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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Pheepho on October 16, 2009, at 21:00:18
I am currently on Moclobemide 900mg which I take in one dose in the am. I was previously taking it as a divided dose, but after discontinuing Zyprexa I found I couldn't sleep, wondered if it was the moclobemide, and tried taking it all in the morning. After 5 months of pretty severe depression and anxiety that occured every morning and resolved later in the day, which my doctor attributed to a biological depression, I finally made the connection with the moclobemide. The depression seemed of shorter duration over time, and I finally realized it always occured about 30 minutes to 1 hour after taking the moclobemide. If I postponed taking it til lunchtime, I would have a good morning, but a dip in my mood early afternoon.
I don't have an appointment with my doctor til next week, but I have started weaning myself down to 750mg. My doctor is alright and I think will realize I need to wean down if I am getting this reaction.
Just wondering if others have experienced this kind of adverse reaction, and other experiences with moclobemide weaning (what should I expect?).
Now I don't know how much of the hell I have gone through over the past 5 months was Zyprexa withdrawal, and how much was an adverse effect from the moclobemide. I was on moclobemide for about 18 months before discontinuing Zyprexa, and I didn't notice an adverse reaction but I guess was always battling with some depression. I wonder if the Zyprexa was kind of masking the problem with the moclobemide. It gets difficult to figure out what's going on when you are on more than one med. I am currently on 125mg of quetiapine to help me sleep, but I wonder if I will need this if I can get off moclobemide.
Posted by Deneb on October 16, 2009, at 21:41:42
In reply to Moclobemide adverse reactions and withdrawal, posted by Pheepho on October 16, 2009, at 21:00:18
Hello Pheepho
Welcome to Psycho-Babble. I'm glad you're posting questions. There are lots of knowledgeable people here and hopefully someone will answer your question soon. I don't have any experience with either moclobemide or Zyprexa so I'm unable to answer your question.
You mentioned that it took you a while to discover the connection between your depression and the moclobemide. You might be able to discover more what works and what doesn't work with a med/mood journal to track your meds and your moods.
Deneb
Posted by Pheepho on October 17, 2009, at 20:23:31
In reply to Re: Moclobemide adverse reactions and withdrawal » Pheepho, posted by Deneb on October 16, 2009, at 21:41:42
> Hello Pheepho
>
> Welcome to Psycho-Babble. I'm glad you're posting questions. There are lots of knowledgeable people here and hopefully someone will answer your question soon. I don't have any experience with either moclobemide or Zyprexa so I'm unable to answer your question.
>
> You mentioned that it took you a while to discover the connection between your depression and the moclobemide. You might be able to discover more what works and what doesn't work with a med/mood journal to track your meds and your moods.
>
> DenebThanks for the welcome and your comment, Deneb. Yes, a journal is definitely a good suggestion. I have to get myself organized to do that.
Thanks again.
Pheepho.
Posted by Deneb on October 17, 2009, at 20:35:06
In reply to Re: Moclobemide adverse reactions and withdrawal, posted by Pheepho on October 17, 2009, at 20:23:31
You're welcome Pheepho. I should probably follow my own advice and track my moods more. There is a neat tracker here on Babble that assessed your depressive symptoms. You can write down what meds you are taking and other things about your life at the time too. Here is a link:
Posted by tropicalmanna on October 18, 2009, at 2:30:41
In reply to Moclobemide adverse reactions and withdrawal, posted by Pheepho on October 16, 2009, at 21:00:18
Whenever I took more than 300mg at once I got rid of any negative thoughts but experienced anhedonia and lethargy. Moclo has a relatively short halflife so it might be better to take 75-150mg doses over the day. Withdrawal in my experience is not very tough compared to other meds but returning of depressive state may feel like it. It's possible to start another med 1-2 days after discontiunation if needed.
Posted by Pheepho on October 18, 2009, at 17:08:58
In reply to Re: Moclobemide adverse reactions and withdrawal, posted by tropicalmanna on October 18, 2009, at 2:30:41
Thanks, Tropicalmanna for your comments about moclo. I am going to see how I do on splitting up the dose. Just curious, did it disturb your sleep at all? If I take a dose before bed I get insomnia, atleast I'm pretty sure it's the moclo that's causing it. So today I took my last dose at 3pm, hopefully I will sleep!
Deneb, thanks for the link re the med/mood journal. I'll check that out and give it a try.
Pheepho
Posted by bleauberry on October 19, 2009, at 19:05:55
In reply to Moclobemide adverse reactions and withdrawal, posted by Pheepho on October 16, 2009, at 21:00:18
> I am currently on Moclobemide 900mg which I take in one dose in the am. I was previously taking it as a divided dose, but after discontinuing Zyprexa I found I couldn't sleep, wondered if it was the moclobemide, and tried taking it all in the morning. After 5 months of pretty severe depression and anxiety that occured every morning and resolved later in the day, which my doctor attributed to a biological depression,
...very characteristic of adrenal fatigue, testable by doing a saliva sample of cortisol 4 times throughout a 24 hour period to see where the dips and peaks are, and how much out of the norm there are. Not much study has been done on it, but I have come to postulate that many psychiatric drugs can actually cause this type of biological depression that has repeatable patterns everyday.
I finally made the connection with the moclobemide. The depression seemed of shorter duration over time, and I finally realized it always occured about 30 minutes to 1 hour after taking the moclobemide. If I postponed taking it til lunchtime, I would have a good morning, but a dip in my mood early afternoon.
....Moclobemide is generally viewed as a poor performing antidepressant. Not always, but often enough. In any case, I wonder, what would happen if you took it at bedtime??? I think before throwing in the towel it is worth looking at. Sometimes the time of day the dose is taken makes all the difference. You would sleep through the depressing wave of it.
> Just wondering if others have experienced this kind of adverse reaction, and other experiences with moclobemide weaning (what should I expect?).Hard to tell. YOu've been on it a long time. You might feel a lot better real fast, or you might feel worse and flu-like. You will likely feel something, so walk gently until you have a feel for it.
You seemed to get off Zyprexa without much problem, which is one of the hardest to get off of.
>
> Now I don't know how much of the hell I have gone through over the past 5 months was Zyprexa withdrawal, and how much was an adverse effect from the moclobemide....well, the post-Zyprexa adjustment period, well past the actual withdrawal period, can take months. For me it was probably close to half a year. Those receptors take time to readapt in the absence of that molecule.
I was on moclobemide for about 18 months before discontinuing Zyprexa, and I didn't notice an adverse reaction but I guess was always battling with some depression. I wonder if the Zyprexa was kind of masking the problem with the moclobemide.
...Zyprexa does have respectable anti-depression potential by itself, but seems to do best when combined with an AD. It has a synergistic action of boosting all the neurotransmitters, and yet blocking receptors that would otherwise be overstimulated.
It gets difficult to figure out what's going on when you are on more than one med. I am currently on 125mg of quetiapine to help me sleep, but I wonder if I will need this if I can get off moclobemide.
...I'm sorry to hear that. Personally I am not a fan of seroquel. You have to hunt fairly deep to find any great experiences with it. There are better sleep options to try before resorting to powerful antipsychotics, in my opinion. You aren't psychotic are you? I don't know, I'm just not comfortable with the way doctors prescribe these things like candy, using us a planet-wide experiments.
...I wholeheartedly endorse doing everything possible to enhance the quality of your life and sleep. I just think there are better agents to do attempt that. I mean, I could list off at least a half dozen things in a heartbeat, but let's just get down to the matter...bad insomnia = low dose amitriptyline; depression = raise the dose a little higher, maybe add a different AD to it.
Posted by Pheepho on October 22, 2009, at 20:40:08
In reply to Re: Moclobemide adverse reactions and withdrawal, posted by bleauberry on October 19, 2009, at 19:05:55
Thanks, Bleauberry, for your detailed response to my post.
I think I have sort of solved the problem, atleast temporarily, by taking the moclo in 3 doses of 300, 300, and 150. The latest dose I take about 3pm, if I take it later I can't sleep. I've gotten insomnia from about every AD I've tried, and the same is true for moclo.
As long as I take no more than 300 mg at once, I don't seem to get the side effect of depression/anxiety I was having. So that works for now. Would like to avoid another med change at the moment.
I wanted to follow up with you re. Zyprexa withdrawal, as you mentioned you'd had experience with it. I did manage to get off Z about 5 months ago, but it was absolute hell. I had no appetite, couldn't sleep, was anxious, depressed, the only thing I wasn't was psychotic. My doctor did not prepare me for this. You mentioned it took you about 6 months. I feel I started to return to somewhere near normal about a month ago (so 4 months in). I have dropped about 40 lbs, which is approximately what I gained on it, so that's good. But I'm continuing to lose weight, and I'm now at about my ideal weight, and still losing. Will this stop? My appetite has somewhat returned, but it still seems suppressed. I have to remind myself to eat more. Did you have a problem with your appetite when you went off Z? I'm wondering if this will resolve, or if it's the moclobemide. I'm seeing my GP so will rule out other issues, but any input would be appreciated.
Thank you also to the others who responded to my post. It helped me figure out how to manage my dosing and save myself some misery.
Pheepho
Posted by Daniele on December 23, 2012, at 16:06:15
In reply to Moclobemide adverse reactions and withdrawal, posted by Pheepho on October 16, 2009, at 21:00:18
Hi,
I have been on Moclobemide since April 2012 with quetiapine. In November my psy asked me to take 600 mg in the morning and 150 mg in the night + 2 quetiapine in the night. Since the end of November I started to feel very anxious in the morning and the last few days I even experienced panic attacks that made me feel I was going to die. I have also noticed that the anxiety starts little time after I take my moclobemide doses. As my Dr is on holiday I have decided to cut doses of Moclobemide to prevent any new anxiety/panic attacks. I also want to gradually stop this evil medicine. Can you tell me if you had any withdrawal symptoms? Your feedback would be very appreciated. Thanks.
This is the end of the thread.
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