![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by linkadge on October 27, 2022, at 15:14:16
My psychiatrist agreed that I was depressed, and that bupropion isn't working for me. Somehow, I walked out with a prescription for atomoxetine (which I've taken before). I don't know what's going on, but the switch is making me feel worse.
I don't know how many times I can take the same meds over and over again. Unfortunately, the doctor didn't want to try moclobemide.
Frustrating. More time and money wasted.
Linkadge
Posted by jay2112 on October 27, 2022, at 18:32:02
In reply to bupropion to atomoxetine, posted by linkadge on October 27, 2022, at 15:14:16
> My psychiatrist agreed that I was depressed, and that bupropion isn't working for me. Somehow, I walked out with a prescription for atomoxetine (which I've taken before). I don't know what's going on, but the switch is making me feel worse.
>
> I don't know how many times I can take the same meds over and over again. Unfortunately, the doctor didn't want to try moclobemide.
>
> Frustrating. More time and money wasted.
>
> LinkadgeHey Linkadge,
Sorry about your crappy experience. What you should do is print up some of the positive studies on moclobemide. Bring them to your next meeting, and push a bit. Tell him the truth...that atomoxetine made you feel WORSE.
Also, print up some stuff on stims...have you tried amphetamine, or it's related Vyvanse??
Jay
Posted by SLS on October 27, 2022, at 19:32:50
In reply to bupropion to atomoxetine, posted by linkadge on October 27, 2022, at 15:14:16
> My psychiatrist agreed that I was depressed, and that bupropion isn't working for me. Somehow, I walked out with a prescription for atomoxetine (which I've taken before). I don't know what's going on, but the switch is making me feel worse.
>
> I don't know how many times I can take the same meds over and over again. Unfortunately, the doctor didn't want to try moclobemide.
>
> Frustrating. More time and money wasted.
>
> Linkadge
Have you ever combined Effexor with Wellbutrin? Is that what you are taking now? What dosages? How long?A friend of mine had no luck until she combined Pristiq 100 mg/day with Wellbutrin 300 mg/day. Wellbutrin had been often used as an adjunct to Zoloft (Welloft).
What about Cymbalta? Is it available in Canada?
Is there any reason why you are discontinuing Wellbutrin other than it isn't producing magic right now?
- Scott
Posted by SLS on October 28, 2022, at 8:13:06
In reply to bupropion to atomoxetine, posted by linkadge on October 27, 2022, at 15:14:16
> I don't know how many times I can take the same meds over and over again. Unfortunately, the doctor didn't want to try moclobemide.
Your doctor made the right call on moclobemide. It has no maintenance dosage. Dosage escalation continues until you reach the maximum dosage that your doctor is willing to prescribe.
Moclobemide is rather sticky to the MAO enzyme, but it is nevertheless reversible. The half-life is rather short, which argues for moclobemide having a relatively high binding affinity to the monoamine oxidase (type A). The amount of increase in blood pressure resulting from moclobemide is dosage-dependent.
You are not really free to ingest unlimited amounts of tyramine. With moclobemide at dosages of 600 mg/day or higher, the limit to the amount of tyramine ingested during a meal be within the range of 50-100 mg per meal, depending on the reporter. Regardless, one should take moclobemide after a meal, or on a t.i.d. schedule.At a dosage of moclobemide of 600 mg/day or higher, it is recommended that the limit to the amount of tyramine ingested at a meal be of within the range of 50-100 mg. The limit reported depends on the author. Serotonin syndrome is a possibe outcome when combining moclobemide with serotonin reuptake inhibitors. Interestingly, I have seen reports of moclobemide having serotonin reuptake inhibition as a property.
- Scott
Posted by linkadge on October 28, 2022, at 15:34:56
In reply to Re: bupropion to atomoxetine » linkadge, posted by SLS on October 28, 2022, at 8:13:06
>Your doctor made the right call on moclobemide
I'm not sure I agree. The right move would be to try something different rather than the same things over again. I understand that Moclobemide is inferior to the irreversible MAOIs (generally speaking), but it can be effective for some, has a different side effect profile and may be better than SSRIs for apathy.
Linkadge
Posted by SLS on October 28, 2022, at 21:06:13
In reply to Re: bupropion to atomoxetine, posted by linkadge on October 28, 2022, at 15:34:56
> >Your doctor made the right call on moclobemide
>
> I'm not sure I agree. The right move would be to try something different rather than the same things over again. I understand that Moclobemide is inferior to the irreversible MAOIs (generally speaking), but it can be effective for some, has a different side effect profile and may be better than SSRIs for apathy.
>
> LinkadgeYour logic is good. I would try moclobemide, too, were I in your place. I did when I was in my 30s. Nothing good came of it. In fact, it made me feel worse that any other drug I tried. It took 2-3 weeks after its discontinuation for the horror to dissipate. I got a wonderful antidepressant kick from moclobemide for the first few days at 300 mg/day. You can go up to 1200 mg/day. I haven't seen any clinicians go higher than that. The most important thing to consider is that you are not me. Moclobemide was a horrible, horrible drug for me. It left me in a fetal position on the couch and audibly groaning for hour on end. For you, moclobemide might be your miracle drug. I gave you some good information to work with.
May you remain different from me in your response to moclobemide...
- Scott
Posted by SLS on October 28, 2022, at 21:08:39
In reply to Re: bupropion to atomoxetine » linkadge, posted by SLS on October 28, 2022, at 21:06:13
Oops.
Posted by linkadge on October 29, 2022, at 19:24:30
In reply to Re: bupropion to atomoxetine » linkadge, posted by SLS on October 28, 2022, at 21:06:13
I'm not going to get to try it.
I'm back in circles on atomoxetine. I filled the prescription (don't know why) but then disposed of it.
Linkadge
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.