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Weaning from MAOI antidepressants

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I am wondering if anyone has had experience coming off MAOI antidepressants after long term use. I am currently weaning from Nardil (with medical supervision) but am having a really hard time. I am very sick with physical withdrawal symptoms.
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First Helper lesdeusexmachinas
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replied June 13th, 2009
Experienced User
Maybe you could take some vitamins. It help some. Try fish oil supplements. I have not experienced that, but I did experience alot of irritability when coming off Xanax. It went away after a while though. Can you lower the dose? Try taking a little, and lessen the dose as the days go by. It will be alot easier for you that way.
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replied June 29th, 2009
I was on Nardil for 18 years and had to wean off it starting Nov, 2008. I was taking 60mg when started weaning, but my doc had me titrating too fast (1 pill every 2 weeks) so by the time I got to 2 pills a day, I was experiencing extreme anxiety and fear. We increased it to 3 pills a day and stayed on that for 2 months when started to wean off again, this time 1/2 a pill a week. I have been completely off Nardil since March 2, 2009, and I am STILL sick! I have been nauseaous for 6 months, obviously, making it hard for me to eat much. I've lost 45lbs (though I did need to loose it - just not that way!). The nerves in my feet are screwed up and extra sensative, and I generally feel unwell. I have not been able to work since March and every time I've tried to get on a new anti depressant (with doctor) I have to stop because it makes me more sick. I'm presently trying Emsam (MAOI Patch) but have only been on it for 1 week today, but this past week has been one of the worse.

I don't know at what stage you are at weaning off Nardil or if you are completely off, but if you are not, I would highly reccommend that you wean the rest of the way VERY slowly! I read where someone actually cut back 1/4 pill every two weeks and it took him a year to get completely off the med! But he didn't experience the horrible effects of going off it! I'm getting so discouraged and depressed being sick this long that I'm wondering if I have to go back on Nardil to stop the cycle and then re-wean off it again, but this time much slower. Only problem with that is I'm afraid it wouldn't work and I'd have to start all over!

I hope that you don't have to (or haven't had to) suffer like I and others have upon going off Nardil. I am almost certain that it's because of the formulary change in 2003. I weaned off Nardil at least 2 times prior to this time before 2003 without any problems!
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replied September 10th, 2015
i have been on Maoi for 53 years and my phschiatrist says wean them off to 2 then to 1 to nil ,i havewithdrawal stytoms now,cannot contact the phschitrist,help me,please.
b.s.grocock.
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replied June 30th, 2009
At my highest dose, I was at 90 mg per day. I was weaned in hospital a little over 2 years ago...much too quickly...and got very, very sick. The nardil was reintroduced to 75 mg. I took a few months for the nausea to disappear completely but it did.

This time I reduced my daily dose by 15 mg per week. I did ok till I got down to 30 mg and then got sick again. I tried to ride it out but after no change in about 3 weeks I reincreased the nardil. I got back to 60 mg. before I started to feel any better. That was 2 months ago. I'm much better but still struggling with mild nausea. When the nausea completely resolves I will begin weaning again.

This time I intend to wean, not based on DAILY dose, but on WEEKLY dose. At 60 mg/day I'm taking 420 mg
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replied May 3rd, 2015
Has this worked for you Jazzfan?
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replied June 30th, 2009
...cont per week. My first reduction will be to 405/ mg per week. I will take 4 pills on six days and 3 pills on one day. I hope to continue reducing by 15 mg from the total weekly dose every week until I'm completely off. IF this goes as planned, It will take me 28 weeks to get off.

Thanks for sharing your experience. There is a definate consensus that the newer formulation is far more addictive than the one we started taking back in the 80's.
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replied June 30th, 2009
Wow, this "new nardil" sure messes with the body! I wish you the best when you try going off it again. If my docs put me back on it to get rid of the nausea, I plan on weaning of SUPER SLOW - like reducing by 1/4 a pill every 2-3 weeks! IT may take a while, but at least I shouldn't get sick. However, at this point, my doctor doesn't want me to go back on Nardil becasue she doesn't want me to have to go through the withdrawal process again. SO far today has been the first day where I've actually been able to eat without nausea in 6 months! Maybe it's starting to go away on its own - though I hate to say that out loud, you know? lol
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replied July 19th, 2009
It's so nice to talk about weaning off MAOI with knowledgeable people. My psychiatrist knows nothing about MAOI's - I told him I had success back in the 80's with nardil (now on Parnate) and he prescribed it to me. Nothing else works for me. Does anyone know if, like nardil, parnate has a different formula?

I increased my normal dosage because my doctor, like all of theem, insisted I get off a high valium dosage. As I increased the parnate dosage, which my doctor had no problem doing, it really helped me wean off valium. Now I'm on 70 mg a day and its effecting my memory (I've never seen that as a side effect of MAOI's - am I the only one?)

SO now, I want to wean myself off Parnate...of course I have to figure this out myself since my doctor doesn't know crap. I'm starting off by taking 1 mg. less per day, then if I get depressed during the day, I take 1/2 mg at that time. For some reason, parnate acts really fast on me, almost like aspirin, and it helps, but I've noticed it also sedates me too much during the day. If I wean myself off normally, I get depressed - again a symptom I haven't read about in people. I'm feeling nausea as well and less appetite. I did recently notice that.

I've heard the longer you're on it, and the higher the dose, the more difficult it is to wean yourself off. I've been on it for about a year and a half, steadily increasing my dose to 90 mg. at the max though I had almost no short term memory and had to quickly decrease it. In the 80's I took nardil, about 30 mg for two years. As I recall, it lost its effectiveness so I stopped. But is was not a problem to wean off of at all.

When I take parnate at night, I get wired--it effects my sleep, another reason to get off it. Again, my doctor is clueless...anyone else get this?

Anyway, I'm glad I found this forum. Please feel free to private message me here. It would be nice to be in touch with other MAOI users trying to wean themselves off it.
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replied June 2nd, 2012
Parnate withdrawl
I've been on parnate (100 mg./day) for 13 years. I take it all first thing in the morning to give me a fighting chance at a good night's sleep. My shrink prescribed a sleeping pill for those nights I absolutely had to get a good night's sleep. I recently decided to taper or get off the meds entirely. I'm now at 70 mg./day..about 10 mg. reduction every 45 days or so.
For the first few days after reducing the dosage, I feel more depressed and weepy. After that my body seems to get used to the new dosage. I sleep better and feel better at organizational skills.
These changes have not been a product of just reducing my parnate input. To compensate for the decrease of medical activity I have been actively building my body through yoga, visits to the Y 3 times per week, and extended use of my bicycle for basic transportation.
I certainly sleep better. I fall asleep very quickly and earlier. I still get up several times during the night, but prefer to back to sleep after a visit to the washroom or a quick bite.
I think you are reducing far too fast. Try 10 mg/ week or every 2 weeks. Your body has developed a chemical dependence on parnate and would have trouble self-producing so quickly.
What supports do you have to fill the gap? Do you have friends you can lean on during the difficult period ahead? Support groups? A sympathetic shrink? If not, I wouldn't go it alone. Surround yourself in symathetic people and activities that will not overly-tax you, but still give you a positive sense of accomplishment.
Best of luck,
Lorne
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replied December 14th, 2009
Tapering Off Parnate
I am planning to taper off Parnate after almost 3 years because I hate the dietary restrictions and giving up a mostly vegetarian lifestyle (lots of soy)and gourmet cooking. I have to pick over everything I eat whether I shop to eat or go out to eat. According to the book, "The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal...." by Joseph Glenmullen, MD, there was only an appendix on the MAOIs. However, it *strongly recommended* that you find a doctor familiar with tapering. One doc I went to for a second opinion (since my doc has never done MAO tapering), suggested 10 mg/month, and I was on 40 mg. I'm now going slow, down to 35mg. Your body has to adjust. It might be good if you had a side medication ready such as lithium or an anticonvulsant so you don't get too depressed or anxious during this period, but of course everybody is different. Good luck.
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replied December 19th, 2009
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My sister had a problem weaning off of paxial. i used to take prozac and didnt like the side effects, so i got off of them withing two months. I currently taking something called sam-e it is like a vitamin or herb. I m able to handle my problems without feeling so down.
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replied April 22nd, 2010
I was hoping to hear good things about the patch....guess not....was on Nardil years ago and it worked wonders for 10 years. Now I am at a loss.....would like to try the patch, but you have to go off all antidepressants for 2 weeks...I can''t seem to find an antidepressant that works....most of them make me feel crazy Help!!
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replied February 17th, 2013
mimimom, I'm curious, why did you go off Nardil if it worked for you for 10 years? Did it stop working for you or were you having physical reasons you had to stop?
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replied December 28th, 2011
My Mother has been taking Nardil for 15 years, and needs surgery so she was weaned off over a 7 day period.. She's on a 90 mg dose a day. She went through 4 days of a manic rage, 2 days of severe vomitting and nausea, she started falling and ended up in the ER, then suddenly lost touch with reality. She has been in a psychiatric facility for 3 days now in a state of psychosis, she's hearing things/seeing things that aren't there, incoherent, and agitated. Oh, did I mention she hasn't slept in over 6 days?? Coming off of Nardil in a week is def not the way to go. At this point, we just hope her mind comes back.
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replied February 17th, 2013
I know this is well after the fact, but one does not have to be off Nardil (MAOI's) prior to surgery anymore as long as the anethsesiologist (sp?) knows you are on an MAOI so they can keep a close eye on your blood pressure. I have had several surgeries while on Nardil without problem - I just made sure they knew.
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replied October 1st, 2012
reddjoiowa
I had to get off Nardil prior to a surgical procedure.
My doctor had me take the medication (60mg) 3 pills first 3 days, 2 pills for two days, then last pill for two days. I am not encouraging this method, however, it worked and I did not suffer any side effects. your own doctor should have a comfortable method for you to "back out" of your medication.
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replied February 17th, 2013
Unfortunately, your doctor must not have been aware of the change in procedure for those on MAOI's re having surgery - because it's not neccessary any longer to go off Nardil prior to surgery as long as you make SURE the anethseologist knows ahead of time you are on an MAOI. So if in the future you have to have suregery and are still on Nardil, talk with the anethes.. he/she will tell you you don't have to go off it. I have been on Nardil for about 21 years and have had several surgeries in that amount of time without having to go off Nardil prior. Surprised)
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replied September 6th, 2014
Have been on Parnate 25 years/off for two years with daughter/20 years ago. Every attempt at getting off has failed. (Severe allergies that are so bad can't function), used to be on 30mg, over the years down to 20mg, with each attempt decreased. Am trying again, can't take the side effects at 56.
My teeth are damaged from grinding and lack of saliva. Sleep is really messed up, etc. This time am only taking a tiny piece off of one pill, to start.
So far already a nightmare, crazy! Allergies already so bad that I'm afraid to take less. Has this happened to anyone? (Also, whole two years off was so sick, went to specialists/bills so big looking for help was forced to go bankrupt. Doctors finally said nothing they could do go back on this poison.
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replied September 6th, 2014
Hi Bellamia2, I can totally relate, though I'm taking Nardil instead of Parnate. I've been on it for about 24 years and I can't get off it. I had to go off it completely 5 yrs ago and was sick as a dog for 6 months (nausea 24/7) until finally, I had to get back on Nardil. I have since tried going off it by weaning just a half a pill every 3 months. I was taking 3 pills a day to start, and only able to reduce by 1 pill over a 7 month period but was just too sick to continue, so went back on normal dose. It's SO irritating because I feel like I'm a prisoner to this medication! I simply cant get off it unless I want to be sick. I sure hope that you are able to get off it without being so sick for very long!
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replied January 12th, 2015
Getting off Nardil on the fast track
Hello, there!

I have been on nardil for about 4months during which I felt the best in the last few years - my miracle drug! Unfortunately it caused me major blood pressure issues - the worst of orthostatic hypotension which led to a week on the medical floor when I got on meds to elevate the bp (not very successfully). On top of that, the bp meds came with nasty side effects - severe edema that caused my legs to triple in size so I felt like an elephant walking like a duck at times. I was willing to tolerate the 30pb overweight and all the phisical crap because I have been on everything there is and was terrified to drop in the black hole of suicidal depression. Long story short, after seeing cardio, neuro, endocrinology, a few syncopic episodes with blackouts (last one I had to get 3 stitches on the inside of my lip which I cut during falling unconscious), several ER visits and mean paramedics, I had to quit.

From 60mg, dropped immediately to 30mg. The next day I went to zero. I am not a patient person and I know at the lower taper dosage it would not help with the depression, anxiety nor the groggy fog of extreme low bp. I am going throw a 2 week washout so I can get on a stimulant - the only other thing that has helped. I told my doc that I will not get on any other med since I have tried multiple drugs more than once through the last 18 years.
I am on day 5 going cold turkey. I think I can contribute the absence of any significant side effects to the hefty dosage of gabapentin on which I was to begin with (600mg, twice a day, 900mg at night with 10mg of zepelon, plus a little bit of wine - self prescribed, but my doc does not need to know)

My nightmares have turned into night terrors. A continual horror movie through the night from which I wake up from several times in terror fearing to go back to sleep, only to slip in back to where I started. Other then that, I have more energy! I have been active and not been worried to get up from bed first thing in the morning, worried about passing out, ect.

I am defiantly scared how the rest of my wash out period will go by but at this moment I am getting advantage of the surge of energy to get things done, which in turn helps tremendously with the suicidal urges.

Hope this helps someone. MAOI's are not so common (last on the list as you know) and accurate information is scarce. BTW, I tried the emsam patch, which I did not find helpful and that is why I switched to the real thing.
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replied March 11th, 2015
thanks for all the info! I have been on Nardil for 15 years, but the past 6 have suffered onset of dibilitating pain, aches and pains, muscle pains, adductor tendinosis,(myofsascial pain syndrome) and huge weight gain. It worked wonderfully at first, jazzing me up and the only thing that give my life back. I am worried that it has dibilitated me with side effects. Is my pain syndrome a side effect of long term use? trying ot go off has been a nightmare and I quite after a year of trying at three diff. times. I get down to 30 or 45 mgs and start crying and fearing for a mental breakdown, I am only working part time and on diability for the rest. Would i get my life back and movement if I went off of it and tried something else? I hear everyone about hight blood pressure, but anyone else with a chronic pain problem that developed with use of Nardil??? Thanks!
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replied May 21st, 2016
I have been on Nardil 90 mg/day for 30 years & feel I need to try to wean myself off it again. I have tried numerous times to go off nardil, but suffered from debilitating migraines & was unable to function. I seem to have "no filter" & speak (usually swear) without thinking. One psychiatrist said it was due to long term use of Nardil. Has anyone else heard of this? I feel I will have to take Nardil for the rest of my life.
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replied July 2nd, 2016
I have symptoms exactly as you have described headache ect.I have been on
Nardil 28 years. I have tried numerous times to wean myself off. When I was younger (40's) I just seem to become more angry with life. One time 15 years ago after moving down to zero nardil, (Under Doctors care) I simply layed in bed so severely depressed for days, I couldn't handle this anymore and simply went back on to my full dose of 75mg. I had many surgeries during my time on Nardil and only had trouble with the last two.The surgeon seemed to ignore my nardil and placed me in a vary serious situation. To any one reading this, make sure the Doctors have read on Nardil usage with
surgery.
Now as I progress in to my later sixties, I have began to have a much more difficult time attempting to wean myself. I am thinking off another go, and joined this forum to hear success stories but have heard few. Nardil was the drug of choice with my Doctor after trying a few others. This for symptoms of PTSD and has worked well for all these years. To change to a less dangerous drug concerning tolerance of food and other drugs, I would like to try again. I have no Doctor at this time, but know the routine. Three months ago was my last failed attempt, and again I may have to give in and stay on Nardil the rest of my life.
I will come back to this forum every one in a while and look for success stories.
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replied January 3rd, 2017
Stop being an addict to a useless pill. It only works for 1month
I think you need to think positively. Understand that life is better OFF of Nardil.

You get more energy and you feel more reward from pleasureable activities. Nardil dulls that and makes you lazy.
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replied January 3rd, 2017
I think you need to think positively. Understand that life is better OFF of Nardil.

You get more energy and you feel more reward from pleasureable activities. Nardil dulls that and makes you lazy.
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replied January 3rd, 2017
think positively and the symptoms will disappear
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replied July 27th, 2017
Weaning off MAOI
User5197507-27-2017
I'm trying to post a comment in reply to this topic. Last comment was 1/2/2017. Since I can't seem to locate the thread I'll paraphrase the comment. "Nardil makes you feel tired and lazy"; yes I totally agree. I did come off for surgery, doctors gave no alternative in my city. I had discussed that it hadn't been working with my doctor for months. I did the withdrawal under doctor's supervision but it was relatively fast as I needed surgical repair of my right hand. Nardil did work for me for a few years but it became obvious that the antipathy I was experiencing was preventing me from changing my "state of mind" and engaging in activities that would alleviate my depression. The antipathy and weight gain were enough "side effect experience" to motivate me to really try other methods to cope with my depression. I feel that the slump I had created over the last 5 years by not being motivated to change anything (tidy home, get out and be involved) may have become more of a problem than the neurotransmitter issues I went on MAOI to change. I'll repost soon but I'm hopeful I can stay off Nardil.
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