Question: I'm trying to determine what course to take here...

I decided to come off Nardil due to emotional numbness/detachment, pervasive sense of fear, and compulsive/dangerous behavior.

on dropping from 45 to 30 slowly first morning dread and depression came back...It is less now but replaced by fractured thinking and confusion bordering on amnesia, lack of executive function, and increasing anxiety/flat-footedness around clients and in public. OMG and so much Nausea. Compulsive activity and weight has already dropped, sex drive is ramping back up.

My daily cycle for the last two weeks is: wake up sad and/or confused. Take 15 mgs Nardil, 100 mgs of Lamictal, 50 mgs of modafinil. Got me going but almost makes me more confused until I take a small amount of klonopin. Nausea ugh...By brain is spinning with self-obsessed thoughts instead of engaging in my job.

I crash after lunch and then crash further taking another full or half pill of Nardil and 25 lamictal in the late afternoon. Start getting very impatient again. Have to take 2.5 mg ritalin to keep going and then I'm so verbally full of garbage and oversharing. After a bit I feel relatively normal, but a little impulsive like before I dropped down, for the rest of the day. 100mg gabapentin and .5 mgs ativan at night. Cycle begins again in the morning.

I feel like I'm stuck at an impasse...afraid to go any lower because I don't want my original symptoms back, and not sure what to take next. I had a thought of going back up and adding tianeptine; lyrica or phenibut; and/or agomelatine for apathy and the weird fear/anxiety...All of them are here on on their way. My pdoc, who is mostly useless on the topic on MAOIs, wouldn't be on board with them obviously.

Also thought about using them to wean off but which one? they each look attractive in their own way. My hope was a simpler regimen. I feel frantic and stuck.

thank you. I have already commenced taking tianeptine, knowing that some people have luck mixing it with MAOIs to help with the apathy side effects of Nardil, etc. I am taking 37mgs of sulfate per day. There was an initial boost in mood and sociability for the two days.

I am now down to 15mgs of Nardil for the last 3 days, along with the 100mgs of Lamictal.

Still deciding whether to completely withdraw from the Nardil or not. Feelings of paranoia have gone, as has some weight, and I feel less obsessive. Since dropping, However, frustration and rage; the ability to engage in work without racing thoughts; and verbal communications are all getting worse. They were initial symptoms that were improved by Nardil, and I'm not sure what will take the place of Nardil. Tianeptine doesn't seem to address them (I am on day 4).

Questions about tianeptine:
-Because it acts as a serotonin reuptake enhancer, will this impact how my brain acclimates to the dropping levels of serotonin as I am weening off Nardil?
-Because Lamictal and tianeptine act similarly to reduce glutamate, will the tianeptine worsen my lamictal side effects like cognition and confusion?
-Are the dopaminergic actions of Tianeptine likely to cause anxiety in cases of trauma or family histories with bipolar or schizophrenia? Will they interact poorly with small doses of ritalin, buproprion, or modafinil?
-In the case that I do return to a higher dose of Nardil (I was at 45), Is there a chance that Tianeptine will help with social apathy, compulsive behavior, and numbing that were my worst side effects?

Thanks

I think that is a good course of action. I was just prescribed lyrica/pregabalin and will see if that is helpful with irritability and racing thoughts, concentration.

Cheers and thanks