Posted by JonW on July 29, 2003, at 12:07:22
In reply to best, most tolerable post-MAO med?, posted by bobbiedobbs on July 27, 2003, at 23:52:56
> Have been on MAOIs (first Nardil, then Parnate) for 20 years (only med). Doctor is now recommending I try Luvox, Effexor (maybe Serzone or Celexa) for OCD, which he thinks is bigger problem for me than social phobia. Of MAOI users (and those on these meds), which helped most for OCD/social anxiety and which produced the most tolerable side effect profile, particlarly regarding fatigue, sexual side effecs and weight gain? Much appreciated.
Have you ever tried moclobemide, the reversible MAOI? It's not a very potent med, but some respond to it very well. It's cheap as hell to order from Canada. Anyway, might be worth a trial since you can start a new med within 2 days after stopping it.
I have severe social anxiety and atypical depression. The most effective med by itself was Nardil, but for me, completely intolerable. However, no med I have ever taken has cured my social anxiety but maybe that's asking too much. Moclobemide has been amazing to me. It has lifted my depression and relieved my anxiety (at least as much as Paxil or any SSRI ever did), but with essentially no side-effects. In particular, no sexual side-effects and none of that "knocking the tar out of you" like so many meds can do. It's relieved my symptoms without turning me into a robot... I'm still human.
Using meds to enable you to resolve your own problems, I have found, to be a far more desireable and effective approach to remission than an endless search for the miracle molecule. Not to mention one with far fewer side-effects. Are you involved with CBT? I am not aware of its efficacy for OCD, but most anxiety disorders respond very well to CBT -- social anxiety, in particular. I have seen one of the best psychopharm guys for social anxiety, Dr. Liebowitz from Columbia, and he immediately had me add CBT to the meds. Don't mean to preach, but the two are synergistic for most people. Anyway, just some thoughts...
good luck,
Jonps. if you do try moclobemide, give it time. I had some irritability in the begining but that resolved along with my depression as everything settled in. Anecdotally, I have heard there are people who respond very quickly and very slowly to this med. In reality, I'm sure it's a spectrum but maybe not as evenly distributed as some. I had an initial positive response that sort of faded, but I really felt its effect after much time had passed... something like 8 weeks.
poster:JonW
thread:246029
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