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Re: Moclobemide, really works in just 1 week? » Chocoholic

Posted by SLS on November 26, 2001, at 9:33:32

In reply to Re: Moclobemide, really works in just 1 week?, posted by Chocoholic on November 25, 2001, at 21:56:44

Hi again, Chocoholic.

I once knew a Chocolasaurus. Any relation? :-)


> So, this past year, I went to see Terence Ketter at Stanford and he gave me a huge list of ideas.
I would LOVE to know what he said. Can I convince you to PLEASE send me his list? Pretty-please?

sl.schofield@att.net

Dr. Ketter is one of my favorite research clinicians. He's a majorly smart guy. I didn't know that he was still seeing patients. I would have thought him too busy with his brain imaging studies. I know him from my treatment at the NIH (National Institutes of Health) in 1992-1993. He wasn't my doctor, but I knew quite a few people that he treated. He must be a nice guy. Along with Robert Post, I think he was the patients' favorite.

> So, I first added ziprasidone, then dropped moclobemide and added pramipexole (Mirapex).

Did Dr. Ketter choose ziprasidone specifically for its antidepressant properties?

> I am doing a lot better, in spite of some pretty heavy stressors in my life.I am still pissed about having this disorder, though and wish that the damn suffering would go to hell and never return!

I know. I was real pissed to have this disorder in the beginning too. Now, I have accepted completely my having it. For me, it just seems like a luxury to lament and become angry over my misfortune to be born with bipolar disorder. What matters to me now is the experience of life. I don't give a damn what illness I've got, just as long as it can be brought into remission. Like you said, the priority is the quality of life.


> I don't have social anxiety, but my niece was working with Michael Liebowitz at Columbia while he was doing a study with moclobemide for social anxiety. I can ask her about the results if you are interested.

Yes, I would be. Quite a while ago, I came across an abstract on Medline describing one of his studies of moclobemide and social phobia. The results as he described them were positive. However, I am a bit dubious that moclobemide will so frequently produce a long-term robust remission when compared to drugs like Nardil or Paxil. At the time, Roche was working toward getting moclobemide approved in the US for the indication of social phobia, and not depression. In 1996, I spoke to the head of the R&D department there to find out what the deal was. He told me that the project had been terminated due to lack of efficacy. Dr. Liebowitz was the first psychiatrist to diagnose me as having a biogenic mood disorder. I'm still not sure why Columbia chose him to do screenings for their depression evaluation service project. I never saw him among Frederick Quitkin's staff.

> Now I have a question for you since you are so knowledgable about meds (I love reading your posts!).

< embarrased > I am not nearly as qualified as many of the other posters on Psycho-Babble to address your questions. I wish I were.

> I want to get off Restoril--I've been on benzos for over 12 years. Supposedly the thought now is to switch people to Valium or Klonopin and titrate down from there because of the smaller possible increments and longer half lives. Only I get really depressed on long-acting benzos.

I'm willing to bet that it was Klonopin (clonazepam) that you found depressogenic. From my personal experience with Klonopin, I would not consider it to be significantly easier to discontinue than the other benzodiazepines. Actually, I would think it would be easier to get off of Restoril. It is really sort of medium in terms of half-life. You might want to look into using clonidine or perhaps baclofen to help you through the withdrawal period. I bet there are a whole bunch of things that would help. I'm curious about using Neurontin or Zyprexa. For a long-acting benzodiazepine, maybe Dalmane is worth looking into.

There are a bunch of people here who are much more versed in this matter than am I to answer your questions, so I will defer.

> And I guess I need to cut back by tenths--and I can't divide a capsule into tenths. So, do you think it would be feasible to just not take the drug one night every ten days and go down like that? Do you think it would be stable to pour out the powder and mix it in with liquid and drink 9/10 and do it that way? Any other ideas? Do you know of a pharmacy that might make Restoril in liquid form?

Good luck. Please let us know what you decide to do.


- Scott

 

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