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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Radish on February 3, 2019, at 9:32:12
So I asked my pdoc for an MAOI for my SA and depression and he gave me the RIMA moclobemide. I was disappointed immediately because I had already read studies that demonstrated its ineffectiveness. Apparently its not even approved in the States due to that. Im in Canada.
Im trying it regardless because my long con is to initially placate pdocs ego and not challenge him and demonstrate I am a good patient in the hope of gaining his favour and getting an irreversible MAOI. I am not certain this will actually work because I dont know if he prescribes them. Hes sort of strange, very reticent, barely speaks just types on his laptop, and seems conservative.
I have been on 150 mg of moc for 3 days and may be having a paradoxical reaction, but I cant be sure. I feel much more depressed than usual and cant think of any other circumstance to attribute this feeling. Normally I think Im only dysthymic because I can still function ok on the weekends and experience some positive? or neutral? emotions (I dont know what it is like to feel normal because Ive been psychologically compromised since childhood).
But today its the weekend and I cant move, get off the couch, think, or speak. Not interested in eating, cant clean up the home. I mean I can literally DO those things, it just takes an immense level effort that I dont have and it all seems pointless.
The impaired cognition is the most upsetting symptom because I cant even talk to people about how Im feeling because I cant process thought into language and then verbally execute it around people. Writing seems to be easier. But it takes so long. And I cant even read like normally, which is the main tool I have for interrupting my negative feedback loop of hellish thoughts. Im in comfort-seeking mode, trying to end my suffering, and I dont have the mental resources or energy to do much else.
I cant be sure the moc is the cause though, so Ill keep taking it for a week, maybe, even though I cant afford to feel worse. Ill give it a good shot because I dont want pdoc to think Im troublesome, seeing as I didnt take the last drug he prescribed, seroquel, for more than 3 days because it was like a horse tranquilizer. Sure it decreased anxiety ... because I was passed the f*** out.
Thank you for reading this wordy rant!
Posted by Lamdage22 on February 3, 2019, at 13:09:51
In reply to Moclobemide paradoxical reaction, or something, posted by Radish on February 3, 2019, at 9:32:12
I went psychotic on all MAOI. I would advise you to know the symptoms so when you get them, you know what's going on and then you and/or your doctor can react.
Just saying.
Posted by bleauberry on February 4, 2019, at 7:02:48
In reply to Moclobemide paradoxical reaction, or something, posted by Radish on February 3, 2019, at 9:32:12
Wow Radish, I'm very sorry for what you are experiencing.
I hate to say it but I can relate. That's because when I tried Moclobemide - two different times - the reaction I got was very similar to what you described.
I wanted so bad for it to work because the literature seemed so promising, and nothing else in USA was doing the job. I had it shipped in from overseas. But as often happens, the literature is either wrong, deceptive, biased, or something.
What are your psychiatric symptoms?
What are your other physical symptoms, from head to toe? List all of them, even the minor ones that don't seem like a big deal.
Answers to the above two questions can help paint a better picture than either question alone.
What meds or combos have you tried and what went wrong with those?
I hope you have a smoother day today!
> So I asked my pdoc for an MAOI for my SA and depression and he gave me the RIMA moclobemide. I was disappointed immediately because I had already read studies that demonstrated its ineffectiveness. Apparently its not even approved in the States due to that. Im in Canada.
>
> Im trying it regardless because my long con is to initially placate pdocs ego and not challenge him and demonstrate I am a good patient in the hope of gaining his favour and getting an irreversible MAOI. I am not certain this will actually work because I dont know if he prescribes them. Hes sort of strange, very reticent, barely speaks just types on his laptop, and seems conservative.
>
> I have been on 150 mg of moc for 3 days and may be having a paradoxical reaction, but I cant be sure. I feel much more depressed than usual and cant think of any other circumstance to attribute this feeling. Normally I think Im only dysthymic because I can still function ok on the weekends and experience some positive? or neutral? emotions (I dont know what it is like to feel normal because Ive been psychologically compromised since childhood).
>
> But today its the weekend and I cant move, get off the couch, think, or speak. Not interested in eating, cant clean up the home. I mean I can literally DO those things, it just takes an immense level effort that I dont have and it all seems pointless.
>
> The impaired cognition is the most upsetting symptom because I cant even talk to people about how Im feeling because I cant process thought into language and then verbally execute it around people. Writing seems to be easier. But it takes so long. And I cant even read like normally, which is the main tool I have for interrupting my negative feedback loop of hellish thoughts. Im in comfort-seeking mode, trying to end my suffering, and I dont have the mental resources or energy to do much else.
>
>
> I cant be sure the moc is the cause though, so Ill keep taking it for a week, maybe, even though I cant afford to feel worse. Ill give it a good shot because I dont want pdoc to think Im troublesome, seeing as I didnt take the last drug he prescribed, seroquel, for more than 3 days because it was like a horse tranquilizer. Sure it decreased anxiety ... because I was passed the f*** out.
>
>
> Thank you for reading this wordy rant!
Posted by SLS on February 4, 2019, at 9:10:54
In reply to Re: Moclobemide paradoxical reaction, or something, posted by Lamdage22 on February 3, 2019, at 13:09:51
> I went psychotic on all MAOI. I would advise you to know the symptoms so when you get them, you know what's going on and then you and/or your doctor can react.
>
> Just saying.Moclobemide made me more depressed than any other drug has. I titrated up to 900 mg/day and stayed with it because I was desperate. I would say that if your depressive reaction lasts for more than a week, you should discontinue it. It was terrible. I spent several days curled up in a fetal position and audibly whimpering.
- Scott
Posted by Jay2112 on February 8, 2019, at 13:13:13
In reply to Moclobemide paradoxical reaction, or something, posted by Radish on February 3, 2019, at 9:32:12
Hi,
I am really sorry you are feeling so crappy. I am in Canada as well, so good day, eh? Lol. I personally would have given my shot on the moclobemide longer, but it just made me feel listless and anxious. Even with benzo's. I wish I could say it had a more robust effect.
Also, I wouldn't personally try to catch the "likeness" of your pdoc too much. He is supposed to be there for you, at the drop of a coin! You make sure he puts you on the Mercede's Benz of meds, and absolutely don't settle for anything less than feeling great. Best wishes,
Jay
Posted by Radish on February 10, 2019, at 10:48:35
In reply to Moclobemide paradoxical reaction, or something, posted by Radish on February 3, 2019, at 9:32:12
Update
Ok I seemed to have passed over the hump of moc induced deep depression. Im back to my normal mild depression/dysthymia so moc doesnt seem to be Improving that. It may be helping with social anxiety when I take it with ativan, but if so, the effect is so subtle I cant the sure its there and not just the Ativan. Its difficult for me to be certain of anything when it comes to my mental health and drugs. There are too many variables involved all the time??? Everything sucks. :)
Posted by Radish on February 13, 2019, at 16:42:25
In reply to Re: Moclobemide paradoxical reaction, or something, posted by Radish on February 10, 2019, at 10:48:35
Update 2
Well Ive stopped taking it because I took it the other day and felt more depressed than normal. Like no motivation even to eat. Of course I can not the sure Im not just more depressed lately, and I indeed may be, because of increasing social problems/pain. But I cant afford to compound the pain. Certainly not with something supposed to do the opposite. So Ive stopped the drug and am having no withdrawal effects. Which makes me think it really is just a sugar pill in the first place. I am so tired.
Posted by SLS on February 20, 2019, at 17:25:01
In reply to Re: Moclobemide paradoxical reaction, or something, posted by Radish on February 13, 2019, at 16:42:25
> Update 2
>
> Well Ive stopped taking it because I took it the other day and felt more depressed than normal. Like no motivation even to eat. Of course I can not the sure Im not just more depressed lately, and I indeed may be, because of increasing social problems/pain. But I cant afford to compound the pain. Certainly not with something supposed to do the opposite. So Ive stopped the drug and am having no withdrawal effects. Which makes me think it really is just a sugar pill in the first place. I am so tired.I hope you recover quickly. Moclobemide is reversible and has a short half life: 1 1/2 hours. Despite this, it took me over a week to recover from the horrendous suffering that moclobemide caused.
- Scott
Posted by Radish on February 24, 2019, at 7:15:26
In reply to Re: Moclobemide paradoxical reaction, or something » Radish, posted by SLS on February 20, 2019, at 17:25:01
Thanks Scott... its strange.. any idea on how/why moc made us feel so awful?
Posted by SLS on February 24, 2019, at 14:18:28
In reply to Re: Moclobemide paradoxical reaction, or something, posted by Radish on February 24, 2019, at 7:15:26
> Thanks Scott... its strange.. any idea on how/why moc made us feel so awful?
I wish I could remember the specifics. It was a long time ago. If I remember correctly, I found an obscure abstract on Pubmed that led me to believe that moclobemide somehow reduced dopamine activation. It did not involve MAO inhibition. None of the other RIMAs had this property.
While searching for the old literature, this caught my eye.
"In humans, moclobemide increases plasma prolactin levels"
https://link.springer.com/article/10.2165/00003495-199243040-00009
Prolactin increase is often the result of decreased dopaminergic activity. Well, I snooped a little more and found that increased prolactin secretion is a consistent observation with moclobemide. Some investigators propose that this involves the stimulation of certain serotonin receptors. This might serve to decrease dopamine activity downstream, resulting in the increase of prolactin levels and the exacerbation of depression. Just a wild guess.
https://www.ncbi.nlm.nih.gov/pubmed/2250565
- Scott
Posted by Radish on February 28, 2019, at 6:49:25
In reply to Re: Moclobemide paradoxical reaction, or something » Radish, posted by SLS on February 24, 2019, at 14:18:28
Oh thats interesting. That makes sense to me.
This is the end of the thread.
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