Posted by JohnL on November 1, 1999, at 17:09:56
In reply to MOCLOBEMIDE, posted by CHRIS on November 1, 1999, at 10:37:16
Hi Chris. With caution and your doctor's participation you can indeed add another AD to the Moclobemide. Even though SSRIs have been combined with Moclobemide, they probably need more caution. Very low doses to start and feel it out as you go. A safer addition would be one of the TCAs, since they aren't so serotonin-specific. Thus less likelihood of an adverse serotonin reaction. Desipramine would be a good first choice. Or Nortriptyline. They do have more side effects than Moclobemide, but hopefully it wouldn't take much of a dose to kickstart the Moclobemide. Wellbutrin would probably be good too and maybe the safest of all. If you can get it.
But the most logical thing to me would be increasing the dose. Are you handling side effects OK? If so, try going up to 800mg - 900mg. I knew a person who took 1200mg, even though that is way over the max level. But for her it worked great where lower doses didn't, and she had no problem with it.
In general it seems Moclobemide is one of those drugs that really needs to be at a maximum dose to be real effective. Some of the clinical studies that showed disappointing results were in the 300mg to 600mg range. The clinical studies that did not disappoint were in the 900mg area. Great results at highest doses. Are you handling side effects OK? Consider raising the dose? It's a good sign that it has worked better than other things for you so far. Simply raising the dose might be all you need. 600mg isn't very high for Moclobemide.
poster:JohnL
thread:14356
URL: http://www.dr-bob.org/babble/19991028/msgs/14377.html