Posted by Dr. Bob on January 11, 2004, at 5:32:59
In reply to Depression moclobemide narcolepsy « VelocideX, posted by Dr. Bob on November 19, 2003, at 0:13:55
[Posted by MARKED on January 11, 2004, at 3:50:09]
> It was really good to read this post....
>
> I have experienced the morning paralysis feelings for 12years now, and have been diagnosed with various forms of depression (manic, bipolar, chronic, dysthymia, obsessive compulsive diorder)from age 16...I'm 28 now.
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> I have found moclobemide to be the most helpful of any drugs, and have tried about 6 different popular types of antidepressants(fluxetine, tofrinol,zoloft, prozac) over the recommended periods (usually 6-12weeks, most seem to have too many side effects and sedative effects).
>
> The RIMA's seem to work best for me, I have just started again on moclobemide, having been on them in the past for up to 2 years (on and off 4 times with a minimum period of 3months). I have increased up to 750mg, but after that point found the body becomes used to the high dosage and the effects start to neutralise....I wouldn't go any higher than that as it starts to have a toxic effect. Also never just quit taking your tablets, i did once and experienced major suicidal thoughts, and loss of reason to live. Very hard to fight these thoughts so don't do it !!
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> I have a history dating back to when i was 16.
> The sleep, and biological clock patterns have been what has caused me most uncomfort....and I also have felt that i'm borderline narcolepsy. Also I read about Thyrotoxic Periodic Paralysis http://emj.bmjjournals.com/cgi/content/abstract/19/1/78 and have also thought that perhaps testosterone interraction may play a part too, as i seem to only kick into motivation when i'm sexually aroused.
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> I have studied Cognitive Science at Uni, and have also been doing Cognitive Behavioral Therapy for 1 year, and now am part of a support group with a leading psychiatric nurse teacher that conducts the sessions (which are most helpful, and recommended for all).
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> Also i have used Melatonin in the past to help with getting me to sleep (some good sleep, but mostly an induced haze to make you feel sleepy, and i feel it is a quick fix for minor sleep inconsistantcies). Melatonin helps to counteract and initaite the biological day/night pattern. Birds have a natural biological clock that helps them recognise day from night.
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> I have been a smoker as well for the most part, and have found moclobemide to help in the area of quiting, and have quit whilst on the drug for a year. (I wouldn't recommend quiting smoking until you feel at least 80% and stable in your lifetsyle, initiating a replacement is a good idea....excercise for example).
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> I have in most cases had a Social Phobia whilst depressed (not eating, not sleeping well, body/mind in 2 different energy levels). This has been something I have only been able to deal with by change of habits and my environment, trying to be in a relaxed calm setting. I have considered clonazepam and have had good feedback from patients in my support group that i've seen change in a matter of weeks (I have known them from when they were hospitalised and friendships created over the year).
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> Also I would recommend a blood test for various hormones (as yet i haven't had any), and also how the glands are functioning. (Thyroid gland, adrenal gland, testosterone levels).
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> Change of diet is often a good idea, as well as regular excercise. Keeping a logbook of what you feel, and times throughout the day helps recognise syptoms before they get out of control. Seeing and speaking to a psychiatrist/psychologist and bringing with you helpful information when you just can't describe what you feel.
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> Hope this helps, but it really comes down to getting your body/mind in tune and then maintaning it with regular excercise, diet, sleep, routine, healthy environments, undertsanding support, positive thinking, and acceptance of change and growth. Concentrate on 1 area at a time, then build on your progress and never make decisions when your down or depressed. There is no start, nor an end there is only consistency. Change is the only constant. Surround yourself with postive influences, and be motivated by others that give love and respect your values.
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> > Hey all,
> >
> > I've been treated for depression for about a year (having had it longer than that).
> >
> > I tried citalopram, fluvoxamine and found them to be too sedating. I tried effexor (venlafaxine), and found it too to be sedating at 75mg/day (I couldn't handle higher doses due to nausea). I also found that all of these medications only marginally improved my depression, and I couldn't tolerate higher doses due to nausea and/or excessive sedation.
> >
> > My depression manifests with a large fatigue (somnolence) component already, and so I don't want to touch anything sedating (e.g. any of the NaSSa s)
> >
> > I'm currently on 450mg/day of moclobemide (Aurorix/Manerix, etc). I've found this to be much more helpful with my depression. I've been on it for about 3.5 weeks now, and I feel a lot closer to normal than I have in a long time. I probably feel about 75% or so. I was put on this due to the relative ineffectiveness of the SSRIs and my fatigue, as it tends to be activating/stimulating.
> >
> > My response to a RIMA (reversible inhibitor of MAO-A) leads me to believe that my depression is noradrenic or dopaminergic in origin, rather than serotonergic.
> >
> > My fatigue component, though somewhat alleviated, still remains significant. I wake up in the mornings feelins so tired that I feel drunk. It eases a bit throughout the day, and some days its not so bad, but I still feel excessively tired, to the point of falling asleep in lecturers. I've tried using / not using caffeine and found that caffeine makes only a mild difference.
> >
> > I've started to wonder if I have borderline narcolepsy. I get the sleep paralysis on waking up a lot of the time and the hypnagogic hallucinations before falling asleep, but not the cataplexy.
> >
> > Funnily though, several times an hour I get the feeling you get when you stand up too quickly... I feel like I'm on the verge of passing out and i lose sensation in my limbs (they feel tingly-numb), and then suddenly its all gone again. This lasts all of about 2 or 3 seconds.
> >
> > What do you guys think? Any recommendations?
>
>
poster:Dr. Bob
thread:281113
URL: http://www.dr-bob.org/babble/20040109/msgs/299305.html