Posted by europerep on December 31, 2009, at 13:03:54
In reply to Re: switching from venlafaxine/mirtazap to moclobemide, posted by West on December 29, 2009, at 18:18:38
Hey all,
thanks very much for your answers.. excuse me for not replying earlier, in fact I didn't see my own thread on the babble board, so I figured I did something wrong, or my thread was erased, or something like that.. i only found this through (the 254th) google search "switch venlafaxine moclobemide" :).. anyways..
@philippa:
thanks :)@SLS:
yeah, from reading the board I could already tell that you don't seem to be too fond of moclobemide.. in fact, considering to switch to moclobemide was my own idea, because I read that MAOIs in general are a sort of last line of defense against depression, and without the stupid dietary restrictions it seemed like the perfect drug.. but I guess there are reasons for why it is commercially unsuccessful after all..
I might actually try reducing the mirtazapine, and then replace it with bupropion, maybe that'll do something..@bleauberry
yeah, I think that's what scott hinted at, about efficacy of moclobemide.. I was so convinced that venlafaxine plus mirtazapine would be great, because it seems to be so popular, etc., but now I'm really disappointed.. does switching from my combo to, say, paroxetine plus reboxetine, or something similar (i.e., SRI + NRI), make sense? I mean it's not that venlafaxine doesn't do anything, that's what I saw when I reduced the venlafaxine (because my pdoc said that maybe I'd be better with less - she had never ever had anyone with 600mg) to 375mg, there I stopped and increased it on my own, because it was terrible.. in the end, if increased serotonin from one medication doesn't make me feel better, will increased serotonin from a different agent do the trick? same for the NE..@linkadge:
i've been on amitriptyline before, up to 375mg, and it didn't work any longer (I've had already taken it for, um, 7 years).. that's why I switched to venlafaxine.. after initial improvement, that gradually disappeared, then came back when I raised the amount I took, then disappeared, etc... so amitriptyline doesn't do it, and I'm scared of the sedation of doxepine.. over here it is rarely used, if not in cases of opioid withdrawal for example,..@west:
well, I'm switching because everything has steadily gone downhill for the past six months, all the things I achieved or succeeded at re-introducing into my life (studying,...) are getting more and more difficult to sustain, if not impossible.. the life I am currently living is certainly not worth it for me, so I guess I have to do something..I don't understand the way I am treated at the university clinic.. I mean if I were a psychiatrist, I would be happy to have patients with TRD, I guess I'd have my own statistics for seeing how many patients respond to this or that treatment, etc.. instead I feel like I'm a liability, and every perspective of what I might try next results from my own suggestions.. my doc wants me to keep on taking venlafaxine/mirtazapine because maybe at some point something will happen.. I mean of course I know that I have to be patient, etc., but it's been months on this combo, I don't think much will change by continuing like this.. anyways.. would there be a point in raising mirtazapine? i read about a 600/120 combo here on the board.. if not, I will try venlafaxine plus bupropion..
poster:europerep
thread:930533
URL: http://www.dr-bob.org/babble/20091227/msgs/931798.html