From MAOI to MAOI

[MaskedNinja]

Diagnosis' so far: Major Depressive Disorder, Social Anxiety Disorder, Agoraphobia & adult ADD. Waiting for a sleep study to commence (apparent hypersomnia).

So, I don't know if it's over yet, but the drought of Nardil (phenelzine) here in the UK meant I had to come off of it. The stress of finding enough supply to allow titrating down & off Nardil was terrifying! But at the same time, I was also relieved. I only went back on Nardil to see if it would work like the 1st time, but it never did. So I feel I've wasted almost 3 years when I should have been on it 9 months max. But I cannot write my own scripts and my doc was adamant it was 'working' despite it not 'helping'. Yes, fact. Of course it was inhibiting MAO and of course, it was having a gabaergic effect too, a well known unique effect of Nardil's. But I 'felt nothing'.

So I insisted I return to Marplan (isocarboxazid), another full MAOI. And after 9 days from handing in the script at the hospital, signed & stamped, then having to wait for it to be signed as 'dispensible' by some higher-up director of gawd knows what (crazy s***, the pharmacy were taking no risks... what risks??), today I finally picked up my Marplan. Popped a 10mg pill before I even left the building.

I feel ok. Bear in mind I also take dexamfetamine 5mg morning & late afternoon + 20mg lisdexamfetamine (Elvanse) morning & late afternoon (total of 21.8mg dex), I checked my blood pressure a few hours later. 133/90. According to several confusing charts I've looked at, for a 40yr old male (I'm forty in 13 days) that is a 'high-end of normal / pre-hypertension' reading. 90bpm pulse. And considering the stress, type 1 diabetes, vaping nicotine and taken shortly after returning from a shopping trip via walking AND hypoglycemia was on it's way, I'm not surprised it was high & it doesn't bother me. Should it? Need to cut out caffeine too and that's hard. I must use an average 400mg a day, often more. Probably average. I have a suspicion that the combined quetiapine is raising it too. The amitriptyline? I'm only on 25mg at night. Bupropion (Wellbutrin/Zyban) 300mg slow release? Was fine before when combined with 25mg dex and 10mg dex + 70mg Elvanse.

Now I've relaxed for a while it's dropped a bit. It now reads 120/81, pulse 96bmp. Normal BP, not sure about pulse though.

Not saying that the Marplan has 'kicked in' yet but it has definitely stopped the remaining withdrawal symptoms from the Nardil (brain zaps, vertigo & loss of appetite among others). All gone just like that. Now I have urinary retention & erectile dysfunction/anorgasmia to look forward too! But I'm 1 step ahead of the urine retention with an antidote - 2mg doxazosin, increasing to 4mg if needed. It's a high BP med also used for urinary retention caused by an enlarged prostate. If that fails theres bethanechol, another antidote which I've found helps that other side-effect too. All MAOI side effects fade with time, sometimes a long time. Depends on how high the dose and how quick the increase.

The plan initially was to start on 10mg Marplan for 1 week, 20mg for 2 weeks, 30mg for 2 weeks then 40mg/day until my next appointment. Bearing in mind I went up to 150mg when I was last on it! The 'official' top dose is just 60mg.

So that is what I will do, just delayed by over a week. At least I won't run out prematurely.

Bizarrely, last time while taking Marplan there was a drought on that too! But thankfully the suppliers were here in the UK. Because I took it on myself to sort things out, I was able to initiate a continued supply by contacting the supplier myself. Low and behold they had emergency stocks. (UK Nardil comes from China... yeah I know! Perhaps the ship sunk, or a dodgy deal went wrong!)

I am always sorting the system's responsibilities out for them. Always! I had to call today to see if my script had been ordered. I had already found out, by myself that the script had been 'okayed'. It was ordered, received and even packed ready for me to pick up! THEY were supposed to call ME as soon as it was ready to pick up. They virtually promised. I've learnt over the years how useless they are at keeping their promises, so I knew I'd have to call them. I wonder how long it would have been until they called to let me know the script was ready?

My main point here is to learn to stick up for yourself when it comes to your own health vs your National Health Service, whatever & wherever that might be. Too many people wait and wait and wait... I nag nag nag! And I get results. They don't communicate, have far too many patients to deal with, mix things up and make mistakes. So take some responsibility and take charge. They can't ignore you forever!

[MaskedNinja]

Guess I'll reply to myself then 🙄

Lots of fireworks going on right now. It is coming up to 10 past midnight, Jan 1st 2020. No Messiah, no dead walking the Earth (yet) and no kinda Armageddon that I know of. I didn't even realise it was gone midnight 'till just now.

I haven't showered in days. Haven't been out anywhere since Friday last week. I had my Psych appointment, then made the most of the fact I was already 'out'.

I will jump in the shower in a mo. Wash off the past year!

I'm dead sober. Vaped some weed but no biggie. The thing I hate about this 'Festive' crap is that a) it's all make-believe and b) EVERYTHING is closed! Just when I feel like attending a self-help group or some semi-social event there isn't anything on! @Good Tidings We Bring, To YOU and You're Kin. We Wish YOU a Merry Christmas and a Happy New Year!"

Liars!

I had my sleep study. To my DISSAPOINTMENT I DON'T have Sleep Apnea 😓

Silly thing to say you think? Well, if it's not that then what the hell is wrong with me??

If I did have sleep Apnea then I'd be wearing some breathing apparatus right now and be getting quality sleep. But Boxing Day (the day after Christmas for non-UK residents) I slept for 26hrs.

The Consultant wrote back to me saying that it must be Neurological. He then followed that up with telling me that the Clinic I already attend (and for the past 6 years) actually runs Neurological Sleep Studies. Nice one doc! Why didn't you think of that 1st seeing as you work there!?

Crazy stuff.

Time for my shower, followed by my God-sent dose of amitriptyline. I think I'll burn some Lavendar too. Seem to have gotten in touch with my feminine side lately and I don't care. I used to, but as I've gotten older that sort of thing don't bother me anymore.

Er...Happy New Year everyone!!!

😁

[MaskedNinja]

Yay! 2nd to Reply! Oh wait, I'm the only one who has...

Out with the old, back with the older! Got rid of that awful lisdexamfetamine. Dextro-amphetamine bound to L-Lysine. Yes, it takes a while to break apart the 2 components in the blood and so making it 'extended-release'. The amphetamine can't be utilised by the body/brain until that happens. BUT! It doesn't feel right.

Before I started lisdexamfetamine (Elvanse) I had trickle-dosed 5 x 5mg dexamfetamine pills throughout the day, keeping levels topped up until after my final dose. But Elvanse feels NOTHING like slow-release dex. A completely different drug.

Even my doc said others had said the same thing but he never knew why (Doaty??).

So, after returning back to 25mg of dexamfetamine a day, this weekend I've made the last of several med adjustments from the last couple of weeks.

Dexamfetamine is now 17.5mg (3 1/2 pills) am & 7.5 (1 1/2 pills) 4-5pm. Seems to avoid any drop in energy without trickle-dosing.

But I'm oversleeping most of the time. After tweaking my small doses of amitriptyline & Quetiapine, I've stopped the amitriptyline & taking just 25mg quetiapine at night. Just to see what happens. Though I have a feeling that its the quetiapine at fault. I'll soon find out.

But I'm taking natural things alongside. Quite an interesting bundle:

500mg Taurine, 320mg Bacopa Monnieri extract (Synapsa), 28mg Saffron extract (Affron) and I'm alternating with 50mg 5-HTP one night and 300mg L-Tryptophan the next and so on. To avoid becoming tolerant to either which always happens.

Ideally, I want to alternate the L-Tryptophan with Melatonin but it is now prescription only here in the UK. Craziness! I have found one online source willing (or simply not caring) to send me Melatonin. I just need to get paid 1st!

Something very interesting I've learnt about Melatonin dosing. 300-500mcg (a microgram is one-thousandth of a milligram) and is the 'optimal' dose to take at night, yet you have supplement companies selling doses up to 20mg! Seems that in Melatonin's case, less is more!

This is backed up with studies and the Pharmaceutical Giants here do indeed have a 300mcg dose licenced for a prescription. Guess I'll have to ask my doc for it (I'll get it guaranteed). But that's not until the 19th Feb, so looks like I'll have to order some. Though I might get a friend from the US to send me some in plain packaging, 'rattle-proof'!

Tiredness - my WORST enemy! (my 1st ever symptom too)

[artnat]

How can you afford Marplan? Does the NHS pay for it ?

[Ally52newbie]

I too had to stop my Phenelzine due to shortage. I have been put on tranylcypromine 10mg twice daily but it's not doing what nardil did. I haven't left my room or interacted with anyone in months. Just feel it's my fault nothing works. Nardil has been short since Kyowa Kirin stopped production last November. They were proposing to restart UK production in March....then covid happened. I really wish this parnate would work. Don't even think I'm on correct dosage. I was previously on 60mg daily Phenelzine.