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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by West on July 14, 2008, at 18:07:03
I have been prescribed moclobemide and still have somewhere a box of Intas Selgin left over from some dlpa/sel. experiments none of which bore fruit. I also have some gsk Zyban manufactured to (i believe) identical formulation to US Wellbutrin, could this be combined safely? I think anecdotal evidence can be more reassuring than empirical in cases of this nature.
Research suggests even at 5mg with moclo there is increased tyramine pressor sensitivity warranting full dietary restriction.
Thing is, the diet i can do, it's the weight gain and sexual difficulties which i'd happily avoid, and if i can do that AND have a more robust response to my depression then it's clearly gold.
Any hope from others?
West
Posted by Astounder on July 16, 2008, at 2:08:52
In reply to Cheat's Parnate) Moclobemide + Selegiline ?, posted by West on July 14, 2008, at 18:07:03
Wellbutrin is safe with MAOIs. It does not cause the serotonin syndrome and pretreatment in fact will dose-dependently abolish the tyramine pressor response (by blocking tyramine uptake) while also attenuating the orthostatic side-effects of MAOIs (by blocking octopamine uptake and NE reuptake). MAO-A inhibitor + MAO-B inhibitor + DA/NE reuptake inhibitor (Wellbutrin) is pretty much all Parnate is.
I'd up the moclobemide + selegiline until you're limited by the side-effects, then up the Wellbutrin until the side-effects go away. If you reach 1200 mg without alleviation, try adding on a 5-HT2A antagonist like low-dose Risperdal (0.5 mg) or high dose Remeron (45-90 mg) before you abandon MAOIs completely.
Posted by West on July 16, 2008, at 7:57:43
In reply to Re: Cheat's Parnate) Moclobemide + Selegiline ?, posted by Astounder on July 16, 2008, at 2:08:52
ok. remeron - so there would be i assume some weighty insomnia going on, which there already is btw with Moc. at 300mg.
Doctors here will be reluctant to prescribe more than one thing at a time unless it's lithium or lamotragine.
I imagine mirtazipine would be ok though as i've been offered it already but the weight gain and sedation put me off. Think prescribed bupropion is out of the picture too as sadly it's only
licensed for stopping smoking.W
Posted by Amigan on July 16, 2008, at 22:10:09
In reply to Re: Cheat's Parnate) Moclobemide + Selegiline ?, posted by West on July 16, 2008, at 7:57:43
I have combined Selegiline with Moclobemide a few times and i didn't like the side effects of this combination. Solmonese, stomach disturbances and nausea.
Both meds are tolerable by me if i don't take them together.
Posted by Marty on July 17, 2008, at 17:41:13
In reply to Cheat's Parnate) Moclobemide + Selegiline ?, posted by West on July 14, 2008, at 18:07:03
I don't know for you but this combo doesn't look good for most people. To be frank, I wouldn't touch that combo with a 15 foot pole.Good luck,
/\/\arty
Posted by West on July 18, 2008, at 8:33:57
In reply to Re: Cheat's Parnate) Moclobemide + Selegiline ? » West, posted by Marty on July 17, 2008, at 17:41:13
Hi guys
I took 5mg with 300mg moclobemide the other day. I don't think it really did much. The moclobemide does make you nauseous as you say, I'm also not sleeping. I really need to take something that works, i'm in a really bad situation. Want my life back: Effexor i'm worried will numb me, Parnate i can't get here, possibly Nardil but i'm scared of the side effects. Which?
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