"i have bipolar disorder that stays on the depressed side, so i also take 750 mg of lithium in addition to 60 mg of nardil. i&#039;ve taken every tca, every ssri, and ssnri. i have aarp insurance, the add-on to medicare. nardil is a tier 4 drug, about $95/mo. i&#039;ve taken everything else, the drug was dropped to a tier 1. i changed all my meds to optum rx, and for 90 days of tier 1 or 2 meds, i pay $0. nardil is the most effective antidepressant i&#039;ve taken. the dietary restrictions are not a problem, but i cheat and have coffee. the problem is the lack of coordination if you need elective surgery.  communication between the anesthesiologist, psychiatrist, retina specialist/surgeon, and 3 rnp&#039;s is pitiful. anesthesiologist refuses to meet with me."