Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Dr. Bob on November 19, 2003, at 0:13:55
In reply to Depression w/ fatigue / moclobemide / narcolepsy??, posted by VelocideX on November 17, 2003, at 23:36:17
> 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?
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.
>
> 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 !!
>
> 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.
>
> 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).
>
> 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.
>
> 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).
>
> 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).
>
> 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).
>
> 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.
>
> 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.
>
>
>
>
>
> > 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?
>
>
Posted by SLS on January 11, 2004, at 9:59:33
In reply to Re: Depression moclobemide narcolepsy « MARKED, posted by Dr. Bob on January 11, 2004, at 5:32:59
> 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).
Have you tried any RIMAs other than moclobemide? Brofaromine or befloxatone?Thanks.
- Scott
Posted by MARKED on January 17, 2004, at 7:35:38
In reply to Re: Depression moclobemide narcolepsy, posted by SLS on January 11, 2004, at 9:59:33
Hi Scott,
No I haven't tried any others....but i do feel based on what i've seen and heard that they can be helpful (not sure which ones off the top of my head). There is a woman in my support group that recently relapsed, and was hospitalised. I spoke with her, and she was taking some sort of RIMA recently and she improved at least 200% (perhaps it was just the thought of her not having to deal with things alone since she was back in support, or maybe it was the placebo effect)..I'll find out on Wednesday 21st Jan (i'll ask her carer the name again).As far as things with me, i have had some thyroid blood tests and testosterone blood test (should have asked for a adrenaline one as well but forgot). Waiting to hear back about that next week (doctor feels the results will be useless).
But she (doctor) now thinks that i may have bi-polar disease. Which i was diagnosed with many years ago. (hence my constant lathargic feeling). She suggested a mood stabiliser (anti-epileptic drug) which seems to work in these situations as well.
The drug she prescribed is Tegretol (Carbamazepine).I'm studying it's effects and they seem promising, so i may not continue with moclobemide. Also they cannot be used with MOST antidepressents including RIMA's (would be lethal). So hence me hesitation to swap to another drug and go again on the merry-go-round trial. Drop off one, and wait for a response on another.Just one more thing that I thought was interesting, she mentioned that it may be (my condition) based on the cell membranes not being as condusive of the neurotransmitters (this also seems to be common with people with: (twiches, sleeping problems, mood disorders) she stated. So i'm taking this new line of thought to think maybe it's not entirely just the bio-chemical chemicals in the brain and their balance, but how they are absorbed in the synapses etc.
Also with reading i've done on Tegretol, most people find they also are co-administering another drug to give the kick of chemical imbalance. Most drugs in the bi-polar sector are not studied that much as there is a small percentage of patients that have this disorder (wish they would read this group more often and see it's more), but they say it's like 2-5% and drug companies will not conduct haigh spending tests to release new drugs specifically for these people (expenses outway the demand). That's why anti-epileptic drugs have been used for these conditions (mood, sleep, bipolar, muscle aches, narcolepsy etc).....so again it's trial and error of getting the right combination.
> Have you tried any RIMAs other than moclobemide? Brofaromine or befloxatone?
>
> Thanks.
>
>
> - Scott
Posted by SLS on January 17, 2004, at 8:26:18
In reply to Re: Depression moclobemide narcolepsy, posted by MARKED on January 17, 2004, at 7:35:38
> The drug she prescribed is Tegretol (Carbamazepine).I'm studying it's effects and they seem promising, so i may not continue with moclobemide. Also they cannot be used with MOST antidepressents including RIMA's (would be lethal).
The combination of Tegretol and MAOIs, along with other antidepressants should be safe. I've never heard of any problems. Where did you get this information? You might want to take a look at Trileptal (oxcarbazepine). Trileptal is an active metabolite of Tegretol that doesn't carry with it the risk of developing agranulocytosis. Regular blood tests are not necessary. Quite a few people here have tried it. You might want to search the archives.
> Just one more thing that I thought was interesting, she mentioned that it may be (my condition) based on the cell membranes not being as condusive of the neurotransmitters (this also seems to be common with people with: (twiches, sleeping problems, mood disorders) she stated. So i'm taking this new line of thought to think maybe it's not entirely just the bio-chemical chemicals in the brain and their balance, but how they are absorbed in the synapses etc.
Did she recommend any treatments? You could take a look at the PB Alternative board and look at the supplements that are suggested to help stabilized cell membranes like fish oil (Omega-3), phosphatidylserine, and inositol.
> Most drugs in the bi-polar sector are not studied that much as there is a small percentage of patients that have this disorder
That, and the fact that bipolar depression is harder to treat with antidepressants. Because of this, bipolar patients have been excluded from most clinical trials so that the drug companies could demonstrate the best response statistics.
I hope you are able to find a combination of medications that works for you. Please post to keep us up to date.
- Scott
Posted by MARKED on January 17, 2004, at 9:14:22
In reply to Re: Depression moclobemide narcolepsy, posted by SLS on January 17, 2004, at 8:26:18
> Did she recommend any treatments? You could take a look at the PB Alternative board and look at the supplements that are suggested to help stabilized cell membranes like fish oil (Omega-3), phosphatidylserine, and inositol.>
Actually, I have used Omega 3 in the past with some slight noticable benefits. The best benefits i've had of alternative non-prescription drugs are: amines and proteins, amino acids. Which surprisingly make me think they are helping other chemicals metabolise quicker and easier (thus better chemical conduction in the cell membranes thru these fast metabilising proteins...most of which aid the mental health and brain directly, as well as fueling the energy mitochondria of the cells). The best combined proteins i've found are thru muscle powders, and supplemental meal replacement shake mixes that bodybuilders use. I have used and found good results with: "Masashi-LP1 (Loaded Protein 1), also "Weider-Mega Mass 2000". One underlining ingredient i have found to be helpful is (nicotinamide, niacinamide) that is used in both these powder forms of supplements. It is just something I have found to be helpful within these amino rich supplements. Looking into it it makes sense with what i'm saying also. Nicotinomide is used primarily as to "aid the release of energy from consumed foods and promotes DNA biosynthesis" (the most complex process in a cell) *which then releases information to control cells various activities. Also co-enzyme Q-10(toxin binder/anti-oxidant) is good , i have used that too. As well as Hawthorn (improves blood flow to the head, heart etc).
Perhaps my cell membrane isn't as porous as a normal subject?? Who knows, will they ever have a test for this and if so what is normal anyway, since porous cell membranes act both ways often. And is this just another possibility thru my ever active mind.
One thing that leads me more to think they are clinicly helpful is that why do doctors still to this day prescribe lithium for people with bipolar? Well lithium is used as a conducive in the cell, and being metallic it is able to penetrate and conduct better (i believe) in cells and membranes/synapses (I'm not a doctor, but 1+1=2 in any language).
Posted by MARKED on January 17, 2004, at 9:39:25
In reply to Re: Depression moclobemide narcolepsy, posted by SLS on January 17, 2004, at 8:26:18
>
> The combination of Tegretol and MAOIs, along with other antidepressants should be safe. I've never heard of any problems. Where did you get this information? You might want to take a look at Trileptal (oxcarbazepine). Trileptal is an active metabolite of Tegretol that doesn't carry with it the risk of developing agranulocytosis. Regular blood tests are not necessary. Quite a few people here have tried it. You might want to search the archives.
> > Did she recommend any treatments? You could take a look at the PB Alternative board and look at the supplements that are suggested to help stabilized cell membranes like fish oil (Omega-3), phosphatidylserine, and inositol.
>
>
> That, and the fact that bipolar depression is harder to treat with antidepressants. Because of this, bipolar patients have been excluded from most clinical trials so that the drug companies could demonstrate the best response statistics.
>
> I hope you are able to find a combination of medications that works for you. Please post to keep us up to date.
>
>
> - Scott
Actually she told me that (I did ask her). They don't recommend taking Carbamazepine with Moclobemide or MAOI's (but I have been looking into that, and am more inclined to believe you than her as she seems not that intune with all the various drugs as this group is). I haven't found a post to support either combination as yet with those 2 drugs, i'd be willing to use both if it is actually ok.Also thanks for the recommendations of those other drugs, alternatives. My psych thinks i'm analysing myself too much and my doctor thinks i think too much....well your help has giving me more postives than all the sessions i've had with them thus far. Thanks :)
I wish i found this place like 12years ago..... I felt inclined to study cognitive science for the basic reason of dealing with my issues, since doctors seem often minimally informed.
What is your situation with what medications, and treatments you are (or have) used ?? And what seems to be the major frustration now while being on moclobemide??
Posted by SLS on January 17, 2004, at 11:14:49
In reply to Re: Depression moclobemide narcolepsy, posted by MARKED on January 17, 2004, at 9:39:25
> What is your situation with what medications, and treatments you are (or have) used ?? And what seems to be the major frustration now while being on moclobemide??I became severely depressed at age 17. At age 22, I was diagnosed as having unipolar depression at Columbia Presbyterian Hospital. I began with the tricyclics and MAOIs. Prozac hadn't been approved yet. At age 27, I was successfully treated using a combination of Parnate + desipramine. Unfortunately, I became severely manic after experiencing 6 months of remission. It was my first manic episode and it seemed to be medication induced. Because of this reaction, I was later diagnosed as having bipolar depression. My doctor at the time elected to have me discontinue the antidepressants and added lithium. I relapsed into depression two months later. The combination treatment did not work subsequently, and have been stuck in the depressive state ever since.
Right now, I am taking:
Lamictal 300mg
imipramine 300mg
Zoloft 200mg
lithium 300mg
Abilify 10mgI just added the lithium. Although I have tied it in the past at dosages up to 1200mg, I have never used it as an augmentor to Lamactal or Zoloft. As an augmentor, I would like to keep the dosage below 600mg
I tried moclobemide seven years ago. It made me unimaginably worse.
With most people, moclobemide produces an improvement during the first week and at low dosages < 300mg. Thereafter, it takes higher and higher dosages to maintain the antidepressant effect. Dosages as high 1200mg are sometimes necessary. This is a common scenario, and I don't think the drug is used as a first-line treatment.
Best wishes,
Scott
Posted by MARKED on March 20, 2004, at 15:13:52
In reply to Re: Depression moclobemide narcolepsy, posted by SLS on January 17, 2004, at 11:14:49
Hey scott.......just an update, i'm on Citalopram now (found that it helps with the aching pains, cycling moods, and I have recently been diagnosed with Obsessive Compulsive-Personality Disorder). So although i was under the impression I was bipolar, as other psychs had treated me...., I believe i'm on the right track now with a SSRI. I do still feel that I need some sort of Dopamine-B inhibitor as I have that CRAVED effect that my mood just can't be lifted without. But i'm at least stable now, and not cycling like crazy all day.
Marked
This is the end of the thread.
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