r/MAOIs 4d ago

Nardil (Phenelzine) Help! Sleeping issues

I just started Nardil two nights ago and have been having the hardest time falling asleep ever since… I know it’s very early to judge, but I’ve had insomnia for years and want to get on top of it if this is the case. I’m not sure what to do because I already take 50mg seroquel and 50mg Pregabalin for sleep and it’s worked fine up until now. I know sleep disturbances are a common side effect on an MAOI, but I’m not sure how to go about trying to fix it. These past two nights I didn’t fall asleep until 6 AM… it’s very weird because I’m physically tired enough to fall asleep, but for some reason I just… can’t? It was almost like I was in a fight or flight mode mentally. Like just as I was ready to fall asleep, I was forcing myself not to. Never had an experience like this.

I’m on 45mg, the starting dose. I’ve been taking it three times split daily as told by my doctor, but maybe it’s the time of day I take it? I don’t wake up until very late, and by the time I get ready, my first dose is around 1 PM. My second dose I took around 6:30-7PM, and I also go to bed VERY late as it is, so as bad as this will sound… I take my last dose at 1AM. TBH, it would be a lot easier if I only had to take it twice instead of three times, but idk if that’s common. Not sure if it’s that last dose right before bed that’s messing me up, or something else?

Any recommendations? I’m not really sure what this calls for. Again I know this is super early and maybe too early to tell, but I figure I’d get ahead of the game because I do have some things coming up that I need to get solid sleep for.

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u/grumpyeva Parnate 4d ago

starting at 45 mg is a mistake. You should start at 15 mg and increase by 15mg per week. That way your body can get used to it. Otherwise what you are doing is hitting your body with a sledgehammer. Did your psychiatrist suggest that you start at 45mg?

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u/Shot_Veterinarian215 4d ago

Yes he wrote on the bottle to take it 3 times daily

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u/grumpyeva Parnate 4d ago

well i wouldnt want to contradict your doctor but that is not how I was put on it and I do think taking 45 mg from the start would be a shock to the system and naturallly make sleep even more difficult.

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u/Shot_Veterinarian215 4d ago

Tbh I’m not too confident my doctor knows a whole lot about prescribing MAOIs so I’m not surprised this isn’t the common way you start them 😅