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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Justherself54 on March 10, 2010, at 18:59:22
I was on moclobemide back on 2001 or 2002 (long time ago). I can't remember much of that time in my life, except I recall discontinuing it due to some sort of a rash (I was with another pdoc at the time). Anywhooo..as we've pretty much exhausted all the meds I can tolerate about twice over, we decided to retry moclobemide again, as I wasn't sure if the rash was caused by it or not.
So here I sit, staring at the med bottle..as usual..trying to work up the nerve to restart yet another med..man..I grow weary..
Any positive feedback and anyone willing to lend a shoulder to lean on would be very welcome.
Posted by Phillipa on March 11, 2010, at 10:58:54
In reply to Moclobemide, posted by Justherself54 on March 10, 2010, at 18:59:22
Well I'm here did you take the pill as looked like you wrote last evening? So frustrating. Love Phillipa
Posted by ed_uk2010 on March 11, 2010, at 15:20:01
In reply to Moclobemide, posted by Justherself54 on March 10, 2010, at 18:59:22
Hi,
Rash is a reported side effect of moclobemide. I don't think it's that common though.
Posted by bleauberry on March 11, 2010, at 15:29:20
In reply to Moclobemide, posted by Justherself54 on March 10, 2010, at 18:59:22
I wish I could offer something positive to say about moclobemide, but unfortunately realworld experience with it is very poor. I cannot recall a single person over the last decade, here at pbabble, that had any benefit from it, other than the first few days.
For me it actually felt horrible. Much worse depression and fast. But we're all different.
There must be somebody out there doing well on it, because otherwise no one would prescribe it anymore. Who they are, I have no clue. Never seen them. Doctors in-the-know gave up on moclobemide years ago.
If you want a MAOI, get a real one.
You could maybe get up your courage to try that bottle you have. But I wouldn't place any bets on it. Sounds like it has high odds of wasting your time, low odds of improving your life, and low odds of keeping it improved even if it did for a short time.
You can't remember how it went the last time you were on it. That probably means it wasn't great. Because if it had been anything good, you would have remembered that. ???
Just my thoughts.
Posted by Justherself54 on March 11, 2010, at 16:17:00
In reply to Re: Moclobemide, posted by bleauberry on March 11, 2010, at 15:29:20
If you want a MAOI, get a real one.
Why on earth would you word your sentence to me in that way? You don't know my med history and as a matter of fact I've been on the "real" ones..more than once.
I'm desperate. My doctor is "in the know" and right now we're grasping at straws. We both know that moclobemide doesn't have a good track record, but we are between a rock and a hard place.
Overall, I found your post quite harsh and really didn't feel supported at all, when the purpose of my post was for support. Was that your intention and if so, why?
And as for not having remembered it..there are great gaps in that particular time of my life that I don't remember. Unrelenting depression and ECT took care of that.
Wow..just wow..
Posted by Justherself54 on March 11, 2010, at 16:20:29
In reply to Re: Moclobemide, posted by ed_uk2010 on March 11, 2010, at 15:20:01
I'll take a rash if the med works..as long as the rash isn't bad enough to be a deal breaker!
Posted by ed_uk2010 on March 11, 2010, at 16:34:28
In reply to Re: Moclobemide » ed_uk2010, posted by Justherself54 on March 11, 2010, at 16:20:29
Well, I certainly hope moclobemide helps you and doesn't cause a rash. On the bright side, moclobemide usually seems to be fairly well-tolerated.
Posted by ed_uk2010 on March 11, 2010, at 16:47:23
In reply to Re: Moclobemide » bleauberry, posted by Justherself54 on March 11, 2010, at 16:17:00
Hi JHS,
Don't take it to heart. I'm certain that Blueberry didn't mean to offend. I think his post sounded critical because he hasn't had a good experience with moclobemide. Let's hope it helps you :)
Posted by SLS on March 11, 2010, at 16:52:29
In reply to Moclobemide, posted by Justherself54 on March 10, 2010, at 18:59:22
Hi.
I really don't have much to say, except to wish you good luck. You can't afford to leave any stones unturned. I understand the mentality that anything yet untried represents hope.
Even though it is generally thought that dietary restrictions are unnecessary when taking moclobemide, some studies indicate that the maximum amount of tyramine to be ingested at any one meal be 50mg.
http://www.ncbi.nlm.nih.gov/pubmed/9860107
- Scott
Posted by ed_uk2010 on March 11, 2010, at 17:14:00
In reply to Re: Moclobemide » Justherself54, posted by SLS on March 11, 2010, at 16:52:29
I read that too Scott. Fortunately, when I took it, I didn't have any problems. It didn't work for me but it did work during the manufacturer's clinical trials so I guess it must help some people.
Posted by Justherself54 on March 11, 2010, at 17:15:26
In reply to Re: Moclobemide, posted by ed_uk2010 on March 11, 2010, at 16:47:23
Thanks Ed..I guess I'm feeling pretty fragile right now and probably reacted too strongly. Thanks.
Posted by SLS on March 11, 2010, at 17:18:56
In reply to Re: Moclobemide » Justherself54, posted by SLS on March 11, 2010, at 16:52:29
> http://www.ncbi.nlm.nih.gov/pubmed/9860107
I'm sorry. This is not the abstract that I was looking to post. Never mind.
- Scott
Posted by Justherself54 on March 11, 2010, at 17:26:10
In reply to Re: Moclobemide » Justherself54, posted by SLS on March 11, 2010, at 16:52:29
Thanks for the link Scott. My pdoc and I discussed sticking pretty closely to the standard MAOI diet, just to be on the safe side..
Rather than starting to retry all the old meds that worked for me, I opted to retry moclobemide, as it was one that didn't have a fair trial, due to the rash (it wasn't a bad one to the best of my foggy knowledge).
Here's hoping.
I sometimes take Alertec which really helps with fatigue and focus, although I'm not sure if it's safe with moclobemide or not. I'd really like to be able to take it, as it is one med that does me some good with no side effects. Do you know if it's safe to take alongside? There's not a whole lot of info I can find on taking the two together.
Posted by ed_uk2010 on March 11, 2010, at 17:37:46
In reply to Re: Moclobemide » SLS, posted by Justherself54 on March 11, 2010, at 17:26:10
>There's not a whole lot of info I can find on taking the two together.
To be honest, I don't think the interaction (or not) has received any study. I can't find anything. Perhaps Scott will have some more information.
Posted by SLS on March 11, 2010, at 17:51:08
In reply to Re: Moclobemide » SLS, posted by SLS on March 11, 2010, at 17:18:56
Concomitant use of modafinil and tranylcypromine
in a patient with narcolepsy: a case report
by
Clemons WE, Makela E, Young J.
Michael S. Aldrich Sleep Disorders Laboratory,
Department of Neurology, University of Michigan,
8D 8702 University Hospital,
Box 0117, 1500 East Medical Center Drive,
Ann Arbor, MI 48109-0117, USA
Sleep Med. 2004 Sep;5(5):509-11ABSTRACT
This is a case report of a patient with narcolepsy treated simultaneously with modafinil and tranylcypromine. The concurrent use of these two medications is normally contraindicated based on theoretical concerns. To our knowledge this is the first report of the combined use of these two medications in a patient for any reason. This combination of medications was particularly effective in the treatment of the patient's narcoleptic symptoms and was well tolerated, with no evidence of the potential cardiovascular side effects. Due to modafinil's lack of sympathomimetic activity and unique pharmacological profile, it may be well tolerated with monoamine oxidase inhibitor's (MAOI's) in humans with respect to hemodynamic parameters and concerns of hypertensive crisis. Further investigation would help clarify cardiovascular safety issues in using this combined therapy. We believe that with proper informed consent from the patient and careful monitoring, a combination of an MAOI and modafinil may be a viable treatment alternative in refractory cases of narcolepsy.
---------------------------------------
I wish I knew exactly what the theoretical basis is for contraindicating the combination of modafinil (Alertec) and MAOI. It isn't immediately obvious to me.
- Scott
Posted by floatingbridge on March 11, 2010, at 17:57:20
In reply to Moclobemide, posted by Justherself54 on March 10, 2010, at 18:59:22
Good luck to you. My fingers are crossed. An MAOI? I 'm sorry that I'm not familiar with it.
Best Results!
Posted by Justherself54 on March 11, 2010, at 18:31:48
In reply to Re: Moclobemide » Justherself54, posted by floatingbridge on March 11, 2010, at 17:57:20
Thanks the best results..much appreciated.
Posted by bleauberry on March 11, 2010, at 20:18:59
In reply to Re: Moclobemide » bleauberry, posted by Justherself54 on March 11, 2010, at 16:17:00
Hey, I'm really sorry. I had no idea of:
1. Your history with real MAOIs.
2. Your history with ECT.
3. The fragile place you are at right now.I also interpreted your post wrongly. That's easy to do when all you can see is writing, you can't see the person's face, body language, or tone of voice. What I saw was someone looking for help with meds, not someone looking for psychological support. Wrongly or rightly, doesn't matter, that is what I saw. And thus the approach of my post, which was completely oriented toward med discussion focusing on the med in question, moclobemide.
From your response to me, I can also see that the wrong interpretation went both ways. I unknowingly read you wrong, and you unknowingly read me wrong. I was really really trying to help. I had no idea I was offending anyone.
I was basically talking to someone who had no history of real maois, no ECT experience, and someone in a somewhat more stable place. So please forgive. I just didn't know. My comments never would have gone the direction they did had I known.
Yeah, I know all about the ECT memory loss. It is pretty severe with me too. There are huge gaps in my life before ECT that are just gone. No recollection of those times.
Since I have some old leftover bottles of meds from those months leading up to ECT, I know I took them, but I don't remember taking them. So I have no idea how they went. But of course, since I went for ECT, that pretty much says the meds didn't go well for whatever reason I don't remember.
I'm with ya all the way.
Anyway, I hope you're feeling better, and again, I apologize. Everything I commented on would not have been said if I had known.
I hope moclobemide goes well. I was going to share some med suggestions and other ideas, but this probably isn't the right timing.
> If you want a MAOI, get a real one.
>
> Why on earth would you word your sentence to me in that way? You don't know my med history and as a matter of fact I've been on the "real" ones..more than once.
>
> I'm desperate. My doctor is "in the know" and right now we're grasping at straws. We both know that moclobemide doesn't have a good track record, but we are between a rock and a hard place.
>
> Overall, I found your post quite harsh and really didn't feel supported at all, when the purpose of my post was for support. Was that your intention and if so, why?
>
> And as for not having remembered it..there are great gaps in that particular time of my life that I don't remember. Unrelenting depression and ECT took care of that.
>
> Wow..just wow..
>
>
>
>
>
>
Posted by Phillipa on March 11, 2010, at 20:33:59
In reply to Re: Moclobemide » Justherself54, posted by bleauberry on March 11, 2010, at 20:18:59
It's going to work!!!!!!! Love Phillipa
Posted by ed_uk2010 on March 12, 2010, at 13:38:20
In reply to Re: Moclobemide, posted by SLS on March 11, 2010, at 17:51:08
>I wish I knew exactly what the theoretical basis >is for contraindicating the combination of >modafinil (Alertec) and MAOI. It isn't immediately >obvious to me.
Hi Scott,
There isn't really a theoretical basis for it. Standard practice seems to be to contra-indicate everything with MAOIs until proven safe!
This is the end of the thread.
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