you to someone who can. Considering that you are already on the medication and are telling the Doctor that it is working well, they are likely to continue treating you with it. You need medical supervision. Do not go it alone.

I have got my Nardil, what now?

Ok, you have your Nardil, I am assuming that since you have gone to the effort of getting it that you have also gone to the effort of reading about the drug and food interactions, if not read it now!!
The literature states that it takes up to 4 weeks to take effect however I noticed improvement from the very first dose. For the first few weeks if your metabolism is anything like mine, you may notice a hypomanic effect. You will feel full of energy, talkative, lots of ideas and excitement. While this is somewhat pleasant after feeling like crap for so long, the best is yet to come. As time goes by the hypomania will ease and you will be left with a relaxed contented confident feeling. I had very severe long standing anxiety depression and social phobia. Within about 8 weeks of starting I had a 95% reduction in anxiety, a total absence of depression and can talk to people with ease. Sounds good huh? Read on, now I will bring you back to earth.
 
See less See more
#167 ·
i think there's quite a range of responses that could occur with phenelzine. i went down to 1 tablet (15mg) a day from 5 tablets, i did lose almost 10 lbs, but my blood pressure actually increased over the course of a month. it is well-known that apart from the food and medicine interactions, the general effect of the MAOIs (other than parnate) is to lower the blood pressure. one way to reduce the bloating may be to cut out salt from the diet, bloating may be edema (build-up of fluids in the body) and too much salt may make this worse. i dont tend to think that nardil works for SA for everyone, or more accurately, that its effect lasts. i have a friend/acquaintance who upped his dose to 120mg/day, it's pretty sad because it hardly helps him for SA anymore, and he's gained probably more than 50 lbs, almost entirely fat. overall i think a good maintenance dose might be just the standard 3-4 tablets a day, your body can get a tolerance to the appetite increase at a higher dose, so going down to this kind of dose might get rid of weight gain entirely for you. YMMV
 
#168 ·
Parnate has definitely made me more susceptible to edema - peripheral edema in particular. If my sleep is a bit off and I'm awake for long periods of time, BECAUSE I'm not lying down, the fluid doesn't drain properly and my feet swell like balloons and I develop cankles heh
 
#169 ·
after balttling through the side effects for so long I have realised that nardils main effect on me now is a numbing one. There is a certain sparkle of life that is missing.
My social anxiety is still improved and much so but man am I apathetic. All I do is work heaps because I dont care about anything.
I am still fat, 15kg weight gain that nothing will shift.
AAt the moment I have just started augmenting ith thyroxine 100mcg a day. Only been a week but already the same old story. Felt fantastic for a couple of days and then side effects.. irritability being the biggest one.
I wonder if it actually means that I am better....being angry that is.
The say depression is suppressed rage. Maybe I am feeling better so its coming out?
But then again, throxine is well known for causing this.
Bah, I hate this ****ty boring lonely pointless life. Optimism is stupid. Odds are I will die alone and unloved having gone through life constantly trying to avoid pain.
But hey, life is suffering right?
Welcome to my nardil update
 
#171 ·
You can drink alcohol on MAOI's, just not the ones with tyramine.
 
#176 ·
Phenelzine has also been linked to vitamin B6 deficiency. It reacts with vitamin B6 via an unknown enzyme to form a biologically inert metabolite. Both phenelzine and vitamin B6 are rendered inactive upon this reaction occurring.
For this reason, it is recommended to supplement with vitamin B6 while taking phenelzine. High doses of vitamin B6 may significantly lower phenelzine levels and subsequently inhibit its therapeutic benefits, however, and thus, excess quantities of vitamin B6 should be avoided.
 
#177 ·
The begining of the End

Since I started this thread I feel I should do what most dont and finish it, so people get the full picture

I am in the early stages of a crash withdrawl from Nardil.
Basically I am going from 5 a day to 1 per day and shortly thereafter zero.
Over the past 12 months Nardil has decreased more and more in effectivness. I have found myself moody and withdrawn and stuck working night shifts because I cant handle days.
and WEIGHT GAIN! I went from 76kg up to 92Kg. I have this huge gross looking distended belly that no ammount of exercise makes a difference to.
I have no energy, feel sad and while I am not having outright panic attacks, I am still nervous uncomfortable and have heaps of trouble being social.
My bowles dont funtion, the only way I can move them is to take 6 ducolax (standard dose is 2) every 3 days and just purge my system. Heaps of flatulance. Dizzyness, tiredness. I realised that I ave been in a depressed yet hypomanic state for months. Racing thoughts all the time. constantly worried about drug and food interactions.

But

Going back to no meds.. very very worried. Major panic attacks, flashbacks agorophobia, terribble depression, massive social phobia.
Its the only thing that helped. Every other time I try to stop my life just starts to fall apart. I lose friends, I risk losing my job. Lots of anger and frustration and misery.

I dont know if I can cope but Nardil has brought my life to a standstill. I want to meet a girl, but I hate my body, I have always kept very slim and fit so having this gut is so depressing. It makes me look like a slob.
I want to find somewhere new to live but the change could tip me over the edge.

So anyway, this is kind of day one. I feel ok except for the electric shocks when I move my eyes. Typical antidepressant withdrawl stuff.

After day 3...thats what I am worried about. I am scared for my own safety. I just lose it, become paranoid, hypersensitive, angry and depressed.
I guess I am writing this as a precurser to a post that may come later, while I am still able to be objective and rational.

Wish me luck
 
#178 ·
Day 3

I have been having terrible horific nightmares. It is like someone has delved deap into my subconcious and found all my fears, all my failures and miserys and hang ups and written a script to include them all in one story line. I didnt dream on Nardil, now the dreams are not only horrific, they are vivid as hell too. I wake covered in sweat and panting for breath then I go back to sleep and straight back into the same nightmare!!

I have also been getting electric shocks, out of control electric shocks every time I move my eyeballs or even my body. One a second pretty much.
I had to start taking nardil again, one in the day to stop the shocks, and one at night to stop the nightmares.

Almost a year ago I broke up with my girlfriend. It was an unhappy relationship from start to finish, we were together for a year or so and I cut contact completely shortly after starting nardil. Completely because we would always get back together and go through it over and over again.
For the past year I have been working night shifts - 60+ hours a week.
Now that I have stopped working so much and stopped the nardil its like all the grief I shut off through excessive work and nardil is coming out. I have been missing her like crazy, crying over her. It is ****ed up because I wasnt happy at all and I was relived for both of us when I cut ties but here I am in a state over her. It probably has to do with finding out she has a new boyfriend too.

I have lived so much of my life as basically a shut in. No ammount of exposure eases the anxiety. No ammount of healthy living lifts my mood enough to make me go out and enjoy life.
I hate myself, I never stop trying to be better than I am but the core me... My moods, paranoia, hypersensitivity, overwhelming sadness..my maddness..all stay the same
Through all this I can see that I am a good guy. But I just keep the whole world at arms length. It is scary, it hurts, its boring and understimulating and stifling and arduous.


So here I am, day 3.
 
#179 ·
5 Days

Still on 2 tablets a day, electric shocks reducing.

3kg weight loss. Fluids. I always said it was fluids

Food intake down

Profound feelings of loneliness. I contacted my ex- girlfriend who I havnt spoken to since we broke up asking her for her support... I have nobody else.

Feel like crying much of the time

Feel slowed down. Mind and body.

Feel hopeless.

Not feeling anything good bout myself

No panic attacks yet

Social anxiety slightly worse

No paranoia yet

No OCD yet

Thoughts of death but not suicide.

I feel terrible. To come off the last 30mg a day... Whats going to happen to me?
Why am I like this anyway?
I feel like my whole life is wrong. I cant escape, I cant overcome this. Its the end of the road. Nobody knows me, I wont..cant let anybody in.
So very lonely
 
#180 ·
Today - Day 6
Zaps are decreasing, havnt dosed today, will take just one tonight at bed to stop the nightmares. I am not as bad as yesterday but still very low.
Woke up this morning realising I had contacted my ex and freaked out. Have a just opened up a huge can of worms..can I cope with seeing her again?

I go past parks and see couples in them and just start crying. It is stupid because she made my life a nightmare...but I still loved her...and I still miss her.

It hits me so hard I feel like I am going to vomit.

Scary thing is, I know I am not much different from this when I am unmedicated without any withdrawls. I just seem to be constantly lonely, constantly grieving..my lost loves...my lost life
 
#181 ·
Damn dude i hope you start feeling better soon.

Trust me this is not the end of the road, you CAN overcome your issues.
 
#182 ·
I don't know what you've tried before, but I would stay on nardil. Go down to one or two pills a day. You can lose the weight easily. Exercise. Then go back up and watch your weight and food intake, you CAN manage the weight.

You may need more NE...i've read long term maoi users sometimes have NE depletion. Try to get Noritryptiline or other SNRI... it might balance everything out.

Good luck
 
#183 ·
Nardil is junk now. I took it for a year and after 2-3 months I felt it get weaker and weaker and then eventually poop out. The reforumation they did to the drug back in 2003 made the drug much worse, and dont forget the weight gain, you'll wind up with a big belly i promise you no matter how hard you work out at the gym. Trust me

Nardil is junk now.
 
#184 ·
Zendog - this is tough to read, man. But definitely keep recording your experience here as a journal. It may be helpful for others who come across it or for you yourself when you're looking back at why you quit and what the withdrawal was like.

I've found when starting/stopping SSRIs or MAOIs your emotions can roller-coaster. Sometimes this has made be dwell on exes more than was healthy. I eventually realized it was the meds, and my emotions normalized.

For the nightmares, maybe you'll sleep better with a sedative. Don't get dependant, but you could probably take something temporarily like Valerian Root or Klonopin.

I never thought I could come off meds, and might still be on them if family & conditions hadn't pushed me off. While I still have some SA and some things are tough on a daily basis, I am pushing myself and will say I'm doing things now I never thought I could do off of meds. I'm doing a better job of rationalizing this SA away.

BTW someone else has this vid in their sig, I watched it recently, and I think there's promise in gradually attenuating SA through exposure and other therapies:

Good luck and keep posting.
 
#186 ·
if you read some of crazymeds posts on MAOI's you'll see that you should probably add Nardil to your Ritalin experience. I've used and abused Ritalin for years along with most all anti-depressants but I too was warned away from stimulants with the maoi's. the ssri's are emotion flatteners for many. not so with the maoi's.
 
#187 ·
I had a similar experience as Zendog's. I'll write about it tomorrow.

Listen, Zendog. It seems you are going throgh a similar hell as I did. Things will get better. Nardil discontinuation is heavy ****, but . I recommend you get some temporary medication for the first months. I used some benzos and 25mg Seroquel for proper sleep. I'll try to write my story tomorrow.
 
#188 ·
My experience is similar to Zendog's. I used Nardil for about 2 years. Dose ranging from 30-90mgs daily. At first it was like all the pieces of my life came together and that I had finally found the solution to all my problems. After about a year things startet to be less stable and I started to mess with the dose, going from 60 to 90mg. This helped for a while but after a month or so things started going downhill again. I consulted my psychiatrist and got a prescription for Lyrica, starting at 150mg a day and ending up at 600mg a day due to tolerance issues. This worked for a while but after a couple of months Lyrica lost its effect and I was even more screwed than before. Let me tell you this; coming off Lyrica when on Nardil was hell for me. I had never been closer to suicide. I was planning to keep this short so let's skip to the ending. Nardil was not working anymore, I was back to my baseline even though I was on 75mgs a day. All the terrible side-effects was still there though(I won't get into all the side-effects in this post). So, I decided to taper off it.
So far this is the hardest thing I've had to do. This is about 5 months ago now. I still feel like ****, but I'm slightly better now. Suicide thoughts is still a daily problem, but they are not as severe as they used to be. Now i use 50mgs of Seroquel each night for sleep and that's it. I am going to see my psychiatrist next friday, but I have no idea what to ask for. I feel like I'm out of options and think I might have to cope with my depression and SA without meds.
 
#189 ·
Day 12

I am now on one tablet every other day at night. One thing that has suprised me is that I have had no reoccurence of the panic and anxiety symptoms that I originally started taking the drug for.. I mean, you can see my discription of what I was like at the start of this thread..I was incapacitated by it so this is a real suprise.
Depression though is a constant and it may be that which is protecting me from the anxiety.
I have been hitting the piss hard the past 2 friday nights, it is really disturbing my sleep and sending my depression way up. It is getting not worth it to drink anymore.
I had a fight with my house mate just before I started cutting down on the nardil. She was being ***** and I got very very upset. I am really holding a grudge about it...even though it is probably going to hurt me more than her.
I knew it was time to move on from where I am living but now I am free of nardil I really see it and am trying to be more pro-active in finding somewhere.
I have basically cut myself off from the people I live with....and I feel fine about it for the most part. In a way I was using them as a substitute for going out and getting a life. I have gotten back into the guitar and learned 3 songs this afternoon. On Nardil I couldnt really progress at all.

Even though I am depressed, I am feeling so much more. I feel the beauty in a rainy or sunny day, in art, my emotions are hyper responsive. I get teary over news articles with any emotional content good or bad.
Much of the anger I was feeling seems to have gone. Still getting nightmares but not so severe.
At my request and after showing my GP a section in my medical journal I bought "treatment resistant mood disorders"
http://books.google.com.au/books?id...&resnum=5&ved=0CD4Q6AEwBA#v=onepage&q&f=false
He has started me on a calcium channel blocker as a mood stabilizer.
I asked for this because I was becoming so angry, really raging about stuff in my head. I dont know if it is the CCB or something else but those feelings have gone now and I feel much more settled.

I also have a script for Tegretol but have to wait till I am off the nardil suprisingly due to possible interaction. I will see how I go, would prefer not to take it.

I have some valium sitting at home, I have taken it once during this withdrawl when I was literally going out of my mind. I am avoiding it because I dont want any rebound symptoms complicating what is the withdrawl and what is a return of my symptoms.
I am taking melatonin for sleep. Seraquel works awesome but at only 25mg at night I put on stacks of weight over 6 weeks. And! I have never had any psychotic symptoms in my life but when I took seraquel I HEARD voices. It was freaking scarcy

I am for the most part keeping up on going out for runs. I trained doing martial arts on Nardil but it was a suprime effort of will to get me out there. I have had to stop going for the past 2 weeks as the brain zaps made it impossible.
Anyway, Now I am naturally inclined to go for a run whereas on Nardil I felt so sluggish and bloated and lacking in energy.
The big distended Nardil belly is gone. I am still fat and have a belly, but the grotesque cancer patient look is gone now much to my relief. I have dropped a solid 3kg (9lbs) in the past 12 days. I am still hungry but it is easy to ignore now.
Anyway, this is all pretty boring I guess. But boring is ok considering what the alternative could be :)
 
#191 ·
Definetly not! Its amazing the simple pleasure of normal bowel movements.

What to say..

20 days since I started tapering down, still on one tablet every other day.
Battling depression more than anything else. Feel very down.
I work night shifts and the change over from my days on to off is definetly making it worse. Add in a few drinks and it exacibates it even more.
Alcohol pretty much just makes me sad now.
Thinking about my ex a lot, find myself disecting the relationship, what went wrong etc etc.
Lost pretty much all interest in being social, spending a lot of time isolating in my room...not out of anxiety, just because it is just hard...like it takes so much energy.

Feeling the beginings of SA start to creep back in which is ****...somehow the depression is protective I am sure.

On the plus side, I am starting to get comments on my weight loss. The scales only say about 3kg but even to myself I can see a massive difference. Its like I am just not so puffy and bloated anymore.
Been jogging most days as well.

When I was on nardil I was obsessed with food, my whole life was centred around food while on nardil. I was hungry all the time, wake up in the middle of the night hungry and in the morning ravonious.
I kept away from junk and for a long while exercised to extreeme, but the sheer volume of food I was eating meant my weight was always inching up.
Even at 7000kj day it still went up.
The only thing that stopped it was 2000mg of metformin a day (Im not a diabetic). It stopped the ravionious, sick with hunger feelings and reduced my intake but still couldnt lose weight.
I find hunger very easy to ignore now that I am off it and find eating to be somewhat of a chore which is how I have always been. Nardil made food very drug like, it certainly gave me more sympathy for people who chronically overeat having experienced this.

I was also drinking huge ammounts of tea and coffee (without sugar) which has also dropped back to normal ammounts and it is probably worth mentioning that I was also getting peripheral neuropathy in both feet while on nardil that has already cleared up.

In a nutshell, looking back on Nardil at the moment:

Positive:
I think I needed it at the time. Things were really rough.
It let me escape from a bad relationship
It gave me the strength to work huge hours and get my finances in order.
It helped me build and repair some relationships

Negative:

The obscene ammount of side effects getting on it. (first 5 months)
Severe Postural hypertension,
total sexual dysfuntion,
fatigue,
urinry retention (I had to catherterise myself more than once)

Highly troublesome side effects staying on it

Dosing every 4 hours
Timing dose to avoid fatigue at important times
Constant worry about food and drug interactions
Reducing effectivness
Numbing of emotions (quite unlike ssris)
Weight gain
HUNGER
Insomnia
peripheral neuropathy
Impared judgement
Impared reflex's
Constant chronic constipation
Bloating

The list goes on..

I will only make one more update on this thread. Say in a month from now. To drag it on any longer seems to defeat the purpose as it is hard to tell the difference between withdrawl and the return of my symptoms.

Thanks for reading
 
#192 ·
This is a good thread. I've been considering trying to get myself on phenelzine, but the generally immense side effects and many dangerous food/drug interactions are daunting. I think I'll just wimp out and try something else.
 
#193 ·
Since my last post I got on agomeletine and it got me off nardil. It works really well for depression, I highly recommend it.
It even helps somewhat with anxiety and social phobia. It is a good drug, not mind blowingly strong, but few if any side effects.

However not good enough... I have been getting ocd like behaviours...really socially debilitating ones that I am too embarrassed to even disclose.
My Doctor thinks it could be a tic as in tourettes. I think he could be onto something

I was struggling along and then my doc put me on abilify 2.5mg. Initially it worked great, way less anxiety, my thoughts slowed right down. But It gradually intensified the tic/ocd thing to the point to where it felt like being hit by a hammer rather than nudged in the ribs to perform this..tic.

Then I got seriously assaulted by some junkie.

I moved house and have new house mates...everything went downhill..my mental state was threatening to ruin everything...

So I filled an old script for nardil.

I have taken my first dose... on top of clonadine and agomeletine. I had a headache and I am reminded of the fear I got every time I had a headache on nardil. Pulse dropped to 50...blood pressure was ok though (have my own machine..essemtial when you take a maoi I think)
I should have let it wash out for a day
However after a sleep I have woken up and the compulsion is reduced like 90% even now several hours after that one dose.
My thoughts have calmed down.
I feel sane.

I look back on the past few months and realise... I have been in pain.
Such intense emotional anguish...almost constantly.
Constant worry about everything and with the OCD thing, so much energy demoted to holding my head together...to fighting it.

I have been suffering so much and it was so constant that it had become normal.
Now that its gone... I dunno, the only analogy that describes it is suddenly being without pain.

Not being scared to leave my bedroom, to come home, to go to class's I do.
Everything is clear, my mind is not racing with a million thoughts all unfinished.

I do feel kinda spaced out, I think it's the same attention problems I had before just without the racing random thoughts.

I can't help but feel a bit sad though, because I know I am going to go through all these side effects again.

Can I live with this drug...can I live without it?

Talk about a rock and a hard place.

I have some idea's though that hopefully my psychiatrist will go along with.

Clonadine potentiates nardil. It is also a hypotensive agent which compicates things. Maybe a small dose at night will let me get by on a smaller dose.

Dexamphetamine potentiates nardil. It is also a very hazardous mix. I also was once addicted to dexampetamine so I know I could never be trusted to have a bottle of them.
So maybe a very low dose say 1mg per 15mg of nardil compounded in a long acting formulation...I think it could work.

Anyway. Again, if your suffering, I would suggest giving agomeletine a try, if it wasn't for the ocd thing the abilify seemed to compliment it nicely. Clonazepam also does but it is a dirty unpleasant life denying drug in anything but very small doses.

Also What has helped me is to remember the 4 noble truths, http://www.4truths.com/ but I am not going to preach to you.

I will update this no doubt. Best wish's to all of you and keep fighting the good fight.

Zen
 
#194 ·
zendog, I remember reading this post last year. It helped me when I was starting just starting out. It has a lot of good information. Thanks and good luck! :)

I've been on Nardil about 5-6 months. It took two months before I remember being able to feel better. It's helped mostly with my depressive symptoms, but also helps reduce my generalized anxiety disorder mental issues (worrying, procrastination). Nardil hasn't helped reduce my SA symptoms at all! :( I was thinking of adding Lyrica to reduce the physical pain and anxiety from GAD/SAD.

The side effects do really suck, but for me I kind of feel like the med is worth it in the end. I think I'll stay on it for a while.

This looks like a good diet/med guide for Nardil that I found here. I saw it on Crazymeds forum. Of course consult your doctor first, before trying any food or medicine! ;)
 
#195 ·
Thank you Nardil! The socially crippling tic/ocd thing is gone or almost gone as of today. I have just been pounding high dosages ie. 90mg/day into myself to get my levels up and it has worked.
I forgot how life can be enjoyable. I may have to face up to the fact that Nardil and I are bound for life.
Whenever the side effects get overwhelming and I stop taking it I forgot what the alternative is. Horrendous suffering. It is a type of madness to be so twisted with anxiety.
I am going to get fat, sexually dysfunctional, lethargic and all the rest.. but I need this drug. There is nothing else that comes close. Nothing that comes within a mile of how ok Nardil makes me feel.
 
This is an older thread, you may not receive a response, and could be reviving an old thread. Please consider creating a new thread.
Top