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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by jaynee on August 21, 2003, at 14:26:17
It is my 2nd day on manerix and I don't feel anything yet, no side-effects, nothing. Does this mean it may not work?
Posted by stjames on August 21, 2003, at 14:47:52
In reply to 2nd day on Manerix(Moclobemide) , posted by jaynee on August 21, 2003, at 14:26:17
> It is my 2nd day on manerix and I don't feel anything yet, no side-effects, nothing. Does this mean it may not work?
It often takes 4-6 weeks to tell if an AD is doing anything.
Posted by jaynee on August 21, 2003, at 16:09:23
In reply to Re: 2nd day on Manerix(Moclobemide) , posted by stjames on August 21, 2003, at 14:47:52
I will wait it out, but when I took Celexa it effected me immediately. About 1 hour after I first took it my pupils expanded and I got really dizzy and spacey. So I guess I was just expecting something weird from this drug too.
Celexa did work well for me, but too many stomach problems. Hopefully this drug will pan out for me. I've read a recent study on it spring 2003, and it does work as well as SSRI's and Tricylics, with much less side-effects, so this is why I will give this drug a try.
Posted by linkadge on August 21, 2003, at 17:19:21
In reply to Re: 2nd day on Manerix(Moclobemide) , posted by jaynee on August 21, 2003, at 16:09:23
You don't have a link to that study do you.
Linkadge
Posted by JonW on August 21, 2003, at 18:25:40
In reply to 2nd day on Manerix(Moclobemide) , posted by jaynee on August 21, 2003, at 14:26:17
Moclobemide has been just as effective as the SSRIs for me with essentially no side-effects. I initially experienced difficulty falling asleep, but that was transient. It took 8 weeks at 450mg for me to really feel its effect.
Jon
Posted by jaynee on August 21, 2003, at 21:02:57
In reply to Re: 2nd day on Manerix(Moclobemide) » jaynee, posted by JonW on August 21, 2003, at 18:25:40
CNS Drug Rev. 2003 Spring;9(1):97-140. Related Articles, Links
Moclobemide: therapeutic use and clinical studies.Bonnet U.
Department of Psychiatry and Psychotherapy, University of Essen, Germany. udo.bonnet@uni-essen.de
Moclobemide is a reversible inhibitor of monoamine-oxidase-A (RIMA) and has been extensively evaluated in the treatment of a wide spectrum of depressive disorders and less extensively studied in anxiety disorders. Nearly all meta-analyses and most comparative studies indicated that in the acute management of depression this drug is more efficacious than placebo and as efficacious as tricyclic (or some heterocyclic) antidepressants or selective serotonin reuptake inhibitors (SSRIs). There is a growing evidence that moclobemide is not inferior to other antidepressants in the treatment of subtypes of depression, such as dysthymia, endogenous (unipolar and bipolar), reactive, atypical, agitated, and retarded depression as with other antidepressants limited evidence suggests that moclobemide has consistent long-term efficacy. However, more controlled studies addressing this issue are needed. For patients with bipolar depression the risk of developing mania seems to be not higher with moclobemide than with other antidepressants. The effective therapeutic dose range for moclobemide in most acute phase trials was 300 to 600 mg, divided in 2 to 3 doses. While one controlled trial and one long-term open-label study found moclobemide to be efficacious in social phobia, three controlled trials subsequently revealed either no effect or less robust effects with the tendency of higher doses (600 - 900 mg/d) to be more efficacious. Two comparative trials demonstrated moclobemide to be as efficacious as fluoxetine or clomipramine in patients suffering from panic disorder. Placebo-controlled trials in this indication are, however, still lacking. A relationship between the plasma concentration of moclobemide and its therapeutic efficacy is not apparent but a positive correlation with adverse events has been found. Dizziness, nausea and insomnia occurred more frequently on moclobemide than on placebo. Due to negligible anticholinergic and antihistaminic actions, moclobemide has been better tolerated than tri- or heterocyclic antidepressants. Gastrointestinal side effects and, especially, sexual dysfunction were much less frequent with moclobemide than with SSRIs. Unlike irreversible MAO-inhibitors, moclobemide has a negligible propensity to induce hypertensive crisis after ingestion of tyramine-rich food ("cheese-reaction"). Therefore, dietary restrictions are not as strict. However, with moclobemide doses above 900 mg/d the risk of interaction with ingested tyramine might become clinically relevant. After multiple dosing the oral bioavailability of moclobemide reaches almost 100%. At therapeutic doses, moclobemide lacks significant negative effects on psychomotor performance, cognitive function or cardiovascular system. Due to the relative freedom from these side effects, moclobemide is particularly attractive in the treatment of elderly patients. Moclobemide is a substrate of CYP2C19. Although it acts as an inhibitor of CYP1A2, CYP2C19, and CYP2D6, relatively few clinically important drug interactions involving moclobemide have been reported. It is relatively safe even in overdose. The drug has a short plasma elimination half-life that allows switching to an alternative agent within 24 h. Since it is well tolerated, therapeutic doses can often be reached rapidly upon onset of treatment. Steady-state plasma levels are reached approximately at one week following dose adjustment. Patients with renal dysfunction require no dose reduction in contrast to patients with severe hepatic impairment. Cases of refractory depression might improve with a combination of moclobemide with other antidepressants, such as clomipramine or a SSRI. Since this combination has rarely been associated with a potentially lethal serotonin syndrome, it requires lower entry doses, a slower dose titration and a more careful monitoring of patients. Combination therapy with moclobemide and other serotonergic agents, or opioids, should be undertaken with caution, although no serious adverse events have been published with therapeutic doses of moclobemide to date. On the basis of animal data the combined use of moclobemide with pethidine or dextropropoxyphene should be avoided. There is no evidence that moclobemide would increase body weight or produce seizures. Some preclinical data suggest that moclobemide may have anticonvulsant property.
Publication Types:
Review
Review, TutorialPMID: 12595913 [PubMed - indexed for MEDLINE]
Posted by cubbybear on August 21, 2003, at 22:15:09
In reply to Re: 2nd day on Manerix(Moclobemide) , posted by jaynee on August 21, 2003, at 16:09:23
Jaynee,
Please keep us posted on your progress. I'm always interested in hearing about other people's success with Moclobemide, because it did *not* work for me. Everyone's different, and I hope you get to be one of the success stories.
This is the end of the thread.
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