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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Meri-Tuuli on May 11, 2006, at 6:49:48
I'm back from Ireland, and whilst there, I began taking the new medication my pdoc is prescribing. Its moclobemide.
I started on half a 150mg tab a day and within maybe 3-4 days I got some small red bumps on my knuckles. I kept taking the med, thinking it might be something from the sea. Well it got worse and I stopped taking it (and now they are fading, so its the med alright).
So now, I will probably have to give up on moclobemide - which ¢?#••! me off because I could feel it working. No panic and increased energy.
I also got slight headaches, a tightness in my chest, dizzy upon standing, and weird spaciness - a sort of drunk feeling.
So all those who say this is a sugar pill, its definately not!
I am utterly sick and miserable. I was hoping that this med might just do something for me. I am begining to realise that I am very sensitive to pysch meds - I mean moc is supposed to be well tolerated!
I'm utterly afraid of trying the TCAs because of the notorious side effects. I mean, if I'm this bad on a low dose of moc, what the hell am I supposed to be like on a TCA??????
And I'm afraid there isn't that much else to try (don't forget I live in the UK. UK = no benzos, no stims, no exotic combos and probably no MAOIs).
I'm utterly hopeless.
Posted by JaclinHyde on May 11, 2006, at 12:10:14
In reply to Dang! Dang! Dang! Moclobemide + rash, posted by Meri-Tuuli on May 11, 2006, at 6:49:48
I had this kind of rash just recently when I came back from a cruise but it had nothing to do with meds. It was impetigo. Just a nice old skin staph infection. Don't just stop the meds until you get a doc to check it out. :-)
JH
Posted by ed_uk on May 11, 2006, at 14:33:01
In reply to Dang! Dang! Dang! Moclobemide + rash, posted by Meri-Tuuli on May 11, 2006, at 6:49:48
Hi Meri
It might be an allergy, it might not be. It would be good if you could see an dermatologist, but you won't be able to :(
Don't be afraid of TCAs. I took lofepramine (Gamanil) for two years with only mild side effects. Some TCAs have more side effects than others.
Ed x
Posted by Meri-Tuuli on May 11, 2006, at 15:59:57
In reply to Re: Dang! Dang! Dang! Moclobemide + rash, posted by JaclinHyde on May 11, 2006, at 12:10:14
Hi!
I stopped the med because it said that was what you're supposed to do on the insert if you got a rash.
I'm fairly certain the rash was caused by the med. I got a similar thing to wellbutrin.
Oh well.
> I had this kind of rash just recently when I came back from a cruise but it had nothing to do with meds. It was impetigo. Just a nice old skin staph infection. Don't just stop the meds until you get a doc to check it out. :-)
>
> JH
Posted by Meri-Tuuli on May 11, 2006, at 16:17:26
In reply to Re: Dang! Dang! Dang! Moclobemide + rash » Meri-Tuuli, posted by ed_uk on May 11, 2006, at 14:33:01
Hey there Ed!
Well a dermatlogist would be good. Funny that, the GP I was supposed to be seeing today has an 'specialism' in dermatlogy apparently. Unfortunately, the health centre messed my appointment up and I didn't get to see him. Still, no idea if he would have had a clue anyway.
The GP just said to ring up the pdoc's office, which I was going to do anyway.
I also asked a pharmacist on the way home, and she was pretty useless.
I rang the pdoc's office and the pdoc rang back. He was pretty clueless too, although he is going to check with the pharmacy department to see if they have any case studies on file. I didn't know they did this sort of thing! He thinks one possibility is to reintroduce it and it might not come back. He's ringing back tomorrow.
Anyway the rash didn't itch at all and it was on either side of my knuckles and got steadily worse, starting to spread up my hand. And after stopping the med, it kept getting worse, but then stopped after two days. It was like small red spots dotted in the area around my knuckles.
Anyway, I got a similar reaction to wellbutrin/zyban, although that rash was on other body parts too, like my elbows and knees. I dunno if these locations correspond with nerve endings.
Could it be that my skin is reacting because of something dopamine related?? I mean, is it the dopamine receptors getting over stimulated (or something like that) or is it more of an allergy?
And if I am allergic to moclobemide, what actually is it that I'm allergic to? I guess the moclobemide molecule or a filler!! Well, its quite a surprise, because this will be the first thing I'm allergic to. I have no allergies, nothing. Oh well.
Posted by Phillipa on May 11, 2006, at 18:29:20
In reply to Re: Dang! Dang! Dang! Moclobemide + rash » ed_uk, posted by Meri-Tuuli on May 11, 2006, at 16:17:26
Meri you said you got a similar reaction on wellbutrin and that it was worse. I hope it's a simple allergy. When you had the one on wellbutrin were you are home or on vacation. Know what I mean? Love Phillipa
Posted by Meri-Tuuli on May 13, 2006, at 7:06:23
In reply to Re: Dang! Dang! Dang! Moclobemide + rash » Meri-Tuuli, posted by Phillipa on May 11, 2006, at 18:29:20
Hi there,
No I was at home when I got the reaction to wellbutrin.
I would like to find out what causes this weird reaction..I am 99% certain that the rashes were caused by the medication. I normally don't react to anything. I mean, if I were one of those 'sensitive' types who had to have special soap for their sheets, etc I might be inclined to think that it wasn't the medication.
Well the only thing I can think of linking the two medications is a dopamine connection. I don't know if I'm particulry sensitive to dopamine stimulation or something, or if I really am allergic to the pysch medication. Or even a common filler. Who knows.
Its very frustrating, because I could feel the medication working.
Oh well.
Kind regards
Meri
Posted by naughtypuppy on May 13, 2006, at 11:24:24
In reply to Re: Dang! Dang! Dang! Moclobemide + rash, posted by Meri-Tuuli on May 13, 2006, at 7:06:23
I had a similar experience on Parnate when I developed a nasty rash that started in my belly button and got little bumps that I thought were bug bites when I got out of the shower. I think it is cause because some MAOIs inhibit N-Methyltransferase which is the bodys natural antihistamine. Do you have particularly sensitive skin, soap allergies etc? A lot of meds give me a rash. If youve found something that is working for you, instead of stopping it, get your doc to prescribe a potent antihistamine such as hydroxyzine or low dose doxepin. Unfortunantly after I thought of the strong antihistamine trick the Parnate didnt work for me the second time around and it was the best AD I have tried so far! Neeedless to say I am now very reluctant to stop a med that shows promise if I can tolerate the side effects. Just started Nardil yesterday, so I hope it doesn't do the same thing
Posted by Meri-Tuuli on May 13, 2006, at 11:54:19
In reply to Re: Dang! Dang! Dang! Moclobemide + rash, posted by naughtypuppy on May 13, 2006, at 11:24:24
Hiya!
> I had a similar experience on Parnate when I developed a nasty rash that started in my belly button and got little bumps that I thought were bug bites when I got out of the shower.
Wow, thats interesting. Thats exactly what my rash looked like - little red bumps that could be easily mistaken for insect bites (like midges - dunno what they're called in america).
>I think it is cause because some MAOIs inhibit N-Methyltransferase which is the bodys natural antihistamine.
I didn't know this.
>Do you have particularly sensitive skin, soap allergies etc?
No! I'm totally not allergic to anything, except it seems, pysch meds :(
>A lot of meds give me a rash. If youve found something that is working for you, instead of stopping it, get your doc to prescribe a potent antihistamine such as hydroxyzine or low dose doxepin.
Thats very interesting. But how do you know the difference between a rash caused by the inhibition of N-Methyltransferase, and a proper hyersensitivy to the medication, or a true allergy??
>Unfortunantly after I thought of the strong antihistamine trick the Parnate didnt work for me the second time around and it was the best AD I have tried so far! Neeedless to say I am now very reluctant to stop a med that shows promise if I can tolerate the side effects. Just started Nardil yesterday, so I hope it doesn't do the same thing
I hope so too! One last thing, do you find that you get alot of the side effects of meds, and that you need the lower end dosages? I seem to be particulary 'med senisitive' and only need pretty low dosages to get quite bad side effects etc. And when I get the side effects, I seem to get most of them listed!!
Its a real pain isn't it!? Good luck with the Nardil.
Posted by naughtypuppy on May 13, 2006, at 13:39:52
In reply to Re: Dang! Dang! Dang! Moclobemide + rash » naughtypuppy, posted by Meri-Tuuli on May 13, 2006, at 11:54:19
> Hiya!
>
> > I had a similar experience on Parnate when I developed a nasty rash that started in my belly button and got little bumps that I thought were bug bites when I got out of the shower.
>
> Wow, thats interesting. Thats exactly what my rash looked like - little red bumps that could be easily mistaken for insect bites (like midges - dunno what they're called in america).
>
Ok, you asked for it! Well, maybe you didn’t but here goes anyway! “How Parnate bugs ate me alive, The Motion Picture”. Last summer, about a month after I started Parnate, I noticed that when I got out of the shower, my chest was red and I was starting to get these little bite marks that went away after a few hours. As time went on they got worse and started to spread further over my body. Something must be biting me, I thought. I started examining my arms with a magnifying glass and found these little red puncture marks that looked like a junkie with a really bad aim. I then did some research on the entomology sites and determined that they must me some sort of mite. The red marks are where the little buggers bite and their digestive juices dissolve the skin, then they suck it up. I went to my GP to confirm this and he said “Yes , you’re definitely being bitten by some sort of mite, but they aren’t one of the ones that usually bother humans such as scabies” and gave me a prescription for hydroxyzine. It’s amazing how little is known about how animal parasites affect humans! Well the hydroxyzine didn’t go well with the Parnate, and made it so I couldn’t sleep so I stopped it. In my research, I figured it must be some sort of bird or rodent mite that had set up shop in my house so I started spraying everything in sight. I went through I don’t know how many cans of spray and over 2 liters of malathion, the big gun of insecticides. I’m surprised that I didn’t go into convulsions inhaling all that stuff. I was washing the laundry with the hottest water possible and running it through the dryer twice. I even shampooed the carpets (and myself) with it, but nothing seemed to help and the problem only got worse. The whole house was being treated like a level four biohazard lab! I was going absolutely crazy with the thought that these things were crawling all over me, but were too small to see. Nothing shoed up on the tape traps that I had set up. I then started developing a oozing rash that started in my navel and spread from there. At that point, my pdoc said to stop the Parnate. He had seen the rash happen before but couldn’t find it documented anywhere. During the next month we both independently discovered the thing about N-Methyltranferase and MAO inhibitors. After I stopped the Parnate the problem was reduced. In retrospect, I figure that the mites were probably Cheyletiella or walking dandruff a highly contagious little critter that is sometimes found on house pets. I was spending nearly every day at that time at my girlfriends, painting her condo and she has a cat. These mites don’t bother cats very much and don’t show up because they groom themselves so often, but they really bother dogs and humans. They are light colored and so small that they can go right through fabric, so it is no wonder that I could never find one. They supposedly can’t exist on humans very long (entomologists don’t really seem to be sure) so the house wasn’t really infested, I just kept getting reinfested. It seemed to improve when I went to bed. I thought that was because of me washing every day, but it was probably because of the antihistaminic effects of the trazodone I took to sleep (Which I got very little of). So you can imagine all the fun that I had with this little adventure on top of a primarily anxiety disorder.> >I think it is cause because some MAOIs inhibit N-Methyltransferase which is the bodys natural antihistamine.
>
> I didn't know this.
>
> >Do you have particularly sensitive skin, soap allergies etc?
>
> No! I'm totally not allergic to anything, except it seems, pysch meds :(
>
> >A lot of meds give me a rash. If youve found something that is working for you, instead of stopping it, get your doc to prescribe a potent antihistamine such as hydroxyzine or low dose doxepin.
>
> Thats very interesting. But how do you know the difference between a rash caused by the inhibition of N-Methyltransferase, and a proper hyersensitivy to the medication, or a true allergy??
>
It's really a process of elimination. The rash (Uticaria or hives) affects the mast cells of the skin and can take quite a while to go away. I've still got bumpy areas after a few months.> >Unfortunantly after I thought of the strong antihistamine trick the Parnate didnt work for me the second time around and it was the best AD I have tried so far! Neeedless to say I am now very reluctant to stop a med that shows promise if I can tolerate the side effects. Just started Nardil yesterday, so I hope it doesn't do the same thing
>
> I hope so too! One last thing, do you find that you get alot of the side effects of meds, and that you need the lower end dosages? I seem to be particulary 'med senisitive' and only need pretty low dosages to get quite bad side effects etc. And when I get the side effects, I seem to get most of them listed!!Same here. Paxil was the wost. I had every one in the PDF.
>
> Its a real pain isn't it!? Good luck with the Nardil.Thanks, I just hope the Nardil doesn't do the some thing, The study I read they used Parnate, but I was under the impression it was a MAO inihition thing.
Posted by ed_uk on May 13, 2006, at 15:17:03
In reply to Re: Dang! Dang! Dang! Moclobemide + rash » ed_uk, posted by Meri-Tuuli on May 11, 2006, at 16:17:26
Hello Meri :)
>Could it be that my skin is reacting because of something dopamine related?? I mean, is it the dopamine receptors getting over stimulated (or something like that) or is it more of an allergy?
Sounds like an allergy of some description.
>I guess the moclobemide molecule or a filler!!
Probably the moclobemide itself. Various generics are available in the UK plus the original brand Manerix. I suppose they might use different fillers.
Ed x
Posted by Meri-Tuuli on May 14, 2006, at 9:24:21
In reply to Re: Dang! Dang! Dang! Moclobemide + rash (long) » Meri-Tuuli, posted by naughtypuppy on May 13, 2006, at 13:39:52
Hey there again,
Thats certainly an interesting story to tell about your parnate rash! So you went through all that bug hunting just to find out it was the parnate? It must be awful to have to do all that de-bugging stuff.
These drugs are awful. I'm hopeless off them, hopeless on them.
I've yet to actually find something that works. And you bet that when I do, I will definately stay on it for quite awhile!!!
I'm totally unsure of as to what to try next. My pdoc seems to rather trust my opinion (which I find rather scary - he's supposed to be the professional not me!) and wants to know what I would like to try next. Oh well.
Anyway my little bumps are nearly faded now.
Let us know how it goes on the nardil....
Kind regards, Meri
Posted by ed_uk on May 14, 2006, at 10:35:47
In reply to Re: Dang! Dang! Dang! Moclobemide + rash (long) » naughtypuppy, posted by Meri-Tuuli on May 14, 2006, at 9:24:21
Hi Meri
What are your main symptoms right now? Depression? Anxiety?
Ed
Posted by Meri-Tuuli on May 14, 2006, at 10:48:53
In reply to Re: Dang! Dang! Dang! Moclobemide + rash (long) » Meri-Tuuli, posted by ed_uk on May 14, 2006, at 10:35:47
Hiya Ed!
Well, I guess my main symptoms are 'just' plain old depression and some panic. But really, the panic is just secondary to the depression. Plus it got worse coming off St John's Wort. And just prior to the moclobemide. Now, it doesn't seem so bad. I could really feel the moclobemide stopping the panic.
Anyway, yeah straight depression, which is kind of no energy, no motivation, apathy, totally blah feeling. Sleep is no problem for me. If anything, I can sleep alittle too much, but I try to resist napping.
I posted a new thread about it actually at the bottom:
http://www.dr-bob.org/babble/20060510/msgs/643828.html
I hope things are alright with you.
Kind regards
Meri
Posted by ed_uk on May 14, 2006, at 13:21:05
In reply to Re: Dang! Dang! Dang! Moclobemide + rash (long) » ed_uk, posted by Meri-Tuuli on May 14, 2006, at 10:48:53
Hi Meri
Based on your symptoms, I think lofepramine might help.
Ed x
Posted by naughtypuppy on May 15, 2006, at 13:18:04
In reply to Re: Dang! Dang! Dang! Moclobemide + rash (long) » naughtypuppy, posted by Meri-Tuuli on May 14, 2006, at 9:24:21
Pretty weird story isn't it. I should change my name to mad dog! The bumps are starting to come back, but at least I know why they are happening this time. I know the feeling about pdcos following patients orders. Just give us a prescription pad and we won't need them anymore. The drugs are almost like being on chemotherapy aren't they?
This is the end of the thread.
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