BobB: Nardil MAOI withdrawal

[BobB]

I’ve been off Nardil for four months now.  The primary symptoms I get are trembling in my legs, nausea, lack of appetite and free-floating anxiety. For the first several weeks after I stopped taking Nardole, this occurred pretty much daily. After about two months, I got can do what I would call my first big window and did pretty well for about three weeks. then, for no apparent reason, I went back into a very strong wave for about another week. I came out of that again and had another three good weeks. I went for a long walk last Sunday, and by Monday I was backed into another wave. I’m slowly struggling to get out of this wave.

 

 I take a number of nutrients including magnesium taurine and Catacolacalm. I also take 10 mg of propranolol three times a day.  When things get really bad, I will take up to .5 mg Xanax.  Today I tried .5 mg Klonopin.  Does anybody have experience with those medications and any advice?

 

Other questions

 

First, are there other nutrients or supplements or any other factors that can help reduce the symptoms?

 

Second, is it too late to go back onto taking a small dose of Nardil? does anyone have experience with going back on Nardole after coming off of it?  I’m not sure I want to try this, but hearing if anyone did it successfully could be useful.

 

Third what causes these waves to come and go? If I can prevent taking actions to create the waves, maybe I could eventually pass through all of this.  Any advice would be welcome.

 

This is really a long struggle. I’d like to hear from people who have gone off of Nardole successfully. Thanks

 

BobB

[BobB]

Another question - why can a long slow walk set off a wave with Nardil?

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  Congratulations for getting off Nardil!  That is great news.  It sounds like you did a much slower and more cautious taper than the vast majority of people do, but you may still have gone a bit faster than your nervous system was able to adjust.  On this site, we suggest a 10% reduction every 4-6 weeks, with the 10% from the current dose, so that the taper is exponential, and each reduction gets progressively smaller.  Very few health care professionals use this protocol.  This link explains the rationale for this method:

 

 Why Taper by 10% of my Dosage  

 

Can you please give us specific information in your signature about your drug history for all drugs and supplements you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each medication decrease or increase.

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Your Drug History in Your Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

On 11/24/2022 at 12:51 PM, BobB said:

Second, is it too late to go back onto taking a small dose of Nardil?

Have you attempted to reinstate in the past?  If so, how did that go for you?  

 

Have you seen improvement in your withdrawal symptoms since you stopped back in June 2022?  

 

Going back on a small dose of your drug, or increasing your dose, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, and we need more information before we can advise you on reinstatement.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

[getofflex]

On 11/24/2022 at 12:51 PM, BobB said:

Third what causes these waves to come and go? If I can prevent taking actions to create the waves, maybe I could eventually pass through all of this.  Any advice would be welcome.

Waves can be caused by: 

 

1) consuming alcohol, and other mind altering substances.  This is a biggie.  

 

2) other drugs and supplements - when in withdrawal, our brains can do unpredictable things with drugs and supplements. 

 

3) exercise that is too intense or too long.  (Shorten the walk to 30 to 45 minutes.)

 

4) stress and drama 

 

5) changes in weather and seasons 

 

6) changes in diet or routine

 

7) too much stimulation ie, staying at a party too long, watching an intense movie, doing too much activity in one day, etc.  

 

Sometimes, waves just happen, because this is our brains way of healing, and cannot always be avoided.  Check out the link on non drug coping skills to find ways to cope with your symptoms during waves.  These can help a lot.  

Edited November 29, 2022 by getofflex

[BobB]

4 hours ago, getofflex said:

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  Congratulations for getting off Nardil!  That is great news.  It sounds like you did a much slower and more cautious taper than the vast majority of people do, but you may still have gone a bit faster than your nervous system was able to adjust.  On this site, we suggest a 10% reduction every 4-6 weeks, with the 10% from the current dose, so that the taper is exponential, and each reduction gets progressively smaller.  Very few health care professionals use this protocol.  This link explains the rationale for this method:

 

 Why Taper by 10% of my Dosage  

 

Can you please give us specific information in your signature about your drug history for all drugs and supplements you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each medication decrease or increase.

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Your Drug History in Your Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

Have you attempted to reinstate in the past?  If so, how did that go for you?  

 

Have you seen improvement in your withdrawal symptoms since you stopped back in June 2022?  

 

Going back on a small dose of your drug, or increasing your dose, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, and we need more information before we can advise you on reinstatement.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

 

[BobB]

getofflex

 

I tried to reinstate Nardo using a daily dose of 1/4 of a 15 mg tablet. I did OK for two weeks and then had really harsh tremors in my legs. I went to the ER and they discontinued Nardol at that time. I’ve been off Nardole now for nearly 4 months.

 

 I’ve had two good windows of about two weeks where I took nothing and was my old self again. Both windows ended when I did some strenuous activities. So now I’m trying to get back into a window.

 

I do take very small doses of Ambien for sleep.  I take about 2.5 mg that gets me to sleep. My biggest symptom is tremors in my legs and hyperventilation when that happens. Is this at all common? Other than getting them out, is there any way to lessen this symptom?  When it gets really bad and I’ve tried cutting it out for about four hours I will finally take .25 to .5 mg of Xanax, to finally break the cycle.

 

I also take sublingual sprays of melatonin, which does seem to help some

 

Any advice on how to lessen the severity of the symptoms, would be greatly appreciated.

 

BobB

[getofflex]

12 hours ago, BobB said:

I’ve had two good windows of about two weeks where I took nothing and was my old self again. Both windows ended when I did some strenuous activities.

This is a good sign.  It shows that you are stabilizing.  Strenuous activities can definitely put us in a wave.  I've experienced this several times myself.  Try to stick with light exercise and activities.  It's because intense exercise stimulates the production of chemicals in our bodies which activate our nervous system.  This causes a sensitized nervous system to become destabilized, and is common with people who are tapering or have recently tapered and haven't fully recovered yet.  It takes a very long time for our nervous systems to settle down and fully heal.  

 

We will need you to make a drug signature.  Please see:

 

17 hours ago, getofflex said:

Can you please give us specific information in your signature about your drug history for all drugs and supplements you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each medication decrease or increase.

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Your Drug History in Your Signature

 

 

12 hours ago, BobB said:

Any advice on how to lessen the severity of the symptoms, would be greatly appreciated.

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Tremors, etc.

[BobB]

To getofflex

 

Does taking GABA help?  I’m looking for some way to lessen daily symptoms.

 

 

[getofflex]

Bob, I seriously doubt it is doing anything at all.  I've been on it many years, and since we only taper one thing at a time, was busy tapering off Lexapro for 5 years.  (I did a couple of fast tapers and reinstatements before I found this site).  I intend to taper off that soon.  We on SA believe that it doesn't even cross the blood brain barrier, so it would probably be a waste of money.  Plus, often drugs and supplements can go paradoxical, and cause the opposite of what they normally do, we only recommend magnesium and omega-3.  

[BobB]

What is the general feeling about Melatonnin?

 

Bob

 

 

[getofflex]

So you are not on any psychiatric drugs at all now? Just the supplements?

 

Melatonin

[BobB]

getofflex:

 

I’m totally off the Nardole now. However, I still take about 2 mg of Ambien for sleep when necessary. Also, when I get massive leg tremors, I will take up to 1 mg of Xanax to get them under control.  when I get into windows, I don’t have to take the Xanax because I’m not getting any tremors, and I can sleep without the Ambien.

 

Bob

 

 

[BobB]

I only take the Xanax after struggling for several hours with tremors, hyperventilating, and sweating.  This symptom occurs during the worst of my waves.  I only take Ambien when I can’t fall asleep.  I take about 1 mg by breaking 5 mg pills into pieces.  I hate taking these drugs, but they are the only actions that reliably address these symptoms.  I know about the dangers and try to avoid taking them till I’m exhausted.  I try meditation, breathing, calming teas, and exercise to offset the symptoms.  But these efforts only make a marginal contribution.  Any other suggestions would be welcomed.

[getofflex]

Bob, no worries about Xanax and Ambient for now.  Good for you for only taking them when absolutely necessary.  Could you please add these to your drug signature?  Thank you.  

[getofflex]

Can you please give us an idea of how often you are taking the Ambient and Xanax, on average.  The reason I ask, is because depending on how often you are taking it, you may be becoming dependent on it, and may be having interpose withdrawal.  

[BobB]

I take Xanax maybe one or twice a week when I am having bad leg tremors during a window.  I get leg tremors and shaking and hyperventilate.  I try to not take Xanax and gut it out.  But after several hours of this, I end up taking about .5 mg Xanax to get them to stop.  I wish there was an alternative to taking a benzo, and am welcome to suggestions.  But nothing else seems to work at all.

 

I take Ambien pretty regularily, especially when I am not in a window.  I break 5 mg tablets into quarters and take a quarter tablet (1.25 mg) if I can't fall asleep, and another quarter tablet if I wake up and can't fall back asleep.  When I'm not in a wave, I don't take either medication.  My last two windows lasted about three weeks and I didn't take either Xanax or Ambien during the windows.  I didn't notice any withdrawal or adverse effects.  I don't like taking either of these. 

 

What is interpose withdrawal?

 

[BobB]

I did some research and I think you are referring to interdose withdrawal?  The way I take Xanax is as an emergency last resort when I am having tremors and hyperventilate and it just won't stop after hours of suffering.  I take the Xanax and it stops the worst symptoms.  At the height of my waves, I have struggled not to take Xanax for at least three days if I experience another extended wave of tremors and shaking.  A couple of times, the Xanax has worn off after about six hours and I start getting tremors.  I took .25 mg to stop it and it worked.  I don't repeatedly take Xanax on any type of regular schedule.  I've been in a wave for two weeks now, and I've taken Xanax three times.  Before I went off Nardil, I would take a Xanax maybe 4 - 5 times a year before stressful events.  My Ambien use was much the same then too.

 

 

[getofflex]

If you've only taken Xanax 3 times in 2 weeks then I doubt you have become dependent.  Just checking to make sure, thanks for the info.  

[BobB]

I am scared of any benzos.  I've been fighting to recover from getting off Nardil.  I don't want to substitute one drug for another.  What I would really love to find is an alternative way to address the extreme leg tremors and hyperventilation.  I can ride it out most times, as the extreme waves last around 45 minutes to an hour.  But they are tough, and I ended up totally sweating and exhausted.  Every MD I've seen just throws more benzos at the situation and gives me a prescription.  If I had followed that advice, I would be thoroughly addicted to benzos.  I can handle the neuro-emotions, the nausea and the lack of appetite.  But shaking for hours just sometimes becomes too tough for me to bear.  Is this a common symptom, or is it particular to Nardil? What is going on with my neurological system that causes this?  Is there someone who has had to deal with this symptom, and are there any ways to lessen its impact?  I've tried breathing exercises, meditation, and exercise.  None of those efforts have any effect. 

[BobB]

I forgot to mention that I also have a prescription to Propranolol (I put that in my signature just now).  Supposedly that helps block the tremors.  I take 20 mg in the am, 10 mg at 2 pm, and 10 mg at 8 pm.  I'm told this is not a risky drug, so I am less concerned about that.  Is that right?  I've been slowly tapering this drug too, down from 40 mg 3x daily in August.  I haven't seen any discussion of tapering off propranolol on this site.  Is there any information on that?

[getofflex]

See my post from Wednesday for a link about leg tremors.  I didn't have this, so I don't know about it. 

 

22 hours ago, BobB said:

I haven't seen any discussion of tapering off propranolol on this site.  Is there any information on that?

According to my husband who is a retired pharmacist, you do not have to taper off propanolol.  Here is information about it: 

 

https://www.drugs.com/search.php?searchterm=propranolol&a=1

 

Please be assured that this is probably from withdrawal, and it will eventually go away.  Try to accept it, and not get overly worried about it.  Please read this: 

 

Steps for Managing WD Symptoms

[getofflex]

I think what is happening is that you are very anxious about this particular symptom of tremors.  I would suggest you try to work on lessening your anxiety about that, and your anxiety in general.  These links will help with anxiety.  

 

Acknowledge Accept Float

 

Music to Calm Anxiety

 

Breathing Technique for Anxiety

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

15 hours ago, ChessieCat said:

Audio:  First Aid for Panic (4 minutes) Female voice - getselfhelp.co.uk

 

Audio:  First Aid for Panic (4 minutes) Male voice - getselfhelp.co.uk

 

Meditation