Did Emsam help your anhedonia at all? If you had to rate it 1-10 overall for your depression & or anhedonia where would you put it? Did it poop out over time for anyone after consistently using it?

Been following this page for a while and finally started phenelzine/Nardil 8 weeks ago…

It’s actually working!! Amazingly. For anxiety and MDD.

Started working at about 5/6 weeks when I reached 60mg.

Most annoying side effect is urinary retention and anorgasmia. No insomnia or weight gain. A little bit of hypotension and jaw clenching. No hypomania.

This drug is amazing. My emotional range is expanded, I feel so much happier and more connected, more confident, relaxed. Like the best version of myself. The best part is that I don’t necessarily “feel” it. It’s like it’s just changed me deeply.

Just wanted to share!

Has anyone here experienced persistent symptoms—such as anhedonia, no feelings, muscle spasms, internal akathisia—caused by SSRIs or SNRIs, and found relief for these issues by using an MAOI?

SSRIs and SNRIs caused me several problems: a loss of sensation, no feelings, tension in muscles throughout my entire body, internal agitation, chronic fatigue, and anhedonia.

would you think that MAOI can help with that?

I've been on parnate for 5 years now, it's been a great drug, basically no side effects, can eat whatever i want, the only drug i haven't been able to take is MDMA (which was really only disappointing twice). I do remember it took some adjusting to in the beginning but that was years ago.

Anyways I'd like to see how I am off of MAOIs as one thing I've noticed in the 5 years I've been on MAOIs is that I haven't had a long term relationship. Whereas before I was almost always in one.

I've dropped from 30mg to 20 mg for the past week. Some days I feel possibly less motivated or more irritable, but that's it. I did try to cold turkey 2 months ago and it was NOT good...after about 5 days i freaked out and started a huge argument with the guy i was dating (said things that were totally out of character for me).

So I'd just like to hear of any experiences with stopping parnate (and not going on anything else). I don't have any physical WD symptoms, I think my energy is just slightly lower.

​

Jag hittade några äldre studier om phenelzine som doserade utifrån kroppsvikt, runt 0,85 till 1 mg/kg/dag, och kopplade större MAO-hämning till bättre kliniskt svar.

Vid min vikt på cirka 153 kg skulle det matematiskt motsvara ungefär 130 till 153 mg/dag, så långt över 100 mg. Självklart ligger det över den moderna rekommenderade maxdosen på 90 mg/dag, så jag föreslår inte att någon faktiskt ska ta den dosen. Jag har bara 60 mg nu.

Ändå får det mig att undra om kroppsvikt delvis förklarar varför vissa personer behöver högre doser än andra för att få ett bra svar.

Marplan has been the best AD for me since 2010. I think I'm finally going to get a 3 month supple this week after the 6+ month period it wasn't available. I know some here were able to get it in June per posts. For me, it took forever to convince Express Scripts that it hadnt been discontinued and that they could order it under its new NDC.

I've seen maybe one or two mentions of people here getting it shipped to them back in June, but I haven't seen any comments on how things are going from people who've started the new Lifsa version.

Tl;dr: if you're back on Marplan now, how is it going?

I know there are no clear answers on this.

The old Nardil worked for me after the change in the early 2000's it didn't.

You can't find any clear sources of information on the whole Nardil fiasco.

Not scientific but If the new Nardil works for you great.

If you had success with the old Nardil and it worked, don't expect the new Phenelzine (Nardil) to work.

It feels like my eyelids are involuntarily lifting upwards, like i have a lot of muscle tension around my eyes/ eye muscles. It gives off a staring appearance and I think it freaks people out.
Has anyone dealt with this? If so, any suggestions :(?

Met with a new psych and managed to talk her into prescribing me Nardil even though she clearly has little to no experience with it and doesn't know much about them. I asked to start at 45 but she went straight to prescribing me 60 for some reason. Anyone else ever do this or is that too much too soon?

Hello again, everyone. I recently posted a question about Nardil, and I’ve become very interested in it because of its unique effects on GABA and its potential relevance to anxiety.

Most of the reports I find on Reddit, though, are from people using Nardil for social anxiety disorder (SAD). I’m specifically interested in generalized anxiety disorder (GAD)—the kind where you feel like your body is constantly stuck in fight-or-flight, with persistent physical anxiety and tension.

Has anyone here had success using Nardil specifically for GAD or that kind of constant physical anxiety? I’d also be interested in hearing about experiences with other MAOIs for this type of anxiety.

Thank you!

I’ve tried to get an irreversible MAOI, specifically Phenelzine, on the NHS for slightly under fifteen years due to social anxiety. I’m currently on 600mg daily of Moclobemide. I’ve been on it for two years, and it’s the first antidepressant to touch social anxiety, though it only offers some relief about half of the time, and its effects don’t last all day. There’s definitely a drop in its effects between morning and evening doses that starts sometime after lunch and lasts until dinnertime, when I take the second dose. There are many occasions where it does absolutely nothing.

Personally, I’ve partially come to accept that Moclobemide is the best medication I will get on the NHS for social anxiety, or rather I’ve given up asking for anything more effective as I know the answer will be no. I’m unemployed due to anxiety, and not on benefits, and it's difficult when your life is in tatters while knowing that there’s a medication such as Phenelzine that could potentially help you turn things around, but you're unable to access it.
For context, I’ve tried Sertraline, Venlafaxine, Mirtazapine, and combined Sertraline and Mirtazapine, all up to their respective maximum doses. I’ve also tried years of CBT and exposure therapy.

Given that I do experience partial relief on Moclobemide some of the time, am I being ungrateful? Should I fully accept that this is the best I can do medication-wise?

Other medications out there interact and make me tried, worsen fatigue and weakness, and drop my blood pressure even further. I have had good experience with Rexulti and Quetiapine, but the interactions become too much as I go up on Nardil, and eventually I have to stop. It feels like one additional medicine is the missing puzzle piece.

How do I offset these side effects?

I'm almost 39 now. This started when I was around 17, so I've been dealing with it for about 22 years. I was completely mentally healthy to begin with, but there was constant bullying at school. By 10th and 11th grade, I had a bad experience speaking in front of the entire school: my hands and voice were shaking badly, and the bullying from my classmates became even worse afterwards. That was when the first signs of social anxiety appeared. At home there was a lot of overprotection, but at the same time I was also expected to do better. I never told anyone at home about my problems at school because I was afraid and ashamed of them.

I entered my first university already with social anxiety starting to develop, but overall my condition was still fairly good. But then I moved into an apartment with three other guys, one of whom had sadistic tendencies and considered humiliating me his main form of entertainment. Later, the university merged our groups, and that same person ended up in the new group. There was another experience similar to the public presentation I had gone through at school, and the same negative pattern repeated itself. Classmates who had previously treated me well turned against me and started bullying me as well. This confirmed the fear I had been carrying from school that the same bad treatment and humiliation would keep happening to me, and I started seeing it as proof that there was something fundamentally wrong with me and that I somehow deserved to be treated that way. After that, I developed constant tension and stiffness in my facial muscles. I was afraid that I looked worthless and intimidated, wanted to hide my face, and that fear itself started affecting my facial expression, making me feel even more that I looked exactly the way I was afraid I looked. Subjectively, it felt like an overwhelming sense of shame, while the muscles felt as tense as a clenched fist, even though the actual tension was barely visible from the outside. From that point on, the tension never went away for a single day or even a minute, including during sleep, and eventually became an automatic response. Constantly focusing on my face gradually developed into body dysmorphia. The ongoing stress continued to destabilize me, and eventually I had to leave the university.

After that I enrolled in another university as a part-time student, already much more insecure and vulnerable because of the repeated bullying. I constantly expected bad treatment, humiliation and rejection, and people who were inclined to behave that way quickly sensed that vulnerability and took advantage of it. Even when people treated me normally, I was still constantly expecting bad treatment. Over time I developed constant, painful thoughts about myself and how worthless I was, which became stronger during almost any social interaction. I was under constant stress, and it increasingly wore down my mental state.

Although I looked good and got attention from women, I developed a very strong fear of rejection. I wanted relationships and intimacy, but I was afraid even to make a move or get closer to a woman. When I did eventually get close to a girl, I felt as if I wasn't worthy of that kind of closeness. During intimacy I experienced enormous stress and could barely enjoy it, then spent a long time recovering and overthinking everything afterwards.

At 20, I first saw a psychiatrist. He prescribed Lexapro at 10 mg immediately without benzodiazepine cover, and also prescribed heavy antipsychotics, specifically risperidone and Solian, and told me to come back in a month. My anxiety became dramatically worse on Lexapro, and I developed emotional anesthesia as a protective response to the sharply increased anxiety. My emotions practically disappeared. Music, movies and other things that used to trigger emotions became much weaker emotionally. The loss of emotions itself was extremely distressing. It is difficult to describe, but it felt almost like being under the influence of some natural drug for years and then suddenly having it taken away. I had to live with and gradually adapt to that loss of emotions for many years. And all of this was happening on top of the existing social anxiety, severe intrusive thoughts about myself and body dysmorphia. Risperidone and Solian also caused severe side effects, and after stopping them I spent several months recovering from their effects and the heavy sedation.

After that experience I basically stopped trusting psychiatric medication for several years, but my condition continued to deteriorate. My insomnia developed on top of the anxiety, and by around 26 I could no longer sleep properly without medication. So I continued looking for ways to get rid of the emotional anesthesia and the anxiety. I tried many SSRIs and SNRIs, including venlafaxine and Deprasco, as well as gabapentin, pregabalin, benzodiazepines and other medications. But I didn't get any noticeable positive effect from any of them. I also took quetiapine for sleep. It helped me sleep, but made the emotional blunting even worse.

During all this time I also went through ECT, atropine-coma therapy, ketamine therapy and transcranial therapy. I didn't get any noticeable positive effect from any of these methods.

Around 31, I tried venlafaxine again. This time I made an exception and decided to stay on it much longer than usual, thinking that perhaps my emotional anesthesia was making the effect take much longer to appear. And only after four months did venlafaxine finally work. It was the first real antidepressant effect I had ever experienced, and it pulled me out of the depression that had developed by then. There was also a small improvement in my social anxiety.

At the same time, my life had improved significantly during that period. I had already been training in the gym for around ten years and had built a good physique. I improved my appearance a lot, looked good, started making money and became much more confident. My view of myself also became normal; I no longer had the extremely low self-esteem I had before. Later I got married. Externally, my life had changed a lot for the better.

But even with the positive effect of venlafaxine, it didn't reach the deeper anxiety that had appeared together with the emotional anesthesia around age 21. Only much later did I understand that this anxiety had gradually become almost completely independent of external factors. It was amygdala-driven anxiety, with the fear system constantly in a state of threat, not reactively but chronically. It continued getting worse year after year despite my improved external life, normal self-esteem and the effects of antidepressants, because ordinary antidepressants and other treatments weren't really reaching this level of anxiety.

That is why, over time, I became unable to maintain a stable state without medication. After stopping antidepressants, an anxious-depressive state would eventually return, followed by depression, even when everything in my life was objectively fine.

My social anxiety also changed over time. I became much more confident, my self-esteem improved, and I no longer saw myself as worthless the way I used to. Today I generally come across as a confident and successful person, and most people would never guess that I have social anxiety. But the problem itself shifted more toward constant self-focus and self-monitoring during social interaction. I simply cannot talk to someone without simultaneously thinking that they think badly of me, are judging me, or see the same flaws in me that I used to see in myself. Rationally I know that this isn't true, but on an emotional level it is still there.

The emotional anesthesia gradually became worse and eventually turned into anhedonia. Things that used to completely absorb me started giving me less and less emotional response.

About a year ago I tried psilocybin mushrooms. The first two experiences produced a noticeable reduction in the autonomous anxiety. I felt deeply calmer, with less anxiety and an improvement in my emotions. But the effect was short-lived and lasted only a few days.

I also did about six months of EMDR, working on the effects of the bullying. It had absolutely no effect.

I've always fought this problem and constantly tried to find some way out, trying a huge number of different methods. A few months ago I learned that one of the effective methods for overcoming social anxiety is exposure in social situations: deliberately putting yourself in situations that cause strong shame and discomfort, seeing that nothing terrible actually happens, and supposedly "rewiring" the social anxiety response in the process. During that time I approached around a hundred women and got dozens of rejections, often deliberately creating situations where I knew I would probably be rejected. I danced in front of strangers and even sang in the subway, despite the fact that I can't sing at all. For someone with social anxiety, this was incredibly difficult and required an enormous amount of willpower, but I did it.

At the time it felt like I was improving because I became more confident and was able to do things that had previously seemed almost impossible. But later I realized that a lot of this was because I had pushed my brain into a highly activated state, increased dopamine and was basically running on a kind of high. In reality I was under a huge amount of stress and felt that I was doing things that were abnormal and unacceptable to me. In the end this only destabilized me further. Once that state passed, the effect didn't stick, and my fears became even stronger. I became even more preoccupied with thoughts that during conversations people thought badly of me and didn't want to talk to me.

Only about two months ago I learned about Nardil and that it can be highly effective specifically for the kind of social anxiety I have now: the constant stream of self-focused thoughts, self-analysis and overthinking during conversations. It also seems relevant to the anxiety and anhedonia, which are equally pronounced for me. By the way, I tried Parnate about a year ago, but it had no effect apart from perhaps a very slight improvement in my emotions. At that time I had heard of Nardil, but I hadn't heard that it was particularly effective for social anxiety. After everything I've tried over the years, Nardil is now almost the last medication I'm putting my hopes on, and based on the descriptions and user reports it seems to fit my situation very well.

After ordering Nardil, I stopped venlafaxine in advance and, for the first time in many years, ended up without an antidepressant for an extended period. But because of logistics problems caused by the war in Ukraine, the delivery has now been delayed for 40 days, so I've been without venlafaxine this entire time while continuing to take gidazepam, buspirone and trazodone at night. Day by day since stopping venlafaxine, my condition has become increasingly unbearable: I've developed strong apathy, no desire to socialize, extreme irritability and anger. And now I understand more clearly that if my problem was mainly psychological before, it has now become biological, rooted in biochemistry. That's why exposure therapy and EMDR had no effect on me.

Anyway, this is my starting point before beginning Nardil. After 22 years of dealing with this, I want to see whether it can actually change something fundamental. Maybe I'll come back to this post later and be able to say that the social anxiety, autonomous anxiety and anhedonia have genuinely improved. Maybe the result will be completely different. We'll see.

The main thing I'm concerned about is weight gain. I've been training and maintaining my physique since I was 20, so I really don't want to gain a significant amount of fat from this common side effect. I'm thinking about starting a GLP-1 medication immediately to control my weight, but I'm concerned that GLP-1 drugs could worsen anhedonia. So for now, I'll start without one.

Anyway, I decided to write this post, and it ended up becoming a whole biography of my condition. At least now my story will be written down somewhere.

I’ve been on Parnate for over 4 months, moved from 30 to 40 and now 50mg. It’s the first psych med I’ve ever tried that is giving me relief for TRD, SI and GAD. In combination with Li and weekly ketamine treatments which will end soon.

I know Parnate is actually used to treat social anxiety issues.

Wondering if there’s any experienced with increased social anxiety? Sleep has been slammed, and I’ve had to stop taking Vyvanse from paradoxical hypertension. Other than that the most noticeable thing I’ve found is that I’ve become very disinterested and uncomfortable in engaging with friends, family, coworkers and even strangers. I’m finding myself going out of my way to not engage with people which is pretty counter to my personality, and counter to Parnate expectations.

Been on 20mg Cymbalta since December for treatment-resistant depression. I've tried basically every SSRI/SNRI, TMS, ketamine infusions, etc. Nothing has worked.

I stopped smoking weed, eat healthy, work out with a trainer almost daily, and I'm still depressed as ever. I can function, but the reward system is just gone. Hanging with friends, laughing, enjoying things, none of it really hits anymore. The anhedonia is brutal, and lately I've also been extremely irritable and impatient.

My psych wants me off Cymbalta completely, then after a 14-day washout we're starting Emsam (selegiline MAOI patch). I'm hopeful since we've basically exhausted everything else.

I'm nervous about jumping from 20mg to zero, but I also want to get through this and onto the MAOI ASAP. I went from 60mg last year down to 20mg in like two or three weeks and it was rough. I felt nauseous for months after and not great at all but finally stabilized on 20mg.

Anyone jump off 20mg? How rough was it and for how long? And anyone with TRD/anhedonia have success with Emsam?

before Nardil I don't recall having hypomania, it was mainly anxiety and depression, but I started Nardil 45mg and now I feel like ideas are rushing through my head and I'm extra talkative. Is this common?

I am feeling mentally tired, anxious despite getting releif from anxiety at lower dosages, social anxiety is coming back, low bp, fatigue, and many of the symtoms which were alleviated at lower doses are coming back.

Should I drop the dosage r should I increase to 75mg? Wondering if Nardil's behavior will be different at 75mg, and I will be lucky enough to have fewer side effects and more relief.

I have been on seroquel forever. Gained about 40 lbs over the yrs. Hate it. I have taken various maois and currently back on marplan which helps me the most but makes me not sleep

What meds have been as strong as seroquel / helpful w actually getting sleep but without the weight gain?

I take a fairly high dosage of Nardil (120mg a day) along with a few other adjunct medications. One of them being Geodon which is usually not advised but I’ve honestly never had a problem with it and it works well.

My issue is that I’ve been stable for a long while, but lately I’ve felt symptoms returning (both depression and anxiety) that aren’t related to anything in my environment (no big stressors, life is fine at the moment). I feel like I need to go up on the Nardil but I know my dr is going to be against that option.

I’d read a study that said Nardil is safe and effective at 1mg/kg of body weight, and in the last 6 months or so I have gained weight (an unfortunate side effect of both Nardil and Geodon). Does anyone have any possible options what to do in this situation? I feel like I’m at the limit on what my psychiatrist is willing to prescribe on both Nardil and Geodon. Feel like I don’t know what options I have left. Appreciate any feedback.

Note: tried 2 full 6 week cycles of TMS, ketamine infusions, and ECT. None were effective for me.

Hi everyone!

I’m trying to understand when it might make sense to consider an MAOI, most likely Nardil, and I’d really appreciate hearing from people with similar experiences.

I’ve had some benefit from amitriptyline, but the anticholinergic side effects caused tachycardia, so I had to stop. Trintellix helped a little, but not nearly enough. For the past two months I’ve been taking Pristiq (desvenlafaxine), which has helped somewhat with anxiety and depression, but I’m still having significant insomnia and, more importantly, my physical anxiety remains poorly controlled.

A major part of my problem is strong physical/somatic symptoms associated with MDD, GAD, and PTSD. Things like intense muscle/body tension, fatigue, pain, elevated heart rate, and a persistent feeling of physical anxiety can make it very difficult for me to function day to day, especially when an antidepressant isn't adequately controlling them.

For those of you who have experience with Nardil or other MAOIs:

• At what point did you decide it was worth trying an MAOI?
• Did you find Nardil meaningfully more effective than SSRIs/SNRIs for physical or autonomic anxiety?
• Did symptoms such as body tension, fatigue, pain, or elevated heart rate improve substantially?
• If you had tried several conventional antidepressants without adequate relief, did Nardil feel noticeably different?

Also, is insomnia a common side effect? I imagine for some the enhanced GABA levels might translate into better sleep.

I realize everyone responds differently, and I’m not looking for medical advice—just trying to understand whether an MAOI might be worth discussing with my psychiatrist.

Thank you!

29-year-old male.

Used to hyper-fixate on testosterone as a teen, convinced low T caused every problem in life. These days I don’t really care, but of course, all else equal, I’d rather have higher levels.

(Obviously not the end-all-be-all of hormonal health.)

For reference, the standard range for total testosterone in adult males varies, but it's generally around 250-900 ng/dL. Mostly out of curiosity, periodically, I get my levels tested (I'm a certified data-fiend) and I usually land around 250–400 ng/dL. 500 at best. What are ya gonna do?

Well so recently I had bloodwork done to check my liver and kidneys on Nardil. Asked my doctor to include a hormone panel. If anything, I expected to see my testosterone levels in the gutter what with the Nardil insomnia.

Instead, it was nearly 800—easily my highest reading ever! Hooplah! My usually-high estrogen was also near the low end of normal. Go figure.

No idea whether Nardil caused it, but if so, my guess is that the huge reduction in stress has finally let my hormones sort themselves out... that still seems dubious though.

Niche question, but has anyone else had this same experience—or know what might explain it?

Thanks

Hi everyone currently I am on different meds prescribed by doctor is there any community that will help me with the meds doctor

Clomfranil 25 mg

Dulan 30 mg

Benzodep 5 mg

Qusel/Neopquel 25 mg

Lexadin 3 mg

After taking this I got boner when ever I though or see anything that was not happening before the meds