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Depression w/ fatigue / moclobemide / narcolepsy??

Posted by VelocideX on November 17, 2003, at 23:36:17

Hey all,

I've been treated for depression for about a year (having had it longer than that).

I tried citalopram, fluvoxamine and found them to be too sedating. I tried effexor (venlafaxine), and found it too to be sedating at 75mg/day (I couldn't handle higher doses due to nausea). I also found that all of these medications only marginally improved my depression, and I couldn't tolerate higher doses due to nausea and/or excessive sedation.

My depression manifests with a large fatigue (somnolence) component already, and so I don't want to touch anything sedating (e.g. any of the NaSSa s)

I'm currently on 450mg/day of moclobemide (Aurorix/Manerix, etc). I've found this to be much more helpful with my depression. I've been on it for about 3.5 weeks now, and I feel a lot closer to normal than I have in a long time. I probably feel about 75% or so. I was put on this due to the relative ineffectiveness of the SSRIs and my fatigue, as it tends to be activating/stimulating.

My response to a RIMA (reversible inhibitor of MAO-A) leads me to believe that my depression is noradrenic or dopaminergic in origin, rather than serotonergic.

My fatigue component, though somewhat alleviated, still remains significant. I wake up in the mornings feelins so tired that I feel drunk. It eases a bit throughout the day, and some days its not so bad, but I still feel excessively tired, to the point of falling asleep in lecturers. I've tried using / not using caffeine and found that caffeine makes only a mild difference.

I've started to wonder if I have borderline narcolepsy. I get the sleep paralysis on waking up a lot of the time and the hypnagogic hallucinations before falling asleep, but not the cataplexy.

Funnily though, several times an hour I get the feeling you get when you stand up too quickly... I feel like I'm on the verge of passing out and i lose sensation in my limbs (they feel tingly-numb), and then suddenly its all gone again. This lasts all of about 2 or 3 seconds.

What do you guys think? Any recommendations?




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