Posted by SLS on June 11, 2022, at 8:35:24
In reply to Re: Oral deprenyl vs bupropion? » SLS, posted by Jay2112 on June 10, 2022, at 19:28:14
Hi, Jay.
Thanks for your valuable contribution of describing the phenomenology of moclobemide, and how you responded to it. Why did you stop taking it?
Regarding your use of moclobemide as an "emergency" drug, I would suggest that the most important role of moclobemide *might* be to knock enough bricks out of the wall of complete resistance to allow other drugs to regain their efficacies as antidepressants.
I like to think that this is possible.
- Scott> > Hi.
> >
> > L-Deprenyl / selegeline / EMSAM is *selective* for MAO-B, but only at low dosages. At higher dosages, selegeline becomes non-selective and MAO-A is also inhibited, Of these two types of MAO enzymes, MAO-A is the the one that is associated with antidepressant effects. The package label for EMSAM is explicit regarding this. Clorgyline is no longer available, but it is an irreversible *specific* inhibitor of MAO-A. It doesn't inhibit MAO-B at all. The NIH had considered it the most powerful antidepressant in the world, but reserved it for their most treatment-resistant cases of treatment-resistant depression - TRD. It left me improved, but they would not allow me to combine it with a tricyclic antidepressant (TCA) like desipramine or nortriptyline, which I had needed to add to Nardil or Parnets in order to respond. Ultimately, they had to discontinue giving clorgyline to their patients because adverse cardiac events were reported.
> >
> > Moclobemide is another MAOI that is specific for MAO-A. It is a reversible inhibitor of monoamine oxidase (RIMA). Unfortunately, it is reversible rather than irreversible, leaving it an inferior choice. Some people get amazing results in the first week at 300 mg/day. However, dosage escalation is usually inevitable to retain the antidepressant response. The maximum dosage is usually considered to be 1200 mg/day. Still, very few people remain improved indefinitely on moclobemide.
> >
> > In summary, inhibiting MAO-A is sufficient to yield an improvement in depression.
> >
> >
> > - Scott
> Moclobomide was, personally, a super-interesting drug. Yes, it has a super short half-life...of 2-3 hours. But, being a rapid metabolizer of drugs, I took smaller doses, like a 150mg dose split in half to a 75mg dose, and I spaced it one of those every 4-5 hours, 4x a day. And boy, it's antidepressant effects are felt immediately! It works more for apathetic, slow, tiring depression, than anxiety..at least at first. I remember so clearly, taking the 75mg dose on a day where I felt deflated by life, and WOW..I was a tad manic, but felt productive.It also has a pro-testosterone effect too. Sex with this stuff was f'ing increadible!! After years of chronic SRI use, just...WOW. So, I keep it in the back of my mind as an emergency drug when all others run out!
>
> And...apparently it works even MUCH better with lithium..in fact I know of a number of individuals at university who are on this combo, and have been in remission for years. I would add, a STRONG GABA drug, like Lyrica, or a strong benzo, really help cool off the stimulating effects of this drug in the evening.
>
> FWIW...IMHO...etc...
>
> Jay
Some see things as they are and ask why.
I dream of things that never were and ask why not.The only thing necessary for the triumph of evil is that good men do nothing.
poster:SLS
thread:1119824
URL: http://www.dr-bob.org/babble/20220530/msgs/1119877.html