Morning! Happy Friday! Back in 2006 I tried Ambien. I thought I was “allergic” to it bc it kept me up all night - maybe slept a few hours in a week. I now believe I was in a manic episode. I currently take Seroquel 50mg and Trazadone 150mg to sleep, and it’s not really working anymore. Even when I take it with 4 Benadryl or 2 NyQuil - nothing. I am wondering if any of you take either of them and they work? Which do you like better? I additionally take lamictal and Viibryd. I know everyone is different but just trying to get an idea if it’s worth talking to my Dr about again. Thanks!!

Female, 44. Diagnosed with persistent depressive disorder, major depression, treatment resistant depression, GAD, Social anxiety.
My doc prescribed the Emsam patch which my insurance denied so she suggested Nardil. But I'm reading through here and it seems Parnate is preferred??
Should I ask for Parnate or try the Nardil?
I have treatment resistant depression and have failed 20+ meds.

1. Lexapro (was on for months. Didn’t notice improvement; 2004)
2. Zoloft (was on for months. Didn’t notice improvement 2006)
3. Prozac (was on for years. Didn’t notice improvement; 2010-2020)
4. Deplin (no improvement)
5. Pristiq - (was on for a few days. Made me exhausted 2008)
6. Remeron (was on for a few days. Made me exhausted)
7. Trintellix gave me bruising (2008)
8. Latuda - was on for a few months; made me feel strange and out of it (2017)
9. Lyrica - can’t recall
10. Lithium - was on few a few months; made me feel strange and out of it (2018)
11. Zonegran - made my periods twice as long (2014)
12. Wellbutrin - tried in the 2000s and again 2021-2023. Didn’t notice much of anything
13. Viibryd - Rough side effects in the beginning. Was on from 2021-2023
14. Auvility - Was on for 1 month; pure exhaustion (Oct 2022)
15. Abilify - made me feel agitated and that inner restlessness; sometimes felt empty (June 2023)
16. Luvox - was on for about 1 week. Made me feel very off and out of it (May 2023)
17. Modafinil - was on for a few days. Made me feel very off and out of it (May 2023)
18. Clomipramine - was not on long. Felt waves of emptiness. (June 2023)
19. Nortriptyline - went up to maximum dosage; was too tired and no depression improvement (2018)
20. Trazadone - made me too tired (2021)
21. Medical MJ - MJ does not work for me; heightened anxiety and paranoia
22. Buspar - 2021 - can’t recall exact side effects but I was not on it for long.
23. Lamictal (2023 100mg started on 8/2 but stopped due to starting ketamine)

I found out during covid that the brain tumor which I've had surgically removed twice already.has decided to grow back. Only treatment is another surger, yea!!
The first surgery left me with left side paralysis after they removed the jumbo egg mass from 2" deep on the right side. I had a pulmonary embolism a few months after my surgery that came.woth a whole new set of problems. Took years of physical therapy to regain enough feeling to walk without a cane, but I still trip on the smallest shit. I was left mentally destroyed, emotionally a disaster, PTSD and a lot of fears.
Second surgery left me with partial focal seizures on the left side, they hurt like he'll and I don't lose consciousness. They're pretty well controlled with Briviact and Lamictal. This one left me even more emotionally messed up.
It is the first thing I think of when I wake up, what crosses my mind a hundred times a day and the last thing I think of before bed. I am truly fucked up. To everyone in the world, I am just fine. But truth betold, I have just gotten really good at acting like I'm completely fine, totally composed and emotionally stable. I am emotionally and mentally exhausted, I've been going through this since 2006.
Now I face a third surgery, but when I am ready since its so small.
I finally have a job that I'm proud of, but life is getting overwhelming again.
It's crossing my mind to just set a date and have the surgery, flip the coin on survival. If I die on the table then I won't have to deal with my problems any more and I can go to God, but on the other hand if I survive, I might come out more fucked up. I still won't have to deal with my current "real" world stresses and bullshit. I'll just have to focus on recovery again only this time I won't rush it like last time.
It has also crossed my mind to just step into traffic or take all my clonazepam and that will be that.
I AM SO TIRED OF THIS, TIRED OF NOT BEING ME, TIRED OF THE SEIZURES, AND TIRED OF PRETENDING ALL THE TIME AND NO ONE (NO ONE!!!!) UNDERSTANDS.

I am planning to make an appointment with a psychiatrist, for the first time in many years. I am looking for suggestions of medications to discuss at the appointment. I am currently only taking lamotrigine. I have tried many different medications in the past, but the side effects have always outweighed any benefits they had if any. But new medications have since come out that may be worth trying.
DIAGNOSES – Unipolar / Atypical Depression, SADD, c-PTSD. I have never had a manic episode. My anxiety is not similar to Anxiety disorder. I do not have any pain, and I never abused any substances.
CURRENT MEDS:
LAMICTAL: I currently take 100mg Lamictal in the AM, managed by my PCP. It takes makes the
lows of my depression not quite as low, and doesn’t help my anxiety. At higher doses it
increases anxiety, and makes it hard for me to focus and concentrate.
MEDICATIONS I HAVE TRIED:
Lexapro – 2004-2006 – helped for 3 months, I felt ‘normal’. Suddently it made sense how everyone else was able to function so well. I was at ease socially, I felt positive, and I could get a ‘normal’ amount of things done in a day. Then it pooped out. It also caused my moods to swing more from low to high and back. I got disproportionately happy or sad with day to day events, swinging fast from one to the other. Not manic though.
Zoloft instead of Lexapro – 2006– Did not help. Still had the swings.
Wellbutrin – 2006 – 3 days. Vomited and liquid diarrhea every 2 hours non-stop.
Effexor - 2006-2008 – Did not help. Still had the swings.
Lamictal – 2008 to present - Kept the lows from feeling desperate and horrible. Just medium low and bad.
Trileptal – 2007 in addition to Lamictal – Did nothing.
Tegretol in addition to Lamictal – 2007 full blown liver failure, complete with grey stool, enzymes in the 1000’s.
Seroquel – 2007 My passive suicidal thoughts started to be less passive.
Notryptaline and Amytryptaline – felt very good at times. But also swinging from high to low. Then just consistently low and numb. Also errors in concentration – made critical unacceptable errors, at work.
Mirtazapine – didn’t really give it much of a try, but it seemed like it was stimulating – harder to sleep, more anxiety.
Cytomel- dramatic increase in irritability without any improvement in symptoms.
Lithium – felt a little better, ‘stable/normal’ but not good or happy. Debilitating constant headache that made it impossible to function.
TMS: I did one round of TMS that took my 21 Question Beck’s Inventory from a 24 (Moderate depression) to a 7, but only lasted a few weeks. Maintenance sessions helped, but also only got a few good weeks out of it. TMS did not help my anxiety. I did a second round which had little effect.
SYPTOMS: I am currently 52. Symptoms likely started age 3-5. At some point, passive suicidal ideation started and is constant.
WHEN I FEEL ‘UP’ - I have never been manic. My first psychiatrist thinks I have been hypomanic. My ‘ups’ take 2 forms.
A - Feeling like a normal person, happy, relaxed, do well at social interactions and functional without any inappropriate behaviors – I only felt this the first few months on lexapro, and a few weeks/days here and there on amytriptaline, a few weeks at the end/after my first round of TMS.
B - Feeling restless and anxious – which is what higher doses of medications do to me. For example, taking 125mg of Lamotrigine instead of 100mg
DOWN’S - Ambivalence. Indecisiveness. Loss of interest and motivation. Self-blame. Self-destructive thoughts. Decreased personal hygiene. Emotional eating and weight gain. Withdrawal. Social isolation. Awkwardness in social situations. Underachievement. Avoidance and denial. Vasovagal freezing. I now can’t make myself go to bed due to anxiety, but wake up consistently at 8am. Resulting in 2-5 hours usually, 7 on a good day. When I procrastinate, I just read paper books, or read/scroll/play on my phone – usually about 8 hours a day. I used to sleep too much – 10-11 hours.
PTSD – from childhood abuse. I mostly have emotional detachment and numbness, with intrusive thoughts about self worth, guilt, shame over day to day errors, and passive suicidal ideation. There are a few specific memories that are traumatic, but it is for lack of a better description, more general. I don’t get flashbacks, and I can talk about things.
VITAMINS: I have taken the following vitamins in the past and may in the future again.
Vitamin D3, K2, Zinc, B complex, Betaine and Selenium. I try to take fish
oil but haven’t found any forms that are small enough to swallow, and I hate the taste of the
liquid one at Costco.

I’ve had BP2 since 2006. I’m doing pretty well on my current meds of Lamictal, Vibryd (antidepressant) and Quetiapine. I’m also taking a thyroid supplement. The hypomanic side is really well controlled. But I still have fairly regular depression episodes lasting 10-14 days. I’m wondering what folks experience has been on the newer bipolar meds. Also would like a Psychiatrist recommendation in the San Jose CA area. Mine retired, great loss. Thanks!

I’m posting on behalf of my mom (53F, 5’2”, 158lbs). She has been experiencing progressive muscle weakness to the point that both of her legs are now paralyzed, and doctors can’t figure out why. She is now confined to a wheelchair and concerned that the weakness will eventually spread to her arms. Any ideas would be greatly appreciated!
Medications: Estradiol 1mg, Lamictal 162.5mg, Lamictal ER 25mg, Synthroid 75mg, Flonase, Ativan 2mg, Lithium ER 300mg, Seroquel 75mg, Aciphex 20mg
As needed: Acetaminophen, Naproxen, Ativan 0.5mg, Imitrex nasal spray 20mg, Albuterol, Tramadol 50mg
Conditions:Asthma, Bipolar 1, Chronic low back pain, Hypothyroidism, Migraine, Piriformis Syndrome
She does not smoke or use recreational drugs. She drinks occasionally.
Below is a brief medical history and timeline of the muscle weakness. Test results and doctors’ notes are here: https://imgur.com/a/ZcGIeRL
2006: Took 8 months of Ultram for very painful hands
2008: Large areas of legs and arms numb/I circled these with a pen to show Primary Care Doctor. He discussed autoimmune issues/tested for RA (negative)
2010 - today: Recurring “carpal tunnel” issues on one or both arms, with no repetitive activities
Sciatic pain 2010 until today: Severe pain/unable to sit or walk(ongoing) Feet very cold at night off & on, the cold feels painful
2005 - 2015 Post exertional malaise/ ongoing severe fatigue, lasting for months at a time. This was diagnosed as depression, but question if this was always the correct diagnosis. Fibromyalgia was discussed at one point, no diagnosis made however.
Around 2017-18 Hypersensitivity to sound, especially background noises. In the evenings, bass and repetitive sounds are painful to hear
1/6/2020 Surgery for Stage 3 Prolapse: Partial hysterectomy, bladder sling (using native tissue) and vaginal vault repair.
**immediately after surgery I experienced 10/10 pain around my right hip area. I was given (4) doses of morphine, none of which helped with the pain. I spent the night on the floor of my hospital room in pain.
10/2022: Caught covid, no hospitalization. Dealt with post-covid issues for three months, including increased heart rate, high blood pressure, severe fatigue. In March 2023 after a clean EKG and echo, I was dismissed from the care of my cardiologist. Blood pressure is normal now.
2/6/23 Radiofrequency ablation at L3, L4, L5 Medial branches
**R leg paralyzed after procedure/not able to bear weight on it at all. Was sent home from PACU with paralyzed leg. Ability to stand/walk recovered after <24 hours. Weakness remained in R leg. NOTE: Weakness on R side was noted by PT in July 2022
Until end of February, 2023: Continues 7/10 pain in piriformis, R trochanteric bursitis, sciatica.
End of February 2023: All pain is gone
2023 Paralysis of legs:
3/27/23 I could walk slowly with walker. At the pain clinic, Dr. did a neuro exam and I was not able to lift right leg off of the floor when sitting.
3/28/23 I was no longer able to lift right leg off the floor when walking.
4/8/23 I was no longer able to wiggle toes on right foot. Ankle and calf on right leg are swollen.
**right leg is very cold (like ice) to the touch. At night the cold is painful - feels better when wrapped in a heating pad
4/24/23 I noticed mild weakness in left leg, mainly quadriceps and top of knee. Can do leg raises to 12 inches with left leg.
4/26/23 evening: only able to raise left right leg about 6 inches.
4/27/23 morning: only able to lift left leg about 1 inch.
4/27/23 evening: Can no longer lift either leg/can’t wiggle toes in either leg. ER stroke evaluation – mild facial drooping on left side, no evidence of stroke found.**both legs are cool and swollen, but are not painful
5/8/23 Noticeable tinnitus in both ears
5/16/23 Tinnitus unbearable, I am using headphones w/background noise 24/7
5/16/23 Pain from pre-RFA is returning: Mainly pain on piriformis and sitting bone, with pain radiating down my right leg.
Thank you so much for taking the time to look through all of this. We would greatly appreciate any ideas!

I just got put on Zonisamide and it seems like it might be causing more seizure activity... Has anyone else experienced this? I'm increasing from 50 to 100mg and took 2 pills at the same time yesterday and an hour later started having a bunch of mini seizure jolts. I took all my other meds immediately and it stopped. When I first increased the dose to 100mg I split the pills to different times of day and it made me super anxious, chest pain, wide awake when I took it at night. Seems like maybe it's having a paradoxical effect, but I wonder if I'm just not giving it a fair shot.
Background: I was on Dilantin+Klonapin in 2006, switched from Dilantin to Lamictal+Klonapin in 2009, increased to max dose of Lamictal in 2015 and March of 2022 started having breakthrough seizures --so they're adding new meds. Zonisamide is the first one we've tried adding.

I collected some of my posts, comments and previous research while I was on phenelzine. Apologies in advance for any redundancy. I am simply combining information in a series of posts. It may make it easier for folks who are taking phenelzine (NARDIL®) currently and for those new to MAOIs who may just be learning about the controversy on previous versions of phenelzine sulfate and the possible variability of the current generic options available, all issues that have reemerged with the discussions about LUPIN's generic's availability.
By no means is any of the forthcoming information NEW or mine or a result of expertise more than a patient doing his own research. Therefore please 'have at it!' Feel free to agree, disagree, append, hurt my frail feelings, whatever is necessary and best to have some productive useful, patient focused discussions.
By no means is any of the forthcoming information NEW or mine or a result of expertise more than a patient doing his own research. Therefore please 'have at it!' Feel free to agree, disagree, append, hurt my frail feelings, whatever is necessary and best to have some productive useful, patient focused discussions.
I elected to separate into different sections with links to each part for easier navigation.

• PART 1A: "Old Nardil vs. New Nardil Comparison: Was The Old Version More Effective?" From Mental Health Daily, 08/16/2014
• PART 1B: Patient comments to "Old Nardil vs. New Nardil Comparison: Was The Old Version More Effective?" From Mental Health Daily, 08/16/2014
• PART 2A: Patient discussions #1 regarding increasing the efficacy of Phenelzine (NARDIL®) From Psycho-Babble Medication by Dr. Bob
• PART 2B: Patient discussions #2 regarding increasing the efficacy of Phenelzine (NARDIL®) From Psycho-Babble Medication by Dr. Bob

Please note that the following information is from an online message board and should not be regarded as medical advice.

______________________________________________________________________________________________

• PART 2B
• Patient discussions #2 on increasing the efficacy of Phenelzine (NARDIL®)
• From Psycho-Babble Medication by Dr. Bob

Old and New Nardil - Here's the difference

Posted by Michael Bell on February 16, 2006, at 22:18:50In reply to What's Different Between the Old and New Nardil?, posted by shasling on January 26, 2006, at 10:05:59
​

Hey folks, long time no see. Sometimes I peruse this board quickly to see what the topics are, and so I decided to respond to this one since it is an issue I have dealt with to a huge exent.From the descriptions of others, research and my own experiences, I believe there are two problems with the new nardil as compared to the old:
1) new nardil is absorbed before it reaches the new intestine
2) even if new nardil does reach the new intestine, the absorbtion *rate* is off balance
That's why placing nardil in plasmin plus enteric tabs were only partially effective. yes, more phenelzine would likely survive the trip through the stomach, but once the enteric tab dissolved, the nardil itself won't be absorbed to the maximum level without an excipient to aid it.
The best excipients to aid absorption into the small intestine are sugar invert (a.k.a. honey) and ethanol (alcohol). Sugar is quite good, but the absorbtion rate, though high, is relatively slow.
As far as absorption into the small intestine, NOTHING beats alcohol. It's rate and level of absorption by the small intestine is extremely high. Obviously, I don't mean kick back shots of tequila, I'm talking mere drops of the substance.
Therefore mixing nardil with either honey or alcohol has been much more effective.

Re: Old and New Nardil - Here's the difference

Posted by sheensmusic on July 9, 2010, at 7:28:54
In reply to Re: Old and New Nardil - Here's the difference, posted by sheensmusic on July 9, 2010, at 7:27:51
​

New Nardil needs to be augmenting because of its loos in some of its specific benefits and effects when it was reformulated to generic!!!
Here are the Cocktails that seem to work if you have had Anxiety resurface and or more ups an downs!
- Neurontin at high dosages seems to be with the new Nardil great for suppressing Anxiety and for Social phobia.. Where the Old Nardil kicked *ss on SP and anxiety..
Now if you ad Neuron-tin in its more like the Original Nardil..
- Lamictal in the mix can boost the antidepressant effects of the new nardil and level off mood swings..
- Seroquel can help with sleep and also help level moods and enhance anti-depressant effects...
The New Nardil Has lost its kick basically in how it is metabolised because of its coating...
Now it needs to be enhanced with other meds in order to get it back more like its originally formulation..
I have spent 16 years on Nardil and went thru its reformulation transition and the withdrawals when it lost effects in its new Formulation by Pfizer in 2003...
I have spent years trying add-On meds to test and manipulate nardil...
I also found that if you take 2 or 3 15mg tabs at night it will metabolize more and you will awake like if you were on the old nardil..
I am on 90mg a day and where it says take 1 tab six times a day..
I found its better too take 2 in a.m. 1 in afternoon and 3 at night and it metbolizes more and effects you more like the old Nardil!!!!

Re: Old and New Nardil - Here's the difference

Posted by Lamdage on July 10, 2011, at 19:47:54
In reply to Old and New Nardil - Here's the difference, posted by Michael Bell on February 16, 2006, at 22:18:50

> The best excipients to aid absorption into the small intestine are sugar invert (a.k.a. honey) and ethanol (alcohol).
Sugar is quite good, but the absorbtion rate, though high, is relatively slow.>> As far as absorption into the small intestine, NOTHING beats alcohol. It's rate and level of absorption by the small intestine is extremely high.
Obviously, I don't mean kick back shots of tequila, I'm talking mere drops of the substance.>> Therefore mixing nardil with either honey or alcohol has been much more effective.Micheal!

I collected some of my posts, comments and previous research while I was on phenelzine. Apologies in advance for any redundancy. I am simply combining information in a series of posts. It may make it easier for folks who are taking phenelzine (NARDIL®) currently and for those new to MAOIs who may just be learning about the controversy on previous versions of phenelzine sulfate and the possible variability of the current generic options available, all issues that have reemerged with the discussions about LUPIN's generic's availability.
By no means is any of the forthcoming information NEW or mine or a result of expertise more than a patient doing his own research. Therefore please 'have at it!' Feel free to agree, disagree, append, hurt my frail feelings, whatever is necessary and best to have some productive useful, patient focused discussions.
By no means is any of the forthcoming information NEW or mine or a result of expertise more than a patient doing his own research. Therefore please 'have at it!' Feel free to agree, disagree, append, hurt my frail feelings, whatever is necessary and best to have some productive useful, patient focused discussions.
I elected to separate into different sections with links to each part for easier navigation.

• PART 1A: "Old Nardil vs. New Nardil Comparison: Was The Old Version More Effective?" From Mental Health Daily, 08/16/2014
• PART 1B: Patient comments to "Old Nardil vs. New Nardil Comparison: Was The Old Version More Effective?" From Mental Health Daily, 08/16/2014
• PART 2A: Patient discussions #1 regarding increasing the efficacy of Phenelzine (NARDIL®) From Psycho-Babble Medication by Dr. Bob
• PART 2B: Patient discussions #2 regarding increasing the efficacy of Phenelzine (NARDIL®) From Psycho-Babble Medication by Dr. Bob

Please note that the following information is from an online message board and should not be regarded as medical advice.

________________________________________________________________________________

• PART 2A
• Patient discussions #1 on increasing the efficacy of Phenelzine (NARDIL®)
• From Psycho-Babble Medication by Dr. Bob

Re: ... Old and New Nardil (warning: very long) » shaslingPosted by Tomatheus on January 28, 2006, at 22:14:49
In reply to What's Different Between the Old and New Nardil?, posted by shasling on January 26, 2006, at 10:05:59

Suzie,Considering that I'm guilty of having made several references to the "old" and "new" Nardils without really giving much of an explanation, it seems appropriate that I should offer a response to your post.To answer the first part of your question on the simplest level, Pfizer essentially changed the formulation of the U.S. version of Nardil. Many of the inactive ingredients in the "old" Nardil are no longer in the "new" Nardil, and the coatings of the two formulations look obviously different. The "old" Nardil had a hard, shiny candy-like coating, whereas the coating of the "new" Nardil is softer and has the lettering ("PD 270") engraved into it. Pfizer began distributing the "new" Nardil to pharmacies in the place of the "old" Nardil in the fall of 2003. I've listed the inactive ingredients of the two Pfizer Nardil formulations below:THE "OLD" PFIZER NARDIL (Parke-Davis Division of Pfizer Inc., 2001)* Acacia, NF* Calcium carbonate* Carnauba wax, NF* Corn-starch, NF* FD and C yellow No. 6* Gelatin, NF* Kaolin, USP* Magnesium stearate, NF* Mannitol, USP* Pharmaceutical glaze, NF* Povidone, USP* Sucrose, NF* Talc, USP* White wax, NF* White wheat flowerTHE "NEW" PFIZER NARDIL (Parke-Davis Division of Pfizer Inc., 2003)* Mannitol, USP* Croscarmellose sodium, NF* Povidone, USP* Edetate disodium, USP* Magnesium stearate, NF* Isopropyl alcohol, USP* Purified water, USP* Opadry orange Y30-13242A* Simethicone emulsion, USPNote: According to a letter sent to Pfizer by the FDA (Katz, 2003), the labeling document that Pfizer submitted as part of its supplemental new drug application (dated March 27, 2003) listed "corn starch, NF" as an inactive ingredient using strikethrough formatting.With respect to whether the "old" Nardil was better than the "new" Nardil, there is some disagreement, but it is my assessment that the "old" Nardil was clearly superior to the "new" Nardil in some individuals. From the experiences that I've read on this board and on the Anxiety Community's Nardil discussion board (http://anxietyhelp.org/treatment/medication/nardil.html), it is clear that some "old" Nardil users find the "new" Nardil to be markedly less effective and less tolerable (in terms of side effects) than the old product. There are others, however, who have reported no noticeable differences between the two formulations. I have yet to read an experience from someone who took both formulations and found the new one to be superior to the old one. From the posts I've read on the topic, it seems that among those who took both the "old" and the "new" Nardils, most tend to describe the old formulation as being superior to the new one. What is not entirely clear is whether the posts I've read are representative of the overall group of patients who have taken both the "old" Nardil and the "new" Nardil. It is generally believed that those with positive experiences to meds in general to be underrepresented on online discussion forums, so it's possible that those with negative experiences on the new Nardil might not actually be in the majority; they might just be more likely to report their experiences here. But then again, there is no way to know to what extent certain groups of patients are overrepresented here or underrepresented here, so I guess that only thing I can say for sure (assuming that all the reports are accurate) is that some patients (at least several hundred, based on some reports) noticed a significant difference between the "old" and "new" Nardils (with the "old" Nardil being superior), and others did not notice a difference.In terms of hard data that show a difference in terms of the ways in which the two formulations exert their effects on the body, I have only been able to find one clearly measurable difference. This is not to say that there are not more differences. The problem for me with respect to finding hard data has been twofold: one, I've only had so much time so far to research the Nardil formulations; and two, the amount of hard data regarding the differences between the formulations is likely limited. In terms of my research, I plan to do more, and it's quite possible (and I would even say likely) that I will find more data suggesting that the two formulations affect the body differently. But for now, the only thing I have is that the peak plasma concentration of the "old" Nardil occurred between two and four hours postdose (Robinson et al., 1985, as cited in Mallinger & Smith, 1991), but the peak plasma concentration of the "new" Nardil occurs approximately 43 minutes after the administration of a single 30 mg dose (Parke-Davis Division of Pfizer Inc., 2003). Because I currently only have the abstract of the original article reporting the peak plasma concentration of the "old" Nardil (Robinson et al., 1985), I don't know what dose of Nardil was given to the patients whose peak plasma concentrations of phenelzine (the active ingredient) averaged between two and four hours postdose. So, I can't really make a direct comparison between the two statistics without knowing whether those who received the "old" Nardil received the same dose as those who took the "new" Nardil. Of course, I will eventually track down the Robinson et al. (1985) article; it's just a matter of me being able to find the time to take a trip down to my nearest med school library. But even though a 100 percent direct comparison cannot be made, it still seems likely that there is a difference between the peak plasma concentrations of the two formulations. If nothing else, such a difference would be consistent with patient reports that the "new" Nardil -- but not the "old" Nardil -- sometimes begins to dissolve in the mouth if not swallowed quickly enough.Between this board and the Anxiety Community's Nardil discussion board, patients have put forth several different (but sometimes related) hypotheses that have attempted to explain why some patients find the "new" Nardil to be inferior to the old product. Generally, there seems to be a consensus that the "old" Nardil's hard coating (possibly an enteric coating, which is not dissolved until it reaches the small intestine) and/or its relatively slow rate of dissolution and absorption in the body are what cause some patients to find it to be superior to the new formulation.At this point, I am researching the possibility that too much phenelzine (Nardil's active ingredient) might make its way directly to the liver (where it is metabolized) if it dissolves in the stomach. In accordance with this possibility, I'm also going to be looking into whether or phenelzine is absorbed directly into the bloodstream (without first going through the liver) when it's enterically coated and absorbed in the small intestine. If both of these ideas are true, then I would be able to say with some certainty that at least part of the problem with the "new" Nardil is that it dissolves in the stomach, allowing too much of the phenelzine to go directly to the liver instead of making its way to the small intestine, where it can go directly to the bloodstream and potentially to the brain. The implications of too much phenelzine going directly to the liver would be twofold: one, there would be significantly less phenelzine to enter the bloodstream, reach the brain, and exert its antidepressant effects; two, a relatively large amount of phenelzine would immediately go to the liver and be metabolized to the bioactive amine beta-phenylethylamine, or PEA (Baker et al., 1999). PEA levels would rise to excessively high levels both because more PEA would be created (through the rapid metabolism of phenelzine in the liver) and because less PEA would be destroyed (via the inhibition of MAO-B, the enzyme responsible for the degredation of PEA). Considering that PEA stimulates the release of dopamine and briefly stimulates dopamine receptors (Barroso & Rodriguez, 1996), dopamine levels would also rise to relatively high levels (higher with the "new" Nardil than with the "old" Nardil) -- levels that would likely be excessively high for many traditional MAOI responders suffering from depression and/or anxiety. So, once again, if my mini hypothesis here has any validity, the problem with the "new" Nardil would be a combination of there being not enough MAO-A and MAO-B inhibited in the brain and there being an excessively high level of dopamine, especially in comparison to serotonin and norepinephrine. Raising the dose of the "new" Nardil would raise the level of MAO inhibition in the brain, but it would also allow dopamine to keep rising disproportionately in comparison to the other neurotransmitters. This could, among other things, explain why patients who took both Nardil formulations were more likely to experience insomnia and other side effects on the "new" Nardil, and why some patients reported after the formulation switch that still felt Nardil's antidepressant effect (to a lesser extent than with the "old" Nardil) but not its anti-anxiety effect (high dopamine = generally bad for anxiety). And of course, it could explain why simply raising the dose of the "new" Nardil would not produce the same results as the "old" Nardil.To answer your last question, it is my understanding that no version of Nardil produced anywhere in the world is exactly the same as the "old" Pfizer Nardil in terms of the drug's inactive ingredients. Based on information that I have gathered, the inactive ingredients for the Australian Nardil (manufactured by Link Pharmaceuticals) are listed differently than the ingredients for the U.K. Nardil (manufactured by Concord Pharmaceuticals). But considering the fact that Link is the "marketing authorisation holder" of the U.K. Nardil and the fact that the U.K. and Australian versions of Nardil appear to have the same type of coating, it's possible that they might actually be the same (with some of the ingredients in the U.K. Nardil being incorporated under the "coating" ingredient for the Australian Nardil), or at least very similar. Here is a breakdown of the inactive ingredients of both the U.K. and Australian Nardils:CONCORD (U.K.) NARDIL (James, 2006)* Mannitol* Povidone* Magnesium stearate and maize starch with the tablet coating containing hydroxypropyl cellulose* Polyvinylacetatephthalate* Stearic acid* Sunset yellow (E110)* Titanium dioxide (E171)* Erythrosine (E127)* Hydroxypropylmethylcellulose (E464)* TalcAccording to David James (2006), Concord's product information and technology executive, the company's formulation "has been in use prior to the current Marketing Authorisation Holder acquiring the rights to the product in 1999."LINK (AUSTRALIA) NARDIL (Link Medical Products Pty Ltd, 2004)* Mannitol* Povidone* Maize starch* Magnesium stearate* Coating (Opadry 20A25096 Red)Finally, with respect to the efficacy of the U.K. and Australian versions of Nardil, I have read mixed reports from those who have posted both here and on the Anxiety Community's Nardil discussion board. Some Nardil users from the U.K. and Australia argue that their versions of Nardil are no different from the "old" Pfizer Nardil. But then again, I don't recall having read a message written by someone from either Australia or the U.K. who took *both* their local Nardil formulation and the "old" Pfizer Nardil. I suspect that the Nardil formulations in both the U.K. and Australia either haven't been changed at all or haven't been changed in significant ways. So, for those who have *only* taken either the Australian Nardil or the U.K. Nardil all along, the new stuff would be just as good as the old stuff because nothing about their versions of Nardil have changed. What I can with respect to the "old" Pfizer Nardil and the various international Nardils is that some former "old" Nardil users on the Anxeity Community's discussion board have tried taking either the U.K. version of the drug, the Australian version, or both, and they generally found the U.K. and Australian Nardil versions to be comparable to the "new" Pfizer in terms of both efficacy and side effects.Even though I live in the U.S., I have been taking the Australian Nardil with somewhat successful but sometimes frustrating results. What's frustrated me about Nardil is that I usually feel its antidepressant effect for the first two to three weeks after increasing to a higher dose (assuming that my dose is at least 60 mg), but then I experience a sort of negative energy that doesn't completely negate the antidepressant effect, but sort of makes it less noticeable. The best thing that I can compare the "negative energy" to is how I felt on Wellbutrin, which would suggest that my dopamine levels might be disproportionately high in comparison to those of norepinephrine and especially serotonin (remember, this is consistent with what I had hypothesized about earlier). I suspect that if I add something like Lamictal to my Nardil (as some Nardil users tend to do), it might help with the "negative energy" and allow Nardil's antidepressant effect to shine through. I might very well end up going this route. But right now, I've actually just begun a trial of the make-your-own enterically coated Nardil that PsychoBabble member Michael Bell first tried. I've already noticed some improvements, but I'm going to wait a few weeks before making a judgment as to whether or not the make-your-own enterically coated Nardil approach is something that's truly working for me. But anyway, if you would like more information on Michael Bell's approach, check out these links:

http://www.dr-bob.org/babble/20050527/msgs/505052.htmlhttp://www.dr-bob.org/babble/alte20050510/msgs/506644.htmlhttp://www.dr-bob.org/babble/alte20050510/msgs/506649.html

Well, I hope you found my post helpful and not too confusing. If you have any questions about anything that I've written, feel free to let me know.Tomatheus

PRIMARY-SOURCE REFERENCESBaker, G. B., Urichuk, L. J., McKenna, K. F., & Kennedy, S. H. (1999). Metabolism of monoamine oxidase inhibitors. Cellular and Molecular Neurobiology, 19, 411-26.

Barroso, N., Rodriguez, M. (1996). Action of beta-phenylethylamine and related amines on nigrostriatal dopamine neurotransmission. European Journal of Pharmacology, 297, 195-203.James, D., personal communication (e-mail), Jan. 4, 2006.
Katz, R., republished personal communication to Alan Dunbar, Pfizer, Inc. (letter), n.d. (apparently 2003). Retrieved January 13, 2006, from http://www.fda.gov/cdefoi/applette2003/11909slr033ltr.pdf
Link Medical Products Pty Ltd. (2004). Nardil Phenelzine Consumer Medical Information. (Available from Link Pharmaceuticals Pty Ltd; Level 1, Bridgeport Centre; 3 Brady St.; Mosman NSW 2088, Australia)
Mallinger, A. G., & Smith, E. (1991). Pharmacokinetics of monoamine oxidase inhibitors. Psychopharmacology Bulletin, 27, 493-502.
Parke-Davis Division of Pfizer Inc. (2003). Nardil® (Phenelzine Sulfate Tablets, USP), labeling information. Retrieved January 13, 2006, from
http://www.fda.gov/cdefoi/label/2003/11909slr033_nardil_lbl.pdfParke-Davis Division of Pfizer Inc. (2001). Nardil® (Phenelzine Sulfate Tablets, USP), labeling information. Retrieved January 13, 2006, from
http://www.fda.gov/cdefoi/label/2002/11909slr030lbl.pdf

SECONDARY-SOURCE REFERENCERobinson, D. S., Cooper, T. B., Jindal, S. P., Corcella, J., & Lutz, T. (1985). Metabolism and pharmacokinetics of phenelzine: Lack of evidence for acetylation pathway in humans. Journal of Clinical Psychopharmacology, 5, 333-37.

Male/33/160lbs/doesn’t smoke. Sooooo I’m going to try and break this down simple and can always answer more but if anyone can help or give advice I would be so thankful. 2006 (I was 17) got my first seizure. Luckily I was able to stumble to my dad’s room while pretty much unconscious he watched me have tonic clonic seizure lasting 40 minutes (yes 40 minutes). He called 911 they took me to the hospital and I had 6 more. One of which I had DURING an EEG. The hospital neurologist said it was epilepsy and put me on trileptal a month later same thing happened. He then added keppra to the mix. A month later I went into status epilepticus. I stopped seeing that doctor and went to NYU/Columbia university and saw Dr. Karceski. He looked at the EEG and said it’s not a seizure it’s a “silent migraine” he put me on amitriptyline. A month later same thing. I get them every month roughly for ONE DAY that day I can have 1 all the way up to 10. It then takes a week till I can feel “normal”. After doing the amitriptyline for a year with no help I saw a Lyme disease specialist. He said it was due to Lyme’s Disease granted I had it when I was 12 months old (first person in NJ to ever get Lyme they actually flew Mayo Clinic) he put me on doxycycline. I was on that for a year to once again no prevail. Mind you every time I see a new doctor I get off everything so whether I am on any medicine or not it has yet to have any effect. I then went to Morristown Neuroscience Center. He looked at the same eeg and said it’s not a seizure or a migraine it’s a sleep disorder. He put me on clomipramine. Long story short a year and no results. Then went to UPenn and she said it’s epilepsy and put me on lamictal. Kept upping the dose till 600mg a day and zero results. Pretty much gave up and my life is pretty much in fear. I’ve been on Dilantin, depakote, trileptal, keppra, lamictal, gabapentin, klonopin, diazepam, I’m sure I’m missing a few. I have tons of videos of recording of my episodes. They can be different all the time. They time of month they start always begins in my sleep then I will get them the rest of the day. I can’t eat for a week after either. I can have tonic clonic all the way to standing up walking in another room because I feel them coming have it while still standing then come back to where I was and speak jibberish. Regardless of the severity of the episode the after effects are always just as bad where I literally am on a different planet for a week. I’ve gotten mri’s mra’s catscans 7 day eeg’s. No doctor can agree on what they see and no doctor can find anything to help. 16 years later over 800 seizures and I feel I just need to give up I just don’t get why they don’t care. If anyone had been in my situation and found a solution please share. I have many videos of me having and episode but I will post the most recent at the moment it will be in the first comment. I will add more if requested. Please help!

Sooooo I’m going to try and break this down simple and can always answer more but if anyone can help or give advice I would be so thankful. 2006 (I was 17) got my first seizure. Luckily I was able to stumble to my dad’s room while pretty much unconscious he watched me have tonic clonic seizure lasting 40 minutes (yes 40 minutes). He called 911 they took me to the hospital and I had 6 more. One of which I had DURING an EEG. The hospital neurologist said it was epilepsy and put me on trileptal a month later same thing happened. He then added keppra to the mix. A month later I went into status epilepticus. I stopped seeing that doctor and went to NYU/Columbia university and saw Dr. Karceski. He looked at the EEG and said it’s not a seizure it’s a “silent migraine” he put me on amitriptyline. A month later same thing. I get them every month roughly for ONE DAY that day I can have 1 all the way up to 10. It then takes a week till I can feel “normal”. After doing the amitriptyline for a year with no help I saw a Lyme disease specialist. He said it was due to Lyme’s Disease granted I had it when I was 12 months old (first person in NJ to ever get Lyme they actually flew Mayo Clinic) he put me on doxycycline. I was on that for a year to once again no prevail. Mind you every time I see a new doctor I get off everything so whether I am on any medicine or not it has yet to have any effect. I then went to Morristown Neuroscience Center. He looked at the same eeg and said it’s not a seizure or a migraine it’s a sleep disorder. He put me on clomipramine. Long story short a year and no results. Then went to UPenn and she said it’s epilepsy and put me on lamictal. Kept upping the dose till 600mg a day and zero results. Pretty much gave up and my life is pretty much in fear. I’ve been on Dilantin, depakote, trileptal, keppra, lamictal, gabapentin, klonopin, diazepam, I’m sure I’m missing a few. I have tons of videos of recording of my episodes. They can be different all the time. They time of month they start always begins in my sleep then I will get them the rest of the day. I can’t eat for a week after either. I can have tonic clonic all the way to standing up walking in another room because I feel them coming have it while still standing then come back to where I was and speak jibberish. Regardless of the severity of the episode the after effects are always just as bad where I literally am on a different planet for a week. I’ve gotten mri’s mra’s catscans 7 day eeg’s. No doctor can agree on what they see and no doctor can find anything to help. 16 years later over 800 seizures and I feel I just need to give up I just don’t get why they don’t care. If anyone had been in my situation and found a solution please share. I have many videos of me having and episode but I will post the most recent at the moment it will be in the first comment. I will add more if requested. Please help!

I definitely feel the pain/depression, but I haven't been able to cry over things that even normally would make me cry. Since the end of October, the following has happened:

1. My grandmother (my last remaining grandparent) whom I was very close to found out she had lung cancer and passed away a couple of weeks later.
2. My great aunt (who I was also very close to and played a very large role in helping me cope with this disorder) also found out she had lung cancer around the same time as my grandmother (she also found out she had leukemia). She was in her 80s and lived a happy, long life, but that doesn't make it hurt less. She passed away while I was at the funeral home with my grandmother and I was unable to go to her funeral because work doesn't cover extended family and I was on leave for bereavement already for my grandmother.
3. My cousin passed away after many years of fighting cancer, being in remission, fighting again, etc. I also couldn't go to her funeral.
4. My sister has been in the hospital since the beginning of December with necrotizing fasciitis (flesh eating bacteria that only about 12 Americans get each year). She has had multiple surgeries and they thought they finally got it all and started reparative surgery to replace all of the tissue they had to cut out. Found out yesterday that they didn't get it all and it is back, so back to surgery it is.
5. This one may seem unworthy of this list to some, but I think some will relate. My mother's 15 year old chihuahua that I bought for her in 2006 finally succumbed to congestive heart failure (as her sister-my 14 year old chihuahua) did in 2019. This, of course, brought back a LOT of hurt from that time (my chihuahua was like my first born child) and it makes me worry about my mother because that was HER best friend and she is not coping well. By the way, my mother had to go to the doctor the same day as she died and ended up being put in the hospital for acute kidney failure (she is out now), so she didn't even really get to say goodbye before she was buried.
6. Another (I say another because I have lost so many childhood friends over the years) one of my old friends died a couple of weeks ago.
7. My med switch from lithium to Lamictal is not going so well (as some of you may have noticed from my out of character rants). I am very much on a roller coaster and I go from 25mg to 50mg tomorrow and start all over. I am very sensitive to med and dosage changes.
8. Also noted on here in a comment to another user's post, my diagnosis was changed from BP2 to BP1. Although, that doesn't magically change anything about me, it has really upset me. I guess it is because I have watched my BP1 sister's life and it hasn't been pretty. There are reasons for that (i.e. she won't stay on her meds), but still.

I am sure the reason I can't cry is med related, but can anyone relate? I can see the brick wall that I am speeding toward, but I haven't hit it yet and I am scared of what is going to happen when I do.

Wanted to share my story with everyone. Hopefully can help some other people.
Dec 2001 - On a ski trip with friends, broke my leg in a fall and suffered an undiagnosed head injury
Dec 2005 - First grand mal seizure. Came out of nowhere, was at a party and then next thing I knew I was sitting against a wall covered in puke. No epilepsy diagnosis at the time, I had no thoughts that it was either. Assumed maybe just a freak storm in my brain.
Jan 2006 - Second grand mal seizure (at a Burger King rest stop on the way back to school, the ones in public are the most embarrassing). Epilepsy diagnosis at this time.
Feb 2006-May 2012 - Records 8 more grand mals, experimenting with various drugs and treatments, the usual, nothing of terrible interest occurs during this period.
Oct 2012 - Take the plunge and get a partial right temporal lobectomy. Right hippocampus, and amygdala are removed.
Summer 2017 - Finally removed from all meds.
Jan 2020 - Break through seizure in the middle of the night. Back on lamictal. This was probably the "worst" (in terms of the mental anguish that went with it) as it was never supposed to happen and I was 'cured'.

Hello. Thank you for reading this. You might be able to help save my life. I’m worth saving because I’m intelligent, passionate, loving, loved, have a big impact on my family, and feel a deep connection to this universe.
I’m a 43 year old male with everything to live for and believe I am losing my ability to keep fighting to heal.
I believe their are providers and centers and maybe medicines that could help me - I just need assistance finding them please.
The most succinct overview I can provide:
43, male, Boise, ID High functioning autistic Suffering from a rollercoaster of mental struggles that I’ve battled since 2006 Raised by a textbook borderline, addict mother, with an enabling, loving, alcoholic father Diagnosed with bipolar disorder in 2006 but likely never had full blown mania Likely mixed state bipolar mostly depressive Sometimes told my bipolar is well controlled and trauma and am told my PTSD are my main struggles Contracted covid in February 2020 and am maybe %80 better - severe damage to my stomach and brain On Lamictal, Adderall, clonazepam, and the tiniest amount of Seroquel possible due to the agitation it causes me - I wish I could take more I have potent reactions to medicine and have had severe akathisia with Safris, and some others I can’t remember Employed in a job I love, but one where I cannot keep up Loved deeply by my ex and my current fiancé - deeply hated by the mother of my children and she has tireless worked, and finally succeeded, at destroying my relationships and parenting - at any cost - the children have suffered the most Learned to not hate myself No suicidal but finding it more and more pointless to live No addicted to anything, although I do like the occasional hit of THC - I do not drink Tried 47 sessions of TMS which seemed to help clear my mind Eat healthy, but unable to exercise due to post covid PEM and a bit of POTS and exhaustion Covid seems to have attacked my prefrontal or entire cortex and I’m no longer able to rely on my intelligence to sort out my ups and downs But, I was a bit of a beautiful mess long before that Unable to tolerate most if not all antidepressants - though I’m always open to trying Ketamine was not positive though I might try a different course Interested in mdma and psilocybin assisted therapy - and after two years of study and preparation and multiple attempts at both I felt nothing - likely due to the SSRIs was on Spend my days trying to be the best partner, teammate, and stepfather I can When the work day is over, there’s nothing left but lying in bed, rocking back snd forth, and sobbing frequently I was bedridden all last year - there are no more friends, outings, exercise, joy, or hopefulness I’m trying my best to stand in the light Please help me if you can - because I’m well positioned to pass it forward and help others
J

I have been on seroquil since 2006 for sever depression-bipolar II. I have never had a manic or psychotic episode, although I have had very unpleasant mixed episodes. I have tried the gamut of antidepressants and even mood stabilizers and nothing worked until seroquil was added to the mix. I have been on doses that range from 200-900 mg. I am currently prescribed 800mg seroquil pm, lamictal 400mg pm, lithium 150/300mg am/pm and tegretol 200mg 3x day but I only manage to take it 2x day for multiple reasons. I am also on a host of other meds due to various ailments which I will list at the end. These are my only meds from my psychiatrist.
Twice in the last 4-5 days I awoke in the middle of the night unable to swallow. I have had some episodes when I am getting really sleepy and feeling like it took more effort to swallow but not feeling panic bc I wasn’t able to swallow. I have occasional restless legs but they were really bad each time I was awakened as well. I could only manage to swallow after multiple attempts -when I would stretch or turn a certain way -and then i could take one swallow. It was terrifying. When I woke up it was gone. I did reduce my seroquil to 700mg the next night - but it happened again- so reduced to 600mg which is where I am now. It has not happened again thank goodness. I have a call into my doc (he won’t be back in u til tomorrow afternoon). I am afraid one of two things will happen - 1. He will say “just continue at 600mg it will be fine” or he will say “come off the seroquil right now! “ without giving me any medication to replace it or deal w the effects of rapid withdrawal. ( I am aware that there is no evidence suggesting seroquil is addictive or that it has any withdrawal type effects but I promise you all that it has extremely unpleasant symptoms during dose reduction).
So my questions are-
Is there another effective way to control my bipolar depression? With or without antipsychotic?
Are there antipsychotics that don’t have the same side effects profile as seroquil? (Not quite as dangerous?)
And lastly- I have received ketamine infusions for the past 3 months for chronic pain. (5 total - 4 loading doses in first two weeks of feb 100mg each) the last one being almost exactly a month ago. I know ketamine helps w depression- it has helped mine- but is there evidence that maintenance ketamine therapy helps bipolar depression in particular? Could this be an option?
Other meds (I know some have neuropsychological effects but they are prescribed for reasons other than my psychiatric diagnosis).
Neurontin 300mg 3x day Synthroid 137mcg am Cytomel 5mcg am Robaxin 750mg 2x day Sunosi 150mg am (I only take half - it gives me panic attacks- for narcolepsy) Losartan 25mg am Atorvastatin 80mg pm Valcylovir 500mg am Meclizine 25mg pm Trulance 3mg am Esmoprazole 40mg am Celecoxib 200mg pm Pramipexole 0.25mg pm
Thank you for reading all of this and for any advice or insight anyone may have.

Hi there,
I've been diagnosed bipolar in 2016 (1 or 3 wdk???) And have ADHD too. I suffer a lot from anxiety and depression since like 2006 and when I'm too high I can experiment psychosises. Since 2018 I tried Seroquel, lamictal and lithium and now I'm about to try Depakote and Seroquel (and a lot of sport) The thing is : I can't really put up with AD and Thymoregulathors. If one makes me feel so bad and gross I wanna die, the other take me too high and too anxious and that's horrible too. At the end, I just feel endlessly sad and gross and I almost wanna die because everything looks absurd. My psychiatrist would like to try or Concerta or Atomexetine beside depakote. I read a lot about these meds but I'd like to know if some of you guys used to try the mix and how it happened because I'm a little frightened about getting too high.

Hi all, I was diagnosed with epilepsy in 2008 but was suspected to have it as early as 2006, my parents just didn’t know staring episodes were actually seizures. I have thankfully been seizure free for 10 (!!) whole years. I do not smoke marijuana or drink alcohol. I plan to continue avoiding alcohol, but I’m curious - can I smoke weed? Will it effect my seizures? I’m on lamictal for it. I just don’t want to break my streak because I’ve been very lucky. Any advice is appreciated

Hi everyone! I am not sure if you all can help but here’s the deal. I’ve always had poor circulation in my feet, causing them to get pretty cold and dead feeling. These days, though, they are turning purpleish blue basically every second of the day, and the coldness and discoloration is halfway up my calves now as well. I have taken two pictures, one of my feet when they look normal and one when they are playing dead: https://postimg.cc/gallery/pPC90N9
My calves and feet also get really bright red in the shower, like super super red. My hands and feet also get insanely hot sometimes at random, as well as my face. Like burning hot to the touch. I chalk that up to migraines though! Any help would be AMAZING!
Medical history: have asthma and was born with chiari malformation, decompression surgery in 2015. Tinnitus in both ears, always. Migraines with and without aura. Deviated septum. I had anemia as a child but have had good iron for at least 5 years. I can pop my shoulders and stuff out of place but have not been diagnosed with any connective tissue or hyper mobility disorders. Got appendix out in 2006, when I was 13 (first day of 8th grade at a new school woo!). Minor spondylosis and bulging discs in my cervical spine too, and apparently chronic inflammation in back and neck (maybe elsewhere). Mental illness as well, anxiety, depression, bipolar2. This is all I KNOW, because I hate hate hate going to the doctor and don’t really want any more diagnoses haha. However, I’d like to keep my feet!
About me: Ex smoker (on and off for about 8 years, about a month quit) do not drink ever and do smoke marijuana. No other recreational drugs aside from psilocybin about once every 3 years
Prescriptions: albuterol inhaler (use maybe once a week), 100mg lamictal for bp2, Claritin, and June FE (birth control)
Edit: forgot some stuff

Posting this out of desperation, as I normally don't put my business out there like this, but here we go. This is very long, but I am at the end of my rope and begging someone to help.
33, Female, white, ~250lb Est. Diagnoses: depression anxiety, chronic back pain, fibromyalgia Suspected: asthma, idiopathic intracranial hypertension (Dx in progress) Current meds (before hospital): Lamictal (tapering down), Prozac (tapering down), Gabapentin, Trazodone, Prn for tizanidine, tramadol, and albuterol rescue inhaler. Smoke: former (on/off 12 yrs, 0.5 pk/day, quit 4 months ago) Drink: former (quit 10 months ago) Vaping: Yes, until I had to go to the hospital.
Sick since 09/04. Called my PCP, didn't hear back, so I ended up starting to take a Medrol pack I had on hand, as that is what my doctor always seems to start with. I didn't hear from her until evening 09/05, and she said to do the Medrol and take Mucinex,which I did.
I have been in the hospital since 9/6. I arrived at with shortness of breath, headache, dizziness. 89% O2 saturation. EKG: clear Chest Xray: clear. Put on 1L supplemental oxygen, given a breathing treatment, and a large dose of IV steroids. The ER doc wanted to send me home, but I said no, because I wanted them to see what happened to my oxygen upon even minor exertion, as that's when it had been getting the worst. Sure enough. After about 25 min of no supplemental O2, the nurse came in to walk with me - but we didn't, because O2 had already dropped to 87%. I was admitted under the diagnosis of "acute respiratory failure with hypoxia".
Since then, I have heen receiving breathing treatments every 4 hours, steroids and antibiotics (IV until yesterday, now oral). Also, my O2 sat would not come above 93% until I was on 3L supplemental oxygen. Yesterday the doctor wanted to start weaning me off. Went down to 2L, I had a moment of really good breathing or something because I was at 95%. Then the doctor aggressively decided to go down to 1L. Within an hour, back down to 87%. Currently I have been back on 2L since yesterday evening and pretty stsble at 92%. Also yesterday he had me do a few slow walks in the hallway with a PCA, during which my O2 stayed stable at 91-92%, but my heart rate has been 95-125, even at rest now. Feels like I've been running a marathon.
This attending physician just won't do anything else to determine what is wrong with me! He just says it's exacerbation of asthma (have had in the past, no bad attacks since 2012 when I went to the ER for a treatment, and prior to that 2006. I have asked why I haven't been seen by a pulmonologist, and why there has been no additional imaging (just the ER chest xray). Doctor says. "I don't need you to see a pulmonologist in order for me to be able to treat you." And also thst there would be no more diagnostic stuff dobe in the hospital; I have to follow up with a pulmonologist after discharge. Which, I mean obviously, but how long will I have to wait for an appointment?
What is going to happen to me? Is this normal for them to just not care about why a 33 year yr old's oxygen is staying so low? To just be concerned about getting my oxygen up and kicking me out? (I should also mention that I DO have very good insurance currently, so I doubt that would be an issue). He's made it very clear he's not going to do anything else for me. I even talked to the patient relations manager, and while she seemed compassionate, when she came back after talking to the doctor, she said sorry but that's the way it is.
I want to know WHY. I could have kept myself alive at home with thd Medrol and my oxygen concentrator, but I came to the hospital specifically to find out why this was happening. Maybe this was a mistake. I want to know what I need to do to not end up here again, which I know will probably be a daily inhaled corticosteroid. I have taken these in the past (Dulera doesn't work, Advair HFA works "alright" during tougher times, Symbicort worked the best but then my insurance stopped covering it several years ago).
I am afraid this doctor will either: not do anything, and keep me here for who knows how long; and/or send me home when I'm still not breathing well and with no answers. I asked the nurses and RTs if they thought he was going to make me leave on a supplemental oxygen tank, and they said no -- they want my O2 sat at 92%+ on room air. At this point I am wondering if I'd be better off doing that, until I can get in to see the pulmonologist.
PS: about the intracranial hypertension, I have been dizzy with a pulsating headache (worse with any type of movement) since 08/19. Also when the pulsating is happening, my hearing is sort of going in and out. I had an MRI on 09/02 which showed bilateral swelling of the optic nerve sheaths, indicating possible papilledema/IIH. My PCP referred me to an ophthalmologist (not a neurologist), and the appointment is not until next Tuesday, 09/17. If I do have papilledema, at that point I will be referred to a neurologist. So while I've been in the hospital not breathing, I've also got this horrible headache, and dizziness when I move around.
Anyone who read all this, THANK YOU, I am feeling so hopeless and really need some support. Please please let me know your thoughts ASAP, I am so nervous about seeing the doctor in the morning (it's 430am as I'm typing this, can't sleep due to the headache).
UPDATE: As of this morning 9/11, the attending physician finally decided to have a pulmonologist come see me. He looked at some old PFT results, and though capacity and stuff was normal, there was one thing that was on the very low side of normal. I don't know the technical name,but it's the gas exchange from O2 to CO2. He said it is likely they will order a cat scan, but he's leaving it up to them.

Back in 2006, my wife took a head injury that resulted in seizures (mostly absence/partial seizures, which then progressed to convulsive ones as well.) She saw a pediatric neurologist (she was 16 at the time) who diagnosed her with temporal lobe epilepsy, and put her on Keppra and another med that she can’t recall now. The meds helped and after a few years (2009) the seizures were under control and she was taken off of the meds and discharged from her neurological care. The next ten years went by without incident, up until March of this year. She was working at a major retailer and was struck in the head by a metal shelf fixture, which resulted in a concussion. The first couple months after the injury were filled with MRIs and CTs and physical therapy and chiropractic care, and then at some point (it’s been such a long journey that I don’t even remember when) she started having seizures again. Her auras frequently include: intense deja vu that feels like whiplash (she describes this as her brain ping ponging around in her skull), the smell/taste of gasoline/motor oil/vasoline, the feeling in her stomach like she’s on a roller coaster, very high aggression/anxiety, feeling an intense feeling of dread, like there is some sort of impending doom. At first, her seizures looked like her eyes rolling back in her head with her eyelids fluttering, going non-responsive for several seconds to several moments at a time (conscious but non-responsive), going nonverbal, and having a hard time processing/understanding language. As they continued, they’ve progressed to also include some facial twitching and muscle weakness on the right side. Once a seizure happens, the after effects seem to last hours - she has memory loss and is dazed, disoriented, non-verbal, and she does not make rational and safe choices at times. At first she was on modified duty at work, working 1-4 hours per shift, but she’s now been on a leave of absence for several months. I still work, but I’ve had to miss a significant amount of shifts recently in order to be home with her. Because she had the experience of having seizures in 2006, she was able to coach me on how to handle some things - she doesn’t want to go to the hospital unless the seizures last for way too long or they include a new symptom (like when the facial tics started). In the end of July, there were two occasions that I took her to the hospital. They did blood tests and a CT and sent us home. In the midst of those hospital visits, she had a neurologist appointment, where she was prescribed Keppra because that’s what she was on back in 2006. The Keppra gave her awful side effects this time around, including worse aggression/agitation and suicidal ideation, so she was pulled off of that and started on Lamictal. At the beginning of August, she had a seizure and when she came out of it, she was very disoriented and seemed to think that it was 2003 (when she was 13.) I played along for a bit in order to not upset her, then reached out to her mom (who lives in a different state) who helped a bit and we were able to explain the situation to my wife, who was very freaked out but allowed me to take her to the hospital. They again basically just said that she had post-concussion syndrome and her memory would probably come back at some point, and sent us on our way. After about 36 hours, most memories were back, but she’s still experiencing lasting effects from that memory drop. Last week, she had a series of seizures while at physical therapy. The therapist there got ahold of her neurologist, who advised that she needed to be taken to the hospital via ambulance and loaded with Vimpat, and then kept overnight for observation. We ended up staying in the hospital for two and a half day, during which time she had an EEG and another seizure following that, and they gave her a prescription for the Vimpat in additional to her current prescription of Lamictal. She’s been seizure free for a week as of today, which is the longest span that she hasn’t had one in probably a month and a half or so. She had a neurologist appointment two days ago, where it was decided that her dose of Vimpat will include and she’ll be removed from the Lamictal, but when we went to pick up the new prescription, the pharmacy said that her insurance has been canceled (maybe because she’s on a leave of absence from work? I don’t know, but that’s really fucked up since it’s a work related injury that triggered this..) and the Vimpat is almost $1000 without insurance, so she wasn’t able to pick it up. This has been okay for a couple days because she’s got enough of the previous prescription to continue with the right dose, but eventually those will run out and we’re not really sure what to do. Money has been really tight with me missing work to help manage her care. Basically the neurologist says that she’s experiencing both epileptic seizures and non-epileptic ones, and that the pediatric neurologist never should have taken her off of the anti-seizure meds to start with. So now our running theory is that my wife has had epilepsy the entire time, and has actually been having absence seizures periodically throughout the last ten years, but they weren’t notable enough to really give thought to. (Sometimes she’ll have missing time, or have really intense episodes of deja vu, but we’ve just previously chalked it up to her spacing out for a bit or just having a weird brain.) We also think that she’s got photosensitive epilepsy, because several of her seizures were preceded by flashing lights. On two occasions that I’m aware of, including the day that she had the seizures at physical therapy, we were previously at a restaurant that had one of those buzzers that flashes when your food is ready. The seizure that occurred in the hospital was shortly after the EEG (which showed as normal, by the way) where they put flashing lights in her face. I know that photosensitive epilepsy is pretty rare, and that most people are triggered by the flashing lights immediately and not an hour or two later, but that’s the pattern that we’ve noticed. Stress is definitely a trigger as well, in additional to loud sounds, especially unexpected ones. I don’t really know why I’m posting this.. I don’t really have a question or anything. I guess I mostly just wanted to tell someone what’s been going on. Things have been hard and stressful. I’ve got a lot going on for myself, including unrelated grief and mental illness, and so dealing with all of this has been very rough. Of course, she’s my wife and I don’t begrudge her for any of this. I’m glad that I’m able to step up and help her wherever I can.. but it does have a toll. I guess, does anyone have any ideas on how to handle, well, any of this? If you’ve read this far, thank you so much. I’ve gained a lot of insight by reading through posts here, and I appreciate every last one of you guys.

I wanted to post this on epilepsy but it got blocked. If someone wants to share this there and can figure out how, then please do!
I've been researching the side effects of lamictal and wow! I've found only one peer-reviewed published journal article about hair loss with n=1, but they attribute it wholly to lamictal (link below). However, I did read in many places that seizure meds in general have the common side effect of hair loss (link below), as do SSRI's (link below), and possibly even heart burn med (link below). The studies and other anecdotal info I've read all say that the hair starts growing back after discontinuation. I've started titrating myself off a week ago after having been on 150mg for 7 years. Here are other published side effects attributed with this drug that I've experienced. ~ indicates I'm already seeing a positive difference in just a week being on half the dose. I will say that I'm rather disappointed that I'm just now researching all of this. I've decided that I'm going to be more aware of things my body does AND of the things I put into my body from now on.
~blurred/double vision (I seriously had problems focusing when trying to read, bought reading glasses at drug store, now a week later I don't even need them!)
Clumsiness/poor coordination (I noticed this getting worse but didn't attribute it to the med until I started researching it, so I guess I'll see)
~runny nose (was so embarrassing and annoying and wow what a change already-virtually gone)
~heartburn (was taking 10mg Omeprazole nightly or my heartburn was BAD, Haven't taken it in a week and zero heartburn. Here's something interesting: Omeprazole also has a listed side effect of hair loss.)
Painful periods (I'm curious to see if stopping the med affects this, fingers crossed)
Hives (had a REALLY weird unexplained bad outbreak, lasted 2.5 weeks straight, then would randomly come and go in the middle of the night over the entire mid section of my body, docs never figured out why, but after~5 months it went away on its own. Not sure if it's related to this med but it is a documented side effect sooo... Might not be related but I'm not weeding it out)
Difficulties metabolising alcohol (I've not had a drink since titrating down, but sneezing, headaches, and heartburn with mild alcohol consumption is usually attributed to difficulties metabolising it-most think it's allergies or a normal hangover, but it's not, going to a pool party today so I'll see... Again: the link with Omeprazole)
~Dry eyes (mildly noticed this getting better, but I live in the desert...)
Hair loss. Lots of it. I didn't put it all together until I went to my stylist and we talked about it at length. Came home, researched everything I'm taking, thought about when the various symptoms above started: ALL when I started lamictal!!
Hopefully this info helps someone.
Sources for side effects: Mayo Clinic
webMD
one study on hair loss
Hair loss with epilepsy meds
SSRI and hair loss (just in case you're interested)
Omeprazole has possible hair loss side effect

So I just started Lamotrigine for Hemiplegic Migraines and prolonged motor auras as a preventative--and so far, it's been about the only preventative I've noticed a decreased number of HM/aura symptoms. My dreams are crazy vivid now, it take HOURS to wake up, and I get a mild itchy rash on my forearms when I take it and when I eat (?!?).
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But I just happened to read inthe full FDA prescribing info that it inhibits folate?

102 Folate Metabolism: In vitro, lamotrigine was shown to be an inhibitor of dihydrofolate
103 reductase, the enzyme that catalyzes the reduction of dihydrofolate to tetrahydrofolate. Inhibition
104 of this enzyme may interfere with the biosynthesis of nucleic acids and proteins. When oral daily
105 doses of lamotrigine were given to pregnant rats during organogenesis, fetal, placental, and
106 maternal folate concentrations were reduced. Significantly reduced concentrations of folate are
107 associated with teratogenesis (see PRECAUTIONS: Pregnancy). Folate concentrations were also
108 reduced in male rats given repeated oral doses of lamotrigine. Reduced concentrations were
109 partially returned to normal when supplemented with folinic acid.

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Another more in-depth and vernacular article here.
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I just thought it was interesting since I currently take a methyl-b supplement because a doctor-dx'd MTHFR mutation, but lamotrigine might be more effective without it?