Nine years on Nardil
I take an MAOI (Nardil) that does a marvelous job of alleviating chronic mild depression (a.k.a dysthymia) and social anxiety. Iíve been on it for over 9 years so I have a lot of experience with it.
I began taking it primarily to alleviate social anxiety. However, social anxiety and depression, in me, often seem to work in tandem, creating a vicious cycle which can make life very uncomfortable - and this dynamic duo had been putting me through the grinder for quite awhile.
When I first looked into medication treatments I began by trying a couple of the SSRIs. Unfortunately, they did little more than make me feel excessively wired, doing nothing for my SA whatsoever. After this, I became a bit more desperate and began digging deeper. In my research, I found material that spoke very positive things about the treatment of SA using MAOIs. I determined at that point, that if it was the last thing ever I did, I had to try it.
Unfortunately, the MAOIs are like the Desoxynģ (pharmaceutical methamphetamine occassionally used to treat ADHD) of anti-depressants. A ďlast lineĒ treatment. So lemmee tell ya - getting doctors to prescribe it is like pulling teeth. And this is a damned shame. As one psychiatrist put it, ďthe MAOIs are supremely effective anti-depressantsĒ. And when he says supremely, heís not being rhetorical.
So, I begged and pleaded - and pleaded and begged - with a couple of docs before landing a prescription. Once I got it, I had to wait a full six weeks (with fingers crossed) for it to work, but when it did - holey moley - the effect it had was astonishing. It vaporized my depression/social anxiety combo like a scrap ship around the perimeter of a south pacific nuclear test site. Finding Nardil was like finding the freakiní Grail. I found myself thinking things like ďFree at last! Free at last! Thank God Almighty, Iím free at last!Ē
Yessir, Nardil made a HUGE impression on me when I first took it. It energized me and allowed me to feel better than Iíd ever felt as an adult. Itís hard to describe in words what it was like to be able to go to parties and participate in things like play-acting games - to be able to let go, forget myself, act silly, and join in the fun. It was also awesome to have a group of friends throw me birthday parties for the first time in my life (because I actually had a group of friends to throw it.) And I could carry on conversations without feeling awkward, constantly thinking about myself, and wondering what to say. And it was great being able to go to job interviews without having my heart pound out of my chest, my palms sweat buckets, and my voice quaver.
As for me... I have an excellent tolerance of them - very minimal side effects. Less side-effects than I experienced with the SSRIs. At higher doses Nardil can even have a gentle soothing quality. (The increase in GABA?)
Another thing (and shhhh... donít tell anybody, especially my doctor) - but I eat whatever I want with impunity. Everything on the do not touch list - cheese, aged meats, chocolate, avacados, you name it. I discovered that I could do this by inadvertently eating a piece of cheese once. Realizing I had done this, I panicked a bit, then sat around waiting to die of a stroke. But, gee... no hypertensive reaction. Nothing. So I ate more cheese and still - nothing. After this experience, I gleefully put pizza back on the menu.
Over time, Iíve tried out all the other ďoff-limitĒ foods and noticed zero ill effects from any of them - with a couple exceptions: red wine gives me a very mild hypertensive reaction - and... at a fundraising event once, with *donated* beer, I drank half a glass from a keg that was flat and tasted slightly off. This, most definitely gave me a hypertensive reaction. (Tap beers apparently can be dangerous if thereís a buildup of fermentation.)
While foods are one thing, over-the-counter drugs are entirely another. A thoughtless moment found me swallowing a small cup of Nyquil when I was sick. I didnít check the label. Oops. It contains a number of ingredients that donít mix with MAOIs. Headache, lotsa sweating, and a noticeably increased heartrate were the result. I made it through o.k. - but the worst part is the anxiety - wondering if youíre going to, you know, die. Medical literature and doctors do their best to scare you - and this is doubtless for good reason. Not everyone is likely to tolerate them so well. (I read somewhere, that the actual number of people who have significant problems with food interactions are roughly 1 in 4. I also imagine that, if you are in poor health and at risk for stroke to begin with, an MAOI induced hypertensive reaction will break the camelís back.)
Iíve gone off my med a couple times in the past, feeling quite ďcuredĒ. But, sure enough, give it a couple months and there I am - lethargic, low energy, of mood most foul... and highly self-conscious around people once again. Totally bogus. A couple months of this and, forget it... Iím back on the meds. Like an ever valiant warrior, the MAOI charges back on the scene to subdue the twin spectres of depressed mood and social inhibition. What a champ!
I will add, however, that Nardil is not perfect. In and of itself, it wonít make your life a totally fabulous, all-the-time-happy bed of roses. Nor will it turn you into a ď10Ē on the social scale. And life will still have its vicissitudes. But it can very much assist you in finding a far more comfortable existence. Itís a boost. And, hopefully, the boost it gives will find you flowing into a better scene. Cuz, believe me, thereís nothing like a more extended social circuit to alleviate anxiety and quell depression. Thatís what youíre ultimately seeking. Increase your social circle, solidify friendships, and establish a sense of belonging - and youíll have found the worldís best anti-depressant. At least thatís been my experience.
Iíve kept Nardil around for 9 years because it continues to serve as buffer, boost, and brake. On really low maintenance doses it provides a bit of a buffer (Iím on a very low maintence dose about 90 - 95% of the time). When I need a boost, I boost it. And it most definitely will put the brakes on a more precipitous decline. This last aspect is actually one of itís nicer anxiety reducing effects. Just knowing that itís available and that it works, helps keep a lid on anxiety.
Anyway, thatís my word on Nardil after nine years. A++