Posted by psychobot5000 on January 11, 2009, at 21:47:53
In reply to Re: Moclobemide: What about Intermittent dosing?, posted by Mishal on January 11, 2009, at 4:21:13
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> After reading much of your responses, I understand Moclobemide is effective in short term. As many pointed out, if it works to alleviate depression for the first three days on the standard dosage 300mg, then I would consider it taking for three days only. Three days of abstinence will be enough to reverse the tolerance.
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> IF something is only working for a few days, still it is okay for me because at least I can have a few good days in a week. I found Provigil retains its efficacy after a short break. So, this intermittent dosing should work. three good days on Provigil, followed by three fine days on Moclobemide... what about this cycle?
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> What do you think?For what it's worth, I think it might well be worth a try. However, I have a couple of caveats:
Not sure if you've ever been on an MAOi before, but in my experience, they make you (me, actually) feel better at the beginning, possibly by increasing levels of monoamines (noradrenaline, dopamine, serotonin...), whose digesting enzymes they block. ...Then the body presumably down-regulates their efficacy, in response to that. So then, unless you get a genuine long-term antidepressant response (which I would cautiously posit might be a separate effect, something more 'downstream'), you might be back to square one, or somewhere close to it. The reason that I feel this is relevant is because, while raising an MAOi dose can be pleasant, lowering it or going off of it is often unpleasant for patients. Possibly because your body is suddenly stuck with a -lower- level of neurotransmitters than it's used to. This is all speculation, I suppose. But what I'm getting at is that, on a 3-day on, 3-day off schedule, you might (might!) pay for the boost on the 'on' days, with lower mood on the off days. You never know, but I thought I'd throw it out there as a thought.
My only other comment is that several years ago, I read what I remember as a large meta-analysis of antidepressant results. Bucking the CW (at least among SSRI-promoting pharmaceutical reps), they rejected the idea that all antidepressants are created equal in efficacy, and tried to gather data and determine if any were better than others. They sorted it by catagories--MAOis, Tricyclic antidepressants, and SSRIs, and looked at several of each type. The results (I'm sure I remember this part accurately, if nothing else):
1: Unselective MAOis (parnate and nardil, I think--moclobemide's more powerful cousins)
2: Tricyclics
3: SSRIs
4: Moclobemide.
But hey, it presumably works for some people, right? And with fewer side-effects. Best of luck to you!
poster:psychobot5000
thread:873128
URL: http://www.dr-bob.org/babble/20090104/msgs/873458.html