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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 adamie on November 16, 2001, at 19:19:45
Hi. I decided to stop taking my Moclobemide then I changed my mind once again and I'll try to complete a "trial". I am so far 3 days on it. first day I took only 150mg. The last two days I took 300mg and I will be soon taking 450mg and raising to 600mg. Does Moclobemide really work in just 1 week for many people? So far all AD's I've tried have somehow made my depression worse. Some to the point of constant mind torture because I didn't stop them in time. Once I ended up in the hospital. Unless I am convinced I am becoming worse by taking the Moclobemide then I will continue taking it. How long would the usual Moclobemide trial last? I am suffering from sometimes very severe depression which may have atypical features. Also some have told me that perhaps since AD's make me worse that I may be bipolar. Very possible.I will ask my doctor this Wednesday but I would just like to know what the people here think. 2 weeks is a decent trial for Moclobemide? For severe depression would 300mg be enough or should I go with 450-600mg? The family doctor who of course doesn't know a whole lot about AD's told me to take 150mg twice daily. But I have read how 450mg+ is needed for severe depression.
Also how would responding to the medication be like? Is it gradual or does it happen all of a sudden? If one responds to the medication in just 1 week would he notice himself feeling significantly better the few days before?
Also what are people's experiences on this medication?
Posted by Lorraine on November 16, 2001, at 20:02:10
In reply to Moclobemide, really works in just 1 week?, posted by adamie on November 16, 2001, at 19:19:45
Let me preface this by saying that I react oddly to meds. But I felt Moclobemide within the first 3 days. My pdoc assumed that would happen. It has a stimulating effect for me. I liked it but became too anxious on it and could figure out what to do about the anxiety so I stopped using it. May go back to it if I can figure out how to control the anxiety part of the equation.
Good luck.
Lorraine
> Hi. I decided to stop taking my Moclobemide then I changed my mind once again and I'll try to complete a "trial". I am so far 3 days on it. first day I took only 150mg. The last two days I took 300mg and I will be soon taking 450mg and raising to 600mg. Does Moclobemide really work in just 1 week for many people? So far all AD's I've tried have somehow made my depression worse. Some to the point of constant mind torture because I didn't stop them in time. Once I ended up in the hospital. Unless I am convinced I am becoming worse by taking the Moclobemide then I will continue taking it. How long would the usual Moclobemide trial last? I am suffering from sometimes very severe depression which may have atypical features. Also some have told me that perhaps since AD's make me worse that I may be bipolar. Very possible.
>
> I will ask my doctor this Wednesday but I would just like to know what the people here think. 2 weeks is a decent trial for Moclobemide? For severe depression would 300mg be enough or should I go with 450-600mg? The family doctor who of course doesn't know a whole lot about AD's told me to take 150mg twice daily. But I have read how 450mg+ is needed for severe depression.
>
> Also how would responding to the medication be like? Is it gradual or does it happen all of a sudden? If one responds to the medication in just 1 week would he notice himself feeling significantly better the few days before?
>
> Also what are people's experiences on this medication?
Posted by Sigolène on November 17, 2001, at 2:08:48
In reply to Re: Moclobemide, really works in just 1 week? » adamie, posted by Lorraine on November 16, 2001, at 20:02:10
I had to stop moclobémide after 2 weeks because it made my depression worse, like nearly all AD except miansérine, maprotiline and lofépramine (which i think you don't have in USA)
But at the beginning it increases energy by stimulating DA i think, but after a while it has been increasing my anxiety and depression.
Sigolene
Posted by JohnX2 on November 17, 2001, at 2:37:29
In reply to Moclobemide, really works in just 1 week?, posted by adamie on November 16, 2001, at 19:19:45
If you are bipolar and not taking a low
dose of an anti-psychotic or some form
of mood-stablizer (lithium,depakote,lamictal,
tegetrol), then the odds of getting a
sustainable anti-depressant response drop
considerably. This is a fact. Sorry I can't
point to a research report right now,
but I'm hoping others can back me up on this claim.-john
>
> Hi. I decided to stop taking my Moclobemide then I changed my mind once again and I'll try to complete a "trial". I am so far 3 days on it. first day I took only 150mg. The last two days I took 300mg and I will be soon taking 450mg and raising to 600mg. Does Moclobemide really work in just 1 week for many people? So far all AD's I've tried have somehow made my depression worse. Some to the point of constant mind torture because I didn't stop them in time. Once I ended up in the hospital. Unless I am convinced I am becoming worse by taking the Moclobemide then I will continue taking it. How long would the usual Moclobemide trial last? I am suffering from sometimes very severe depression which may have atypical features. Also some have told me that perhaps since AD's make me worse that I may be bipolar. Very possible.
>
> I will ask my doctor this Wednesday but I would just like to know what the people here think. 2 weeks is a decent trial for Moclobemide? For severe depression would 300mg be enough or should I go with 450-600mg? The family doctor who of course doesn't know a whole lot about AD's told me to take 150mg twice daily. But I have read how 450mg+ is needed for severe depression.
>
> Also how would responding to the medication be like? Is it gradual or does it happen all of a sudden? If one responds to the medication in just 1 week would he notice himself feeling significantly better the few days before?
>
> Also what are people's experiences on this medication?
Posted by Chocoholic on November 25, 2001, at 1:13:26
In reply to Moclobemide, really works in just 1 week?, posted by adamie on November 16, 2001, at 19:19:45
>Hi, Adamie-
I took moclobemide for 3 years. I did get a quick response-can't remember if it was one week, but it was at least by two weeks. My response improved over time and I titrated up to 450 for my best response. More made me too agitated.
Chocoholic
> Hi. I decided to stop taking my Moclobemide then I changed my mind once again and I'll try to complete a "trial". I am so far 3 days on it. first day I took only 150mg. The last two days I took 300mg and I will be soon taking 450mg and raising to 600mg. Does Moclobemide really work in just 1 week for many people? So far all AD's I've tried have somehow made my depression worse. Some to the point of constant mind torture because I didn't stop them in time. Once I ended up in the hospital. Unless I am convinced I am becoming worse by taking the Moclobemide then I will continue taking it. How long would the usual Moclobemide trial last? I am suffering from sometimes very severe depression which may have atypical features. Also some have told me that perhaps since AD's make me worse that I may be bipolar. Very possible.
>
> I will ask my doctor this Wednesday but I would just like to know what the people here think. 2 weeks is a decent trial for Moclobemide? For severe depression would 300mg be enough or should I go with 450-600mg? The family doctor who of course doesn't know a whole lot about AD's told me to take 150mg twice daily. But I have read how 450mg+ is needed for severe depression.
>
> Also how would responding to the medication be like? Is it gradual or does it happen all of a sudden? If one responds to the medication in just 1 week would he notice himself feeling significantly better the few days before?
>
> Also what are people's experiences on this medication?
Posted by SLS on November 25, 2001, at 12:05:14
In reply to Re: Moclobemide, really works in just 1 week?, posted by Chocoholic on November 25, 2001, at 1:13:26
Hi there, Chocoholic.
> I took moclobemide for 3 years. I did get a quick response-can't remember if it was one week, but it was at least by two weeks. My response improved over time and I titrated up to 450 for my best response. More made me too agitated.
Are you still taking moclobemide?If not, why did you stop taking it? How are you doing now?
Do you have any social anxiety that moclobemide helped you with?
Thanks.
- Scott
Posted by Chocoholic on November 25, 2001, at 21:56:44
In reply to Re: Moclobemide, really works in just 1 week? » Chocoholic, posted by SLS on November 25, 2001, at 12:05:14
>Hi, Scott-
Here is a brief history--
I was diagnosed with Bipolar II about 5 years ago, at first by process of elimination. I have been through probably 20-30 different drugs in the last 9 years. When I was diagnosed I had been in the throes of a suicidal depression. First I started on Serzone, then added lamotrigine (one of my favorite meds of all time--I could make a great commercial for it!). The Serzone was only minorly helpful, but the lamotrigine cleared out some of the fog and let me think again. A year later,we substituted the moclobemide after someone at the FDA finally told me how to get it (I had researched it a couple of previous years). It really helped increase the quality of my life and functioning, and more and more over time. However, I still was cycling a lot and still getting some pretty awful (but not nearly as profound or long-lasting) depressions--it is all relative, I guess. So, this past year, I went to see Terence Ketter at Stanford and he gave me a huge list of ideas. So, I first added ziprasidone, then dropped moclobemide and added pramipexole (Mirapex). I am doing a lot better, in spite of some pretty heavy stressors in my life.I am still pissed about having this disorder, though and wish that the damn suffering would go to hell and never return!I don't have social anxiety, but my niece was working with Michael Liebowitz at Columbia while he was doing a study with moclobemide for social anxiety. I can ask her about the results if you are interested.
Now I have a question for you since you are so knowledgable about meds (I love reading your posts!). I want to get off Restoril--I've been on benzos for over 12 years. Supposedly the thought now is to switch people to Valium or Klonopin and titrate down from there because of the smaller possible increments and longer half lives. Only I get really depressed on long-acting benzos. And I guess I need to cut back by tenths--and I can't divide a capsule into tenths. So, do you think it would be feasible to just not take the drug one night every ten days and go down like that? Do you think it would be stable to pour out the powder and mix it in with liquid and drink 9/10 and do it that way? Any other ideas? Do you know of a pharmacy that might make Restoril in liquid form?
Chocoholic
Hi there, Chocoholic.
>
> > I took moclobemide for 3 years. I did get a quick response-can't remember if it was one week, but it was at least by two weeks. My response improved over time and I titrated up to 450 for my best response. More made me too agitated.
>
> Are you still taking moclobemide?
>
> If not, why did you stop taking it? How are you doing now?
>
> Do you have any social anxiety that moclobemide helped you with?
>
> Thanks.
>
>
> - Scott
Posted by SLS on November 26, 2001, at 9:33:32
In reply to Re: Moclobemide, really works in just 1 week?, posted by Chocoholic on November 25, 2001, at 21:56:44
Hi again, Chocoholic.
I once knew a Chocolasaurus. Any relation? :-)
> So, this past year, I went to see Terence Ketter at Stanford and he gave me a huge list of ideas.
I would LOVE to know what he said. Can I convince you to PLEASE send me his list? Pretty-please?Dr. Ketter is one of my favorite research clinicians. He's a majorly smart guy. I didn't know that he was still seeing patients. I would have thought him too busy with his brain imaging studies. I know him from my treatment at the NIH (National Institutes of Health) in 1992-1993. He wasn't my doctor, but I knew quite a few people that he treated. He must be a nice guy. Along with Robert Post, I think he was the patients' favorite.
> So, I first added ziprasidone, then dropped moclobemide and added pramipexole (Mirapex).
Did Dr. Ketter choose ziprasidone specifically for its antidepressant properties?
> I am doing a lot better, in spite of some pretty heavy stressors in my life.I am still pissed about having this disorder, though and wish that the damn suffering would go to hell and never return!
I know. I was real pissed to have this disorder in the beginning too. Now, I have accepted completely my having it. For me, it just seems like a luxury to lament and become angry over my misfortune to be born with bipolar disorder. What matters to me now is the experience of life. I don't give a damn what illness I've got, just as long as it can be brought into remission. Like you said, the priority is the quality of life.
> I don't have social anxiety, but my niece was working with Michael Liebowitz at Columbia while he was doing a study with moclobemide for social anxiety. I can ask her about the results if you are interested.Yes, I would be. Quite a while ago, I came across an abstract on Medline describing one of his studies of moclobemide and social phobia. The results as he described them were positive. However, I am a bit dubious that moclobemide will so frequently produce a long-term robust remission when compared to drugs like Nardil or Paxil. At the time, Roche was working toward getting moclobemide approved in the US for the indication of social phobia, and not depression. In 1996, I spoke to the head of the R&D department there to find out what the deal was. He told me that the project had been terminated due to lack of efficacy. Dr. Liebowitz was the first psychiatrist to diagnose me as having a biogenic mood disorder. I'm still not sure why Columbia chose him to do screenings for their depression evaluation service project. I never saw him among Frederick Quitkin's staff.
> Now I have a question for you since you are so knowledgable about meds (I love reading your posts!).
< embarrased > I am not nearly as qualified as many of the other posters on Psycho-Babble to address your questions. I wish I were.
> I want to get off Restoril--I've been on benzos for over 12 years. Supposedly the thought now is to switch people to Valium or Klonopin and titrate down from there because of the smaller possible increments and longer half lives. Only I get really depressed on long-acting benzos.
I'm willing to bet that it was Klonopin (clonazepam) that you found depressogenic. From my personal experience with Klonopin, I would not consider it to be significantly easier to discontinue than the other benzodiazepines. Actually, I would think it would be easier to get off of Restoril. It is really sort of medium in terms of half-life. You might want to look into using clonidine or perhaps baclofen to help you through the withdrawal period. I bet there are a whole bunch of things that would help. I'm curious about using Neurontin or Zyprexa. For a long-acting benzodiazepine, maybe Dalmane is worth looking into.
There are a bunch of people here who are much more versed in this matter than am I to answer your questions, so I will defer.
> And I guess I need to cut back by tenths--and I can't divide a capsule into tenths. So, do you think it would be feasible to just not take the drug one night every ten days and go down like that? Do you think it would be stable to pour out the powder and mix it in with liquid and drink 9/10 and do it that way? Any other ideas? Do you know of a pharmacy that might make Restoril in liquid form?
Good luck. Please let us know what you decide to do.
- Scott
This is the end of the thread.
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