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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by bearfan on July 14, 2010, at 17:51:11
Was thinking of trying this before a 'real' MAOI whether to see if it works. Admittedly it's not as efficacious as traditional MAOIs, but it has a low rate of side effects and compares similar to SSRIs.
Posted by ed_uk2010 on July 16, 2010, at 16:29:55
In reply to Anyone still using Moclobemide?, posted by bearfan on July 14, 2010, at 17:51:11
> Was thinking of trying this before a 'real' MAOI whether to see if it works. Admittedly it's not as efficacious as traditional MAOIs, but it has a low rate of side effects and compares similar to SSRIs.
I imagine you are already aware of this but.......moclobemide does not generally cause sexual side effects.
Posted by vwoolf on July 17, 2010, at 6:34:37
In reply to Re: Anyone still using Moclobemide?, posted by ed_uk2010 on July 16, 2010, at 16:29:55
I used Moclobemide for about three years. I had no side effects from it at all. My depression slowly lifted while I was on it(with the help of massive amounts of psychotherapy)so I tapered off and eventually stopped taking it altogether. That was about four years ago, and I am still clear. If my depression did return, and of course I am aware that it may, I would go back onto the Moclobemide without any hesitation. Btw, it was also a lot cheaper than most other drugs I had tried up to that point. I wish doctors would not be so scared of using it.
Posted by ed_uk2010 on July 17, 2010, at 11:28:50
In reply to Re: Anyone still using Moclobemide?, posted by vwoolf on July 17, 2010, at 6:34:37
>I wish doctors would not be so scared of using it.
Good point. I think some doctors just get scared when they read 'MAOI'. Most doctors know very little about MAOIs, which doesn't help.
Posted by bearfan on July 23, 2010, at 19:02:36
In reply to Re: Anyone still using Moclobemide?, posted by vwoolf on July 17, 2010, at 6:34:37
Is sounds like some people do indeed get a response from Moclobemide. Is it possible that people slam the drug for not doing anything is because they are expecting a powerful effect like from a irreversible MAOI? I am guessing Moclobemide is comparable to SSRIs in efficacy but not much else (SSRIs being not far off from placebo from many people). My Doctor agreed to try it (although he's in the US and has not had much experience with it) What is the wash out from a short half life drug (1 day or 2)?
Posted by ed_uk2010 on July 24, 2010, at 16:24:43
In reply to Re: Anyone still using Moclobemide?, posted by bearfan on July 23, 2010, at 19:02:36
>Is it possible that people slam the drug for not doing anything is because they are expecting a powerful effect like from a irreversible MAOI?
I think it's partly because moclobemide is a relatively 'mild' antidepressant but in spite of this it's normally used after SSRIs and SNRIs have failed rather than the other way around. If it was used as a first-line treatment for moderate depression it might perform OK.
>I am guessing Moclobemide is comparable to SSRIs in efficacy....
I suspect that its efficacy is somewhat less than SSRIs on average. Of course, there are individual differences in response.
>What is the wash out from a short half life drug (1 day or 2)?
What medication are you taking at the moment?
Posted by bearfan on July 24, 2010, at 19:45:04
In reply to Re: Anyone still using Moclobemide? » bearfan, posted by ed_uk2010 on July 24, 2010, at 16:24:43
Last medication I took was 30mg cymbalta which was discontinued 36 hours ago. Something about 4-5 half lives before I can start mocobemide (although i've seen reports of starting it right away on lower than normal doses). Cymbalta's half life is 11 hours so should probably be okay with small dosages. It seems to make sense to start Moclobemide first (before a traditional MAOI), because its only 2 days to start a new medication if it fails (rather than 2 weeks), and if it works well it has a low documented side effect profile.
Posted by ed_uk2010 on July 24, 2010, at 20:46:04
In reply to Re: Anyone still using Moclobemide?, posted by bearfan on July 24, 2010, at 19:45:04
>Cymbalta's half life is 11 hours so should probably be okay with small dosages.
The manufacturer recommends waiting 5 days before starting an MAOI. This may be overcautious with moclobemide but it's better to be safe than sorry.
>It seems to make sense to start Moclobemide first (before a traditional MAOI), because its only 2 days to start a new medication if it fails (rather than 2 weeks), and if it works well it has a low documented side effect profile.
I agree, that definitely makes sense.
Posted by bearfan on July 24, 2010, at 21:46:06
In reply to Re: Anyone still using Moclobemide? » bearfan, posted by ed_uk2010 on July 24, 2010, at 20:46:04
So Ed, what was your magic bullet? I'm so sick of antidepressants, it's either they work and have terrible side effects or they are somewhat tolerable but don't work well enough. My depression is more of the 'I don't want to do anything' kind of thing (atypical)? And I don't understand why in 2010 there hasn't been any significant advance in the 2nd most common worldwide health problem. The only thing I've seen is patent tweaks which usually offer little in the way of side effect relief and almost always no improvements of efficacy. Even if MAOIs work a lot better, it's like i'm going to be walking on eggshells and have little options in polypharmacy or augmenting strategies due to all the life-threatening drug interactions. Also I don't completely buy the argument that drug companies only care about profit and patent extensions. While I do think that a certain part of that exists, there is also a tremendous advantage of developing a new novel "blockbuster" drug that could make up to trillions of dollars worldwide. I know a little of science and business, and I can't see why a pharmaceutical company can't commission a small team of chemists to research a compound that targets the depression illness without the undesirable side effects. Especially with all the biotechnical computers that can make billions of calculations figuring out what to do. Plus I know there are got to be biochemist out there looking for a cure or treatment to help people. Whether it's based on anecdotal situations (wife or relative committed suicide) or bragging rights. These undesirable side effects are well known since the past several decades patients almost always complain of side effects just about as miserable as the depression itself. Undesirable weight gain, Sexual Dysfunctions, and eventually resistance to the medications. How the heck am I suppose to make progress in my life when I have to deal with these things?
Posted by ed_uk2010 on July 25, 2010, at 10:28:20
In reply to Re: Anyone still using Moclobemide?, posted by bearfan on July 24, 2010, at 21:46:06
>Even if MAOIs work a lot better, it's like i'm going to be walking on eggshells and have little options in polypharmacy or augmenting strategies due to all the life-threatening drug interactions.
Well, I dunno. There are some life-threatening drug interactions but there are also a lot of meds that MAOIs don't interact with. Also, you're trying moclobemide first. Moclobemide doesn't have too many drug interactions except with SSRIs and SNRIs.
Posted by bearfan on July 25, 2010, at 15:05:24
In reply to Re: Anyone still using Moclobemide? » bearfan, posted by ed_uk2010 on July 25, 2010, at 10:28:20
EdUK, you live outside of the U.S., right? How widely used is the Moclobemide would you say? Maybe more than Luvox?
Posted by ed_uk2010 on July 25, 2010, at 15:16:04
In reply to Re: Anyone still using Moclobemide?, posted by bearfan on July 25, 2010, at 15:05:24
>How widely used is the Moclobemide would you say? Maybe more than Luvox?
In the UK it is used very little. Fluvoxamine is also rarely used.
Posted by bearfan on July 26, 2010, at 16:13:16
In reply to Re: Anyone still using Moclobemide?, posted by ed_uk2010 on July 25, 2010, at 15:16:04
Do Rima/MAOIs take much longer to work than SSRIs? I've been taking the Moclobemide and not really feeling a whole lot better (still can't wake up in time etc). Whereas the SSRIs I notice symptom reduction very quickly. Also my libido has vanished (this may be a depression symptom) but I thought this one wasn't suppose to cause this?
Posted by ed_uk2010 on July 26, 2010, at 16:50:54
In reply to Re: Anyone still using Moclobemide?, posted by bearfan on July 26, 2010, at 16:13:16
>Do Rima/MAOIs take much longer to work than SSRIs?
No, I don't think so. Moclobemide is supposed to work within a few weeks.
Posted by bearfan on July 26, 2010, at 17:05:39
In reply to Re: Anyone still using Moclobemide?, posted by ed_uk2010 on July 26, 2010, at 16:50:54
Whats the track record on this med with generalized anxiety anyway? I feel a bit keyed up and not in a good way. I took some xanax and it doesn't seem to help much.
Posted by ed_uk2010 on July 26, 2010, at 17:17:06
In reply to Re: Anyone still using Moclobemide?, posted by bearfan on July 26, 2010, at 17:05:39
> Whats the track record on this med with generalized anxiety anyway? I feel a bit keyed up and not in a good way. I took some xanax and it doesn't seem to help much.
I don't think it has any track record in GAD.
Posted by bearfan on July 26, 2010, at 17:21:50
In reply to Re: Anyone still using Moclobemide?, posted by ed_uk2010 on July 26, 2010, at 17:17:06
Strange, because I did seem some efficacy on treating social anxiety disorder. I would think that since that was a anxiety spectrum disorder it would do well with that as well. What does the board tend to (or United Kingdom) due the best long term with those kind of symptoms?
Posted by bearfan on July 27, 2010, at 11:11:30
In reply to Re: Anyone still using Moclobemide?, posted by bearfan on July 26, 2010, at 17:21:50
I actually did notice some relief with social anxiety the other day. Although I'm still not on the therapeutic dose (about 200 a day). For a medication that is suppose to have minimal impacts on sexual function, that seems like the last thing on my mind (what gives)? Ed, do you have experience this medication? From pubmed, the efficacy reports show that its at or slightly below efficacy of SSRIs and TCAs with an equal or slightly more tolerable side effect profile (especially regarding sexual function).
Posted by ed_uk2010 on July 27, 2010, at 15:20:36
In reply to Re: Anyone still using Moclobemide?, posted by bearfan on July 27, 2010, at 11:11:30
I've taken moclobemide but it was many years ago. I don't recall any benefit....or any side effects. I took 300mg twice a day.
This is the end of the thread.
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