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Re: social anxiety-HELP!!! RIMAs

Posted by Adam on November 30, 1999, at 14:40:22

In reply to Re: social anxiety-HELP!!! (Follow-up to Kevin), posted by Rick on November 30, 1999, at 13:47:22

I believe moclobemide is a fairly selecitve inhibitor of monoamine oxidase A, and has a very
low affinity for MAO-B. It (like befloxatone and brofaromine) is thus referred to as a
reversible inhibitor of MAO-A (RIMA). Its effect on dopamine is thus more modest than for
the non-specific MAOIs. I guess it is generally thought of as less robust an antidepressant
than the non-specific, irreversible MAOIs, though there is often a question of dosing:
Moclobemide doses a couple times higher than commonly prescribed often help people who do not
respond to it in the "usual" range (300-600mg/day). I've heard of doses of 900mg-1000mg
being used.

As for the indication of social phobia, results for moclobemide are mixed. Many studies suggest
moc. is beneficial, but there have been some recent studies calling that assessment into
question. One example:

Placebo-controlled trial of moclobemide in social phobia.

Schneier FR, Goetz D, Campeas R, Fallon B, Marshall R, Liebowitz MR

Department of Therapeutics, New York State Psychiatric Institute, NY 10032, USA.

BACKGROUND: Moclobemide, a reversible inhibitor of monoamine oxidase A, previously has been reported to have efficacy in the treatment of social phobia. METHOD:
Seventy-seven non-responders to one week of single-blind placebo were randomly assigned to moclobemide or placebo for eight weeks of double-blind treatment. Outcome was
assessed by independent evaluator, treating psychiatrist and self-ratings. After eight weeks, patients who were at least minimally improved continued treatment for a further eight
weeks. RESULTS: Intention-to-treat sample response rates at week 8 were 7/40 (17.5%) for the moclobemide group and 5/37 (13.5%) for placebo (NS). Moclobemide was
significantly superior to placebo on 2 of 10 primary outcome measures. Moclobemide was well tolerated. CONCLUSIONS: Moclobemide may have efficacy in the treatment of
social phobia, but absence of significant differences on most primary outcome measures and small effect sizes for all outcome measures suggest that the magnitude of its clinical effect is

> Yes, moclobemide (Manerix is the brand in Canada and the UK) may be worth trying at some point. Like so many meds, it seems to have helped some people a lot, helped others moderately, and was ineffective for the rest. The general consensus (both research and anecdotally) seems to be that it's generally not as effective for severe Social Phobia as the "Cheese Effect"-type MAOI's like Nardil. But who knows, it could turn out to be great help for you if given enough time to kick in.
> I know that U.S. citizens CAN legally import Manerix from Canada, but I'm not sure of the process. I have a feeling your local pdoc can procure it for you from a Canadian pharmacist.
> Also, Moclobemide *is* a NON-selective MAOI just like Nardil, since it helps preserve both serotonin and dopamine. What eliminates the food/drug restrictions (and may make it less potent) is that its effects are *reversible*, unlike non-reversible MAOI's like Nardil, Parnate, and Marplan.
> While I'm confident I've got the facts straight here, there are other posters who could better explain the details surrounding selectivity, reversibility, and how to get Manerix over the border.
> Rick
> ---
> > ** I think the first thing for you to do- if you haven't already- is to cut out the herb dude- it drastically exacerbates social anxiety.
> > As far as MOAI's go, Manerix (Moclobemide)is supposedly efficacious for social phobia. This is what they call a selctive MAOI, which has far fewer side effects and dietary interactions than the older versions. But If you are an American, I don't think you can get it. I know nothing else about this drug. (N.B., anyone with pertinent info or experiences please E-mail at once.




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