Posted by bleauberry on November 25, 2008, at 16:31:51
In reply to Moclobemide + SSRI combination, posted by Medline on November 25, 2008, at 13:43:38
Why don't you give Moclobemide up to 900mg a full 8 weeks before making any moves? That would be the wisest option I can think of. There is no way to predict here at 2 weeks what Moclobemide will do 6 weeks from now. Regardless of whether you have felt any hint of improvement or maybe none at all, at this point in time, you are actually just on the borderline of something to start happening. But really, and I know I'm not telling you anything you don't already know, these meds take a good 6 to 8 weeks to set into motion the brain adaptations that lead to improvement of symptoms, and yet another 3 to 6 months for them to fully develop.
Serotonin syndrome can sneak up on you after days or even weeks of everything seeming ok. I can see you have safety in mind by starting Lex at 1.25mg. I would only suggest that you stay at that dose for minimum one week before going up to 2.5mg. And then stay at 2.5mg minimum 2 weeks before going to 3.75mg. Stay there for 3 weeks. Any further increases, stay at each new dose 3 weeks.
I have had serotonin syndrome. It is not cool. It did not occur after dose increases, but rather a couple weeks after the last dose change. While serotonin syndrome can happen immediately with too much/too fast, it can also happen in an accumulative way where it takes time to build up, you don't feel it building up, and it hits out of the clear blue sky with no warning. That's what happened to me.
At least try to mimic a clinical trial by going 8 weeks on Moclobemide. Then decide what to do. Until then, just stay busy, set a date on the calendar 2 months out, and forget it until then.
poster:bleauberry
thread:865206
URL: http://www.dr-bob.org/babble/20081123/msgs/865233.html