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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Daniel on March 22, 1999, at 7:05:31
Hello everybody,
I would appreciate a brief explanation of the moclobemide use written in a non-technical language (for a layman, obviously).
Has anybody any experience with taking it? Did it work? Did you experience any serious adverse side-effects?
I've heard that it is used to treat MAJOR depression only. Is it true?
I've also read that it affects the action on norepinephrine, serotonin, and dopamine (three in one!). Does that mean that it is more efficient than SSRIs (that influence primarily serotonin)?
Thank you.
Daniel
Posted by JohnL on February 5, 2000, at 3:39:05
In reply to Re: Info about moclobemide/Manerix/(Aurorix), posted by Carol Patterson on February 4, 2000, at 20:18:39
Hi Carol.As with any drug, I don't think there is any possible way to predict in advance how Moclobemide will work with any particular individual. In general however the literature suggests it is effective in all types of depressions--melancholic, nonmelancholic, major, dysthymia. Literature also suggests it has a higher failure rate than other antidepressants it has been compared to. I have heard reports of people doing extremely well with it, and I've heard reports of people doing poorly with it. When I tried it I actually got more depressed and irritated. Sure enough, in the side effect label it lists depression as an infrequent side effect. So while it works wonders for other people, it didn't for me. I think it all depends on the individual's unique chemical imbalance and metabolism.
Literature suggests it is one of the most user-friendly drugs in terms of side effects. It is recommended for the elderly and for the sexually active patient. People who had sexual problems on SSRIs who successfully switched to Moclobemide had total restoration of their sexual function. I had absolute total anorgasmia with it, and partial impotence as well, but literature says that is transient. I was getting worse anyway, so I didn't stick it out long enough to see if the sexual side effects I had would have gone away or not. It's not a sedating drug. At higher doses it is energizing.
Moclobemide works by preventing enzymes (MAOs) from breaking down the neurotransmitters. It works mostly on the enzymes that break down serotonin and NE, with a smaller amount of action on the enzymes that break down dopamine. The result is an increased level of the neurotransmitters, with emphasis on serotonin and NE. It has the advantage over other MAOI drugs of not having any diet restrictions. Even so, it is advised to take doses after meals, not before. It also is reversible with a short half life which means another drug can be started after just a two day washout after stopping Moclobemide. Since I got worse with it, I was glad I could start another drug almost immediately.
There have been studies where Moclobemide was successfully combined with other antidepressants. This has been OK as long as dosing is cautious in order to avoid serotonin syndrome (serotonin overload-bad, sometimes deadly). In one of those studies a full dose of Moclobemide was combined with 40mg Prozac. That sounds darn aggressive to me, but apparently it was OK. There have been recorded adverse reactions when it was combined with the tricyclic Anafranil.
Moclobemide also has a reputation of working quickly...when and if it works. So if you decide to try it, you should know inside two weeks whether it is for you or not. If you're not feeling any progress at all, or feeling worse, after two weeks, the prognosis probably isn't very good. Results occur quickly when it's a good match for a particular individual. When it does work, it also has somewhat of a reputation for needing very high doses to maintain effectiveness. Doses as high as 1200mg (well beyond the max) have been used safely to maintain effectiveness.
Sorry, didn't mean to go so long here. But I hope some of this info might be of help to you. Regardless of my bad experience with Moclobemide, I think overall it is a drug with good potential in some people. It's too bad it's not available in USA. You'll never know how it works with you unless you try it. I think what determines how effective one drug is to another is how closely it targets a particular person's chemical imbalance. I believe that only from medication reactions can we get a clue as to whether we're hitting a bullseye or missing the target completely. JohnL
Posted by Noa on February 5, 2000, at 6:43:52
In reply to Re: Info about moclobemide/Manerix/(Aurorix), posted by JohnL on February 5, 2000, at 3:39:05
Wow, John! Moclobemide is not something I am looking into, but I REALLY liked your post. It was so thorough and well organized, and for someone who knows nothing about the subject, I could read it and feel like now I understand a bit about this drug. Thanks.
Posted by mat on February 6, 2000, at 18:14:08
In reply to Re: Info about moclobemide/Manerix/(Aurorix), posted by Noa on February 5, 2000, at 6:43:52
I can confirm what John said about moclobemide being energizing at higher doses. It did nothing for me at 600mg (recomended max dose) but I switched myself up to 900mg and it began to have a mild stimulant effect which was most welcome.
mat
Posted by Anna P. on February 8, 2000, at 22:03:22
In reply to Re: Info about moclobemide/Manerix/(Aurorix), posted by JohnL on February 5, 2000, at 3:39:05
>
> I just wanted to add that moclobemide is also helpful for people with the OCD and phobic disorder, as it acts on serotonin system.
No sexual side effects, unfortunately, I keep gaining weight on it. Recently tried Reboxetin it's not for me. It wasn't helpful with anxiety, and caused insomnia. Actually, I felt anxiety while on it.
My depression includes the elements of the OCD, which is complicated.Anna P.
Posted by brettG on October 5, 2000, at 19:49:10
In reply to Re: Info about moclobemide/Manerix/(Aurorix), posted by Anna P. on February 8, 2000, at 22:03:22
After being on the drug for about 2 months - I am glad I finally found this information.
I was on a previous drug (Exefor) where my sexual appetite was "reduced" - hence the reason why I was moved across to Aurorix. I started on the initial dosage of 300mg - which was Ok - but still wasn't feeling any "better" - and then increased to it to 450 mg for a while. The result of this wasn't any better either with my anxiety levels increasing considerably (so much so that I couldn't sit still for any period of time - I was constantly restless.) Stomach troubles flared up - with constant "runs" - and a general feeling of YUCK. So we upped the dosage to 600 mg - and I nearly went mad with the side effects. I have also gained approximately 8 kgs in the last few weeks (I'm only a slight person (was 71kg 183 cm tall) - so the increase hasn't been such a bad thing - but the gain weight has all been in the stomach area - and with bloated feelings - it's not a comfortable experience at all. (I also suffer from Irritable Bowel Syndrome - which I sometimes feel is directly related to the depression.)I have been back to the doc and we have reduced the dosage back to 300mg a day (150 in the morning and 150 at night - but I am still having troubles. After reading the notes posted here - I can see that other people have also experienced failure (limited success)with the medication - which makes me feel a bit better. Feeling so revolting has made the home life quite difficult with my partner - and they're starting to feel it's something they are doing - and have no understanding whatsoever about how it feels to be in a totally depressed state. (At least I find it difficult trying to explain to them).
I'm heading back to my GP today (who is a close friend as well) - so hopefully we'll be able to find a suitable solution. All I know at the moment is that I don't want to continue with Aurorix - I think I'd be better off them completely and let nature take its course - rather than continuing to feel this way any longer.
I'd be interested to hear from other people on this subject. The more opinions I get - the better informed I feel.
Cheers
Brett
This is the end of the thread.
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