Posted by JohnL on February 5, 2000, at 3:39:05
In reply to Re: Info about moclobemide/Manerix/(Aurorix), posted by Carol Patterson on February 4, 2000, at 20:18:39
Hi Carol.As with any drug, I don't think there is any possible way to predict in advance how Moclobemide will work with any particular individual. In general however the literature suggests it is effective in all types of depressions--melancholic, nonmelancholic, major, dysthymia. Literature also suggests it has a higher failure rate than other antidepressants it has been compared to. I have heard reports of people doing extremely well with it, and I've heard reports of people doing poorly with it. When I tried it I actually got more depressed and irritated. Sure enough, in the side effect label it lists depression as an infrequent side effect. So while it works wonders for other people, it didn't for me. I think it all depends on the individual's unique chemical imbalance and metabolism.
Literature suggests it is one of the most user-friendly drugs in terms of side effects. It is recommended for the elderly and for the sexually active patient. People who had sexual problems on SSRIs who successfully switched to Moclobemide had total restoration of their sexual function. I had absolute total anorgasmia with it, and partial impotence as well, but literature says that is transient. I was getting worse anyway, so I didn't stick it out long enough to see if the sexual side effects I had would have gone away or not. It's not a sedating drug. At higher doses it is energizing.
Moclobemide works by preventing enzymes (MAOs) from breaking down the neurotransmitters. It works mostly on the enzymes that break down serotonin and NE, with a smaller amount of action on the enzymes that break down dopamine. The result is an increased level of the neurotransmitters, with emphasis on serotonin and NE. It has the advantage over other MAOI drugs of not having any diet restrictions. Even so, it is advised to take doses after meals, not before. It also is reversible with a short half life which means another drug can be started after just a two day washout after stopping Moclobemide. Since I got worse with it, I was glad I could start another drug almost immediately.
There have been studies where Moclobemide was successfully combined with other antidepressants. This has been OK as long as dosing is cautious in order to avoid serotonin syndrome (serotonin overload-bad, sometimes deadly). In one of those studies a full dose of Moclobemide was combined with 40mg Prozac. That sounds darn aggressive to me, but apparently it was OK. There have been recorded adverse reactions when it was combined with the tricyclic Anafranil.
Moclobemide also has a reputation of working quickly...when and if it works. So if you decide to try it, you should know inside two weeks whether it is for you or not. If you're not feeling any progress at all, or feeling worse, after two weeks, the prognosis probably isn't very good. Results occur quickly when it's a good match for a particular individual. When it does work, it also has somewhat of a reputation for needing very high doses to maintain effectiveness. Doses as high as 1200mg (well beyond the max) have been used safely to maintain effectiveness.
Sorry, didn't mean to go so long here. But I hope some of this info might be of help to you. Regardless of my bad experience with Moclobemide, I think overall it is a drug with good potential in some people. It's too bad it's not available in USA. You'll never know how it works with you unless you try it. I think what determines how effective one drug is to another is how closely it targets a particular person's chemical imbalance. I believe that only from medication reactions can we get a clue as to whether we're hitting a bullseye or missing the target completely. JohnL
poster:JohnL
thread:3899
URL: http://www.dr-bob.org/babble/20000128/msgs/20551.html