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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by peacetoy on November 9, 2005, at 7:09:06
Hi, anyone here with any opinions/experiences of moclobemide? I might be switching to it (from Effexor, which isn't doing much), partly because of the v low risk of sexual side effects.
After 8 years on Prozac, and numerous drug combinations over the last year, I feel my libido and sexual function has been really badly affected. I want to try being SSRI-free (though drug-free is not really an option for me at the moment).
Moclobemide seems to have a pretty poor reputation as an antidepressant, often being labelled "weak". However, there are controlled studies that suggest it's as efficacious as TCAs and SSRIs. Any opinions/experiences?
cheers,
Andrew
Posted by ravenstorm on November 9, 2005, at 8:24:10
In reply to Moclobemide?, posted by peacetoy on November 9, 2005, at 7:09:06
I haven't found anyone on the boards, so far, who has done well on this drug. I believe two people got worse from it.
Have you considered remeron or serzone? I believe they are suppossed to have a low risk of sexual side effects.
Posted by jclint on November 9, 2005, at 12:11:03
In reply to Re: Moclobemide?, posted by ravenstorm on November 9, 2005, at 8:24:10
Hi, I got no benefit from it unfortunately, despite trialing it out for several months. Although the lack of sexual side effects is correct. I agree with the previous poster, I think you may want to try something like Remeron, which is much stronger, and has a low incidents of said side effects?
Posted by Declan on November 9, 2005, at 12:58:00
In reply to Re: Moclobemide?, posted by jclint on November 9, 2005, at 12:11:03
It's just a bit agitating. Some people take large doses and notice nothing, which wasn't the case with me. If I'd taken the recommended starting dose I'd have been a basket case. Taking less may be appropriate. It seems to be one of those drugs that's not that bad and not that good. But they've all got their problems.
Declan
Posted by Tomatheus on November 9, 2005, at 18:18:57
In reply to Moclobemide?, posted by peacetoy on November 9, 2005, at 7:09:06
peacetoy,
When taking both Paxil and Prozac, I cycled back and forth between mild hypomania and depression, with each "episode" lasting three to four days. So, my experience with SSRIs/TCAs is limited. (Interestingly, I never felt hypomanic or manic on Wellbutrin, moclobemide, Parnate, or Nardil monotherapy. Independent of SSRI-induced hypomania, I suffer from dysthymia).
On moclobemide, I noticed very little whatsoever. I felt slight relief from my dysthymic symptoms for a few days after starting moclobemide, and after that it felt like I was taking nothing. The highest dose I took was 900mg/day.
From what I've read, moclobemide does not seem to be very effective in practice. Of course, everybody's different, so it's possible (although I wouldn't go as far as saying probable) that you might be an exception.
Tomatheus
> Hi, anyone here with any opinions/experiences of moclobemide? I might be switching to it (from Effexor, which isn't doing much), partly because of the v low risk of sexual side effects.
>
> After 8 years on Prozac, and numerous drug combinations over the last year, I feel my libido and sexual function has been really badly affected. I want to try being SSRI-free (though drug-free is not really an option for me at the moment).
>
> Moclobemide seems to have a pretty poor reputation as an antidepressant, often being labelled "weak". However, there are controlled studies that suggest it's as efficacious as TCAs and SSRIs. Any opinions/experiences?
> cheers,
> Andrew
>
Posted by Phillipa on November 9, 2005, at 20:16:39
In reply to Re: Moclobemide? » peacetoy, posted by Tomatheus on November 9, 2005, at 18:18:57
Okay I'm lazy but what is moclobemid? Fondly, Phillipa
Posted by Tomatheus on November 9, 2005, at 21:01:18
In reply to Re: Moclobemide?, posted by Phillipa on November 9, 2005, at 20:16:39
Phillipa,
It's a reversible inhibitor of MAO-A. With irreversible MAOIs, such as Nardil and Parnate, it is my understanding that the drug permanently binds to the MAO in the brain and elsewhere in the body. So, even if serotonin and norepinephrine reach dangerously high levels, the irreversible MAOIs will not detach themselves from the MAO enzymes. With reversible inhibitors, the drug is able to detach itself from the MAO enzymes under certain conditions (I believe it's when norepinephrine levels get too high). So, if a patient consumes enough tyramine to trigger a hypertensive crisis on Nardil or Parnate, the same amount of tyramine is supposed to have only a negligible effect on the patient's blood pressure. Patients are still warned against consuming ultra-excessive amounts of tyramine-containing foods while taking moclobemide, but the drug is basically considered tyramine-safe.
Moclobemide generally tends to be less effective than both Nardil and Parnate, and it is not available in the United States (allegedly because of "commercial reasons"). Americans can order moclobemide from certain online pharmacies (as I did), but of course, I can't say here on PB exactly which site I got it from.
Tomatheus
Posted by katekite on November 11, 2005, at 23:18:03
In reply to Moclobemide?, posted by peacetoy on November 9, 2005, at 7:09:06
I have taken moclobemide on several occasions, (for depression/anxiety). The longest I made it was 10 days. I am very sensitive to all the psych drugs so it was no surprise for me to find I eventually had to stop it due to insomnia, I haven't found any drug I can tolerate yet. I would have liked to continue it.
However, compared to 90% of other drugs I've tried it was great for lack of side effects. It was mildly stimulating, sex was way better than normal at the recommended starting dose. At the later lower dose I tried I noticed no effect on sex.
As far as mood, it did seem to decrease really negative stuff like a angry negativism, right away. But I didn't feel happy either. On the other hand the longest I made it was 10 days and at a very low dose so I'm not sure it was a fair trial as far as mood improvement goes.
I've heard that unlike ssris if its going to work you should feel better inside of 2 weeks.
One thing I have found with it is it is great as a take-as-needed drug. If I happen to wake up irritable normally I would have a irritable day all day long, if I take a moclobemide it changes that day into a perfectly normal productive day. If I take it when I am just sad and low energy, hoping to get a boost, it doesn't seem to do much.
Kate
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