Psycho-Babble Medication | about biological treatments | Framed
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Making the switch. Prozac to Moclobemide.

Posted by JohnL on November 11, 1999, at 3:00:03

I like to follow everyone's drug tactics at this board. I don't think this post is of much significance for opening a new discussion, but I did want to update everyone on changes in my drug treatment.

After 6 months on Prozac nearly all my depressive symptoms were eliminated except the dreaded resistant anhedonia. Have tried augmenting with St Johnswort, Lamictal, Lithium, Naltrexone, SAMe. Everything had mild merits, but no effect on anhedonia. I learned a very important lesson on Naltrexone though. If a drug seems intolerable at first, taking the smallest amounts for a while to build tolerance allows eventual full dosage without problems. I tried Moclobemide once, had a horrible initial reaction at the minimum dose, quickly abandoned it.

After a week taking small bits of Moclobemide to take a second look-see, I'm tolerating it fine this second time around. Why is that? Anyone else ever noticed the body seems much more accepting to a disagreeable drug the second time around? Anyway, I guess I could be stable and OK the rest of my life with Prozac, but I'm not ready to throw in the towel yet. Not happy with mediocre. I'm willing to risk trying something new until I find a way to beat anhedonia into submission. Have tried all the SSRIs, so now I'll try an MAOI.

Moclobemide is supposedly good for all kinds of depressive subtypes. It has a questionable reputation at low-medium doses, with a good reputation at max or higher than max doses. Side effects so far (300mg) are easy. Shooting for 600mg to 900mg range. I was disappointed to run into disabling sexual dysfunction, but I'm pretty sure it's because the Prozac is still in my system. No wash out period. I think the addition of Moclobemide effectively elevated the effects of Prozac in my system, causing sexual dysfunction that didn't previously exist. We'll see as the Prozac fades. In all the studies I've looked at, there is nothing negative at all about Moclobemide concerning sex. It has even enhanced sex. SSRI sexual dysfunction has been 100% reversed by switching to Moclobemide. Hope so. We'll see.

My real hope is that this new approach will go a step further and have some effect on anhedonia. Won't know till I try, right? It's encouraging that studies show TCAs, Lithium, SSRIs, Pindolol, Naltrexone, etc are routinely added to Moclobemide for augmentation, even though the label warns against that. So I can go back and retry everything on Moclobemide if needed. Anyway, I live in Maine, 5 hours from Montreal. I can get refills by taking a day trip or by calling in a mailorder. For now, I have enough for 60 days. If all else fails, I can always go back to Prozac, but for now I'm willing to take the leap forward into uncharted waters. All my cyberbuddies, wish me luck! :) JohnL




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