![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by beaches09 on February 9, 2009, at 15:32:08
Hey guys what's up. I am Atypical with Severe but non-melancholy depression. Also symptoms of ADHD. Tried many meds in the past. SSRI's help in high doses but just create another imbalance that causes more problems.
After lots of research I am ready to try Parnate.
However, I am considering trying Moclobemide / 5mg Selegiline combo a try first.
I've been isolated for a few years and find it extremely hard when I attempt to go out and live a life and I get knocked back into my state in a snap.
Could you guys post your experiences with Moclobemide and Selegiline? I have about 2 days to make my decision. My doc will go with me either way. I also have all the symptoms of ADHD.
Please let me know anything you can. Normally I would say lets just try it, but I've read a lot of people say it doesn't work, and I have an opportunity to finally get my life back on track next month. But I need to have my head together and crap together in order to succeed. So this decision is important.
Please help, thanks!
Posted by mav27 on February 9, 2009, at 21:26:35
In reply to Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 9, 2009, at 15:32:08
I've only tried moclobemide and it has never worked for me. I've gone up to 1200mg but still got no positive effects. It caused the most severe insomnia though, beaten only by nardil and it curbs my appetite so i lost weight quite fast on it which wasn't such a bad thing.
I've given it about 3 tries i think in the last 6 years or so.
Posted by SLS on February 10, 2009, at 6:48:14
In reply to Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 9, 2009, at 15:32:08
Moclobemide is one of the least effective antidepressants out there. It starts out strong the first week, but then you relapse and have to keep raising the dosage in an attempt to get it to "stick". It rarely does, even when people go up to 1200mg. Rarely, people will get suicidally depressed on moclobemide, but this can be said of just about every antidepressant. I felt worse on moclobemide than at any time in my history.
- Scott
Posted by bleauberry on February 10, 2009, at 16:55:54
In reply to Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 9, 2009, at 15:32:08
Dr Bobs Psychobabble Tips section, or I think it used to be called Psychopharmacology Tips? has some good feedback on Moclobemide. It was basically a worldwide discussion by doctors from various countries on their experience with the drug. I would say the majority of them said it was ok for mild to moderate depression, and a lot of them said it just wasn't effective. But in a few countries they said it was a first line med and worked very well. One doctor commented that he didn't know why it worked so well in a certain country but not another. Another commented that it doesn't have that something extra that the other MAOIs have, that it is ok for garden variety depression but not for true blue.
The only problem is I don't know where to find that old Tips section. It was awesome. I wish Dr Bob would put another one together. It was a masterpiece at the time, and still is, if you can find it. Maybe someone on the administrative board can help figure that out.
Anyway, the general concensus seemed to be it was maybe somewhere between ineffective or ok for mild depression, with a few doctors saying they had very good results with it. Don't know why the discrepancy. Obviously though someone must be doing ok with it or they wouldn't still be selling it. It is too expensive from a business point of view to keep a dud drug on the market. They have to have sales, and sales depend on people refilling prescriptions, or getting new prescriptions, neither of which will happen if no one is getting benefit from the drug.
Posted by West on February 10, 2009, at 19:07:40
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien » beaches09, posted by SLS on February 10, 2009, at 6:48:14
Moclobemide sucks for severe depression. Really.
Posted by beaches09 on February 10, 2009, at 19:21:53
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien, posted by West on February 10, 2009, at 19:07:40
Ok that pretty much dose it for me lmfao. I've read maybe 3 positive reviews everwhere on the net and 90% negative. Thanks guys I won't even waste my time.
I was thinking of Zoloft with 5mg Selegiline and l-phenylalanine.
What do you guys think? In relation of giving that a chance vs just going for parnate.
I have severe depression indeed with all the symptoms accept for my moood. My mood is generally chipper. Which is weird and why I thought this whole time for years I've never been depressed. But at the same time suffering the extreme impact of it on my life and actually I should say major lack of a life.
Posted by garnet71 on February 10, 2009, at 20:37:43
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 10, 2009, at 19:21:53
Beaches,
You sound like such a fun-loving, uninhibited, carefree person. Not to diminish your suffering, but maybe you could focus a little more on your positive traits? I know I should!
Correct me if I'm wrong, but I think I remember a former post you wrote where you said you feel a lack of ability to complete things or accomplish things you had set out to do. Is that true?
Maybe you are very artistically inclined, and a non-conformist. Do many things in life seem boring to you?
Posted by garnet71 on February 10, 2009, at 20:46:47
In reply to Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 9, 2009, at 15:32:08
"But I need to have my head together and crap together in order to succeed."
I'm facing the same dilemma right now. But sometimes I think I chose the wrong path for success, and I should have become self-employed while I had the chance. There so much you can do to 'succeed' outside of the conventional.
Kickin' myself in the azz for going to back to school sometimes. I was ahead in all ways--health-mental and physical, friends, home, finances, job, health care...and I might add pretty well self-educated. Now my whole life is falling apart and I'm near bankruptcy, foreclosure, lost friends due to being so damn busy all the time, and the most recent-no health insurance. Sometimes I look back and think I could have read a thousand books and got the same as I would from a $200,000 6-year education-which now I'm not sure if I will even be able to complete. I'll never really know, but can't help but ask the question.
So what do you mean by 'successful', if you don't mind my asking?
Posted by beaches09 on February 10, 2009, at 21:33:03
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien » beaches09, posted by garnet71 on February 10, 2009, at 20:46:47
Yes that was me. Thank you. Actually, that's what I've been doing is usually focusing on everything positive. I've been doing that for the last 6 years and that's why I never thought I was depressed. I'm just not able to get anything done in life like the way I was before I turned 20 years old. I go out and try to work, try to do the social things I used once to love, etc. And after about usually a months time I run completely out of "mental juice" and I fall on my face and have to retreat to my fortress.
I still have physical energy in great amounts. It's all the mental energy that seems depleted. Like being a computer that doesn't have an operating system installed.
I finally started looking online to figure out what this is and learned about atypical depression possibly with bipolor II tendencies and it completely fits me. I laughed when I read the part that "the person is able to experience positive emotion in relation to a positive life event". Because that's what I've been doing all these years is distracting myself with tons of feel good events. So I just thought I wasn't depressed. I thought depression was just being sad.
Basically what I mean by being successful is just being able to do it period. Without getting completely burned out after a month and having to screw everything and retreat to rebuild my mental energy.
I think my neurotransmitters are just extremely low with probably a slight dominance in serotonin explaining my chipper behavior, with a major lack in dopamine.
I used SSRI's in the past, they were ineffective in low to moderate doses. I liked them very much in high doses. But at the same time it just created another imbalance that caused more problems especially ADD and motivation type problems.
That's why I just think the best general way to go might be an MAOI and go to the source and just corrent the overdrive enzyme problem in the first place and balance ALL the transmitters equally.
My main reason for wanting to give a different combo a try first is because when I get back to life I want to start working out and lifting again and supplementation is key to success in that area and with Parnate I won't be able to do that.
Ok that's a bit of a ramble. So what's going on with you what happened? Are or were you taking a med before?
Posted by beaches09 on February 10, 2009, at 21:45:55
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien » beaches09, posted by garnet71 on February 10, 2009, at 20:46:47
By the way, I agree. I am also one to vote for unconventional methods and trying to find your "niche" your own way. :)
Posted by Garnet71 on February 12, 2009, at 3:29:00
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 10, 2009, at 21:33:03
Hi Beaches,
I'm sorry your life is not as productive as you want it to be. Interesting that you can be well for about a month, then you get burnt out. I think some of us are just very sensitive to stimuli-colors, sounds, touch; along with overly-sensitive perception where our minds just suck in waaaay too much information both consciously and unconsciously, that it just drains us of our mental energy. I've been highly productive much of my life, but even then, I had to retreat each day, usually laying in a quiet room alone. I love to be around people too, but then I have to have my time alone because being with people is absolutely draining..especially crowds. I don't think that's an illness, but when it negatively affects your life, then it would have to be i suppose. You should read the book "Highly Sensitive Person" by Elaine Aaron.
As for meds, I have been really trying to stay away from them. It's been 2-3 weeks since I've been on any AD; about 4 days since Ativan. I may have some medical problems, so am awaiting test results before I take anything else. I see the PDoc tomorrow, maybe I'll get a script for my anxiety, and just hold onto it. I might ask for a benzo, along with Buspar for the long-term use, which I don't have much experience with but heard from my military doctors that the side effects are so mild for most. I also can't stand SSRIs, although they eliminate the anxiety, they make me depressed and tired all the time.
I've recently come to the realization that I am just a non-conformist, not for the sake of being a nonconformist, but just an unconventional person that would be happier marching to my own beat rather than trying to fit in with society's expectations. I think we should try more to embrace our individuality. I believe its wrong to do otherwise, and I learned the hard way.
Hang around here some more--it seems you haven't tried everything. Before going into another class of meds, though, did you ever try Wellbutrin, along with Effexor? Since you have similar effects from SSRI as I, I thought you might want to know that combo worked for me a long time ago, although I've recently tried the generic of Wellbutrin with no luck.
Take care Beaches!!!
Here's a song for you:
http://www.youtube.com/watch?v=KMRn2JcSrtg&feature=related
Posted by Garnet71 on February 12, 2009, at 4:02:08
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien, posted by Garnet71 on February 12, 2009, at 3:29:00
Beaches, just an afterthought - I personally don't think Effexor (not an SSRI but I think it might be an SNRI) is a 'safe' drug, although it worked for me in the past. Just intuitively. I don't want to suggest something without noting that..not that my opinion should influence you or anyone else, its just I couldn't help mentioning to you my thoughts on that drug.
I'm not picking on Effexor, I also don't think Prozac or Paxil are the safest ones either.
Effexor and/or Wellbutrin might affect your dopamine levels, if I recall correctly, although I am certainly not the source on that issue. Wellbutrin is also a drug that some with bipolar take along with Lithium or other mood stabilizers. It helps some with motivation/energy issues.
If you decide to try Wellbutrin, get the brand if you can. If you get the generic, there is one manufacturer that produces the drug with no coating, it's pink; there is one manfucturer that produces the drug with a blue/purple coating similar to the brand. The pharmacy can special order the one with the coating if you ask. My last PDoc snickered at me when I mentioned the different effects due to the possibility of the coating. He said the drugs coating does not affect it at all and basically ridiculed me for bringing this up. Some people swear it makes a difference though-the brand vs. generic and/or the coating, and maybe your PDoc would have a different opinion than mine.
Hope I'm not adding repetitive information here.
Good luck!
Posted by beaches09 on February 12, 2009, at 18:01:21
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien, posted by Garnet71 on February 12, 2009, at 3:29:00
That is pretty right on about the sensitive overwhelming stimuli thing that is very very much right on with me. I will definitely look on Amazon for that book. :)
Yeah I wonder about the meds and their safety as well. Because before I started taking any meds in first place 5 years ago I never had this problem, nowhere anywhere near to the degree that I am having problems now.
I decided I was going to give them up and said screw that. Well the 5 years has gone by and I've managed to get out of the house for 4-6 weeks only once each year and spent the rest of the time in my bedroom in isolation.
My fault for not mentioning but I've been on Wellbutrin and many others. Each med I've tried has a positive effect and an equal negative effect. Not referring to regular side effects but the chemical imbalance it creates. Wellbutrin by itself wasn't good for me at all didn't matter the dose, it just made me feel completely cracked out, snappy, and narcissistic. When I mixed it with 40mg of Paxil the two worked really wonderful together actually I was doing very good. But I was still lacking the norepinephrine to balance those out, so I had other problems that arose on that combo.
I never tried Effexor though I have at times been a little curious, from it's workings I can see how it must have been a good combo for you. I know someone that is taking it though and she says because of the short half life if she misses her dose by even an hour she starts to feel really crappy. And also the horror stories I've seen on the net like you say from people trying to get off it. LoL.
I've been considering remeron with low dose selegiline. Hitting all 3 transmitters. Or maybe even Zoloft with selegiline. I liked zoloft it was good, but then I'm still missing the NE. I think my NE is a big deal too because when I took Strattera my entire body and mind completely felt like it was reborn. And I was able to sleep 6 hours a night for the first time in my entire life and wake up feeling more refreshed than EVER, and it made me calm and focused. At the same time though it made me depressed and introverted, so not good by itself.
I'm open to giving a couple more combos a try but at the same time I'm ready to get the show on the road and from what I've read about so many people like me Parnate completely turned them around where other combos were left in the dust. I'm just tired of wasting years and ready to start living again.
It's more than just the mental energy thing. Even when I do get myself out for that short time, I feel like a complete walking dead person. As if I was in a coma. I don't feel like the real me that I once used to be. I feel like that person is locked in a cage and I'm this other completely wacked out weird person that is standing outside the cage trying to set that person (me) free. And my executive functioning is completely non-existent.
One combo I tried last year for a short while was Zoloft, Wellbutrin, with low dose Adderall. That was the BEST ever. I was me and everything I used to be, wanted to be, and needed to be. I was almost ready to get back on that but I need to think long term and Adderall long term is definitely not a good idea.
Yeah I'm with you marching to my own beat. I love it completely. Having my own ideas and being and wanting to be different than the "average norm". I have many great ideas, desires, plans, strageties. If only I could get out of this enormous black cloud and do something about them. So that's the plan. I'm ready to get the show on the road so I'm pretty sure I'm going to get Parnate from my doc next week. Give that a good go and see what happens. From what people say it sounds like once they got on it they finally realized what it meant to be actually living. As if they came out of a bad dream. I'm in such a horrible dream and there has been no getting out for a long time lmfao.
I am curious how your doc appointment goes. :)
Posted by beaches09 on February 12, 2009, at 18:20:25
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 12, 2009, at 18:01:21
Actually let me just mention so not to scare you or anyone off of meds and put the wrong idea in your head. I don't know that they made me this way. When I think about it and remember the good times where I was actually living it was when I was on certain meds. And everything is gradual that it's hard to tell sometimes. So without the meds in the past that I tried, it's very possible all the great things I did I never would have accomplished anyway and therefore was just the same as I am now. When I think about it, I've actually yeah had much of this problem the majority of my whole life. So don't let what I said deter you. I can say though that it's worse than ever, which just happens to be after the fact of doing meds in the first place. So I don't know.
Posted by garnet71 on February 12, 2009, at 19:21:29
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 12, 2009, at 18:01:21
Beaches, I posted just a few lines above yours...
http://www.dr-bob.org/babble/20090203/msgs/879704.html
Ok, if I were in your shoes, I would FIRST try the Effexor and Wellbutrin combo; augment with ADD drug later if not to par--doesn't have to be Adderall..there's been several more invented since then...and after Ritalin..I know I wouldn't want to take that long term either..
Don't go on more physically potent drugs now until you tried that!! It would only be another month..you've waited this long..one more month!!
How old are you, by the way?
Posted by beaches09 on February 12, 2009, at 23:24:57
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien » beaches09, posted by garnet71 on February 12, 2009, at 19:21:29
OK I'll have to check your thread out.
I take your word for it completely of course when you say that was a good combo for you. What were the effects like for you? I believe it would most likely work for me as well, but I think I'm going to have to pass on that one lol. I just did a lot of research online and there seems to be a lot of issues about it. Large list of side effects that could actually effect health not just the regular symptomatic type side effects. Plus 45% cases in a study reported short term memory loss.
Plus being a young buck that will be needing to get back in the dating pool, I can't have the sexual dysfunction. That's a really huge thing for me. Being on SSRI's in my earlier years I had the burden of that and it was unbarable and ruined some relationships. Even though I'm technically not living a life now, at least for the first time in my life "that part of me" completely works 100% and isa totally rockin like a champ and I need to keep that otherwise it will be the biggest blow to my self esteem.
I am in my twenties, how old is your son? We'll see, that's why I was thinking maybe Remeron with Selegiline. Remeron works on Serotonin and NE without the sexual dysfunction. And selegiline is an MAO-B inhibitor working on Dopamine.
Posted by beaches09 on February 13, 2009, at 1:46:56
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 12, 2009, at 23:24:57
Ok. I know I'm not supposed to do this. But I decided I wanted to give a single dose a wiggle. Even though I know it takes weeks to kick in. I got 150mg capsule Effexor XR from my lady friend and took it. Obviously I know not to expect much for a single dose, but I actually feel pretty different. In a good way. And seriously there is one thing in particular. I am freaking sexually turned on AS HELL. As If I just took a whole bottle of stamina RX or something. Did you have negative sexual side effects or positive ones? This is freakin amazing LMFAO omg. HAHAHAHAH
I thank you for your posts, don't want you to think I was shootin your opinion down. I could see this combo working for sure with the wellbutrin but I'm scared to do this med from everything written on the net. lol ooooo damnnn hahahaha
Posted by sdb on February 15, 2009, at 11:54:46
In reply to Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 9, 2009, at 15:32:08
> Hey guys what's up. I am Atypical with Severe but non-melancholy depression. Also symptoms of ADHD. Tried many meds in the past. SSRI's help in high doses but just create another imbalance that causes more problems.
>
> After lots of research I am ready to try Parnate.
>
> However, I am considering trying Moclobemide / 5mg Selegiline combo a try first.
>
> I've been isolated for a few years and find it extremely hard when I attempt to go out and live a life and I get knocked back into my state in a snap.
>
> Could you guys post your experiences with Moclobemide and Selegiline? I have about 2 days to make my decision. My doc will go with me either way. I also have all the symptoms of ADHD.
>
> Please let me know anything you can. Normally I would say lets just try it, but I've read a lot of people say it doesn't work, and I have an opportunity to finally get my life back on track next month. But I need to have my head together and crap together in order to succeed. So this decision is important.
>
> Please help, thanks!about moclobemide I heard that it doesn't work so good but thats a very small number of people and second hand information.
There are controversial studies on moclobemide with some proving efficacy others say it's almost placebo.
But who knows. Everybody is somehow different. The people in the studies also.
Good look!
Posted by Garnet71 on February 15, 2009, at 19:46:15
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 12, 2009, at 23:24:57
One combo I tried last year for a short while was Zoloft, Wellbutrin, with low dose Adderall. That was the BEST ever. I was me and everything I used to be, wanted to be, and needed to be. I was almost ready to get back on that but I need to think long term and Adderall long term is definitely not a good idea.
------------------------------------
Beaches, is your PDoc appointment tomorrow? So that combination works great for you, but you only did it a short time due to Adderall concerns, or was it your doctor that made you quit the Adderall?
About the sex thing..Wellbutrin cancelled out that issue brought about by Effexor...totally cancelled it out. I totally understand about needing to 'live'. For us older women, that matters more when we get older and can be torturous, but for you guys....I understand with your age and all. My son is 20, btw.
The more and more I read, I think (not sure) the SSRIs give me low dopamine, and the Wellbutrin or Effexor canceled it out (when it worked0. Any of the SSRIs work for me to take away the Anxiety--any of them--but they make me depressed and some give me to manyother strange symtpoms. So--my doctor is now giving me Buspar, at my request, for long -term anxiety issues, augmented by Ritalin (which I've only taken 1 day so far). The Xanax, I think, is only for a month. I am better, but its too soon to be sure. I'm still waiting for medical test results.
Considering Wellbutrin/Zoloft/Adderall was best for you--wouldn't you consider Wellbutrin/Effexor...then maybe add in less potent ADHD med, low dose, if you find something else needed?
I don't know sometimes Beaches. Sometimes I think you're going to step 3 without doing step 2 first!
Posted by desolationrower on February 17, 2009, at 4:16:00
In reply to Re: Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 13, 2009, at 1:46:56
1. was the 'lady friend' you got it from hot? sometimes the simple explanation is the correct one.
2. when i switched fluoxetine to venlafaxine i had restoration of sexula function for a week or so, then it went away.
3. it can be that because moclobebide sucks on its own, and selegiline isnt' too effective. but together, they could be very good. i'd rather expect it. however, its not proven, and some parnate is a proven treatment, there isn't much advantage to the moc/sel combo.
4. atomoxetine sucks as an AD, have you tried reboxetine or a tca.
d-r/
Posted by beaches09 on February 19, 2009, at 6:14:34
In reply to Please post your MOCLOBEMIDE / Selegiline Experien, posted by beaches09 on February 9, 2009, at 15:32:08
How did this turn into a thread of having to explain myself when I was inquiring simply about Moclobemide..
Skipping step 2? I know you are being nice and trying to help and I appreciate that. But, only using the limited information of me I have provided here and the last near decade of my life spent screwed up and in this horrible state as a result of "going through the whole tons and tons of meds ordeal" in the past is more than enough to qualify me for treatment by the means of whatever it takes..
As far as meds go if we want to talk about hardcore drugs, if you ask me, hardcore are the kind of drugs that alter your brain chemistry and get you addicted and cause numurous other health problems. Being just about the majority of antidepressants/mood stabilizers/benzos/stimulants drugs out there. They screw with the chemicals in your brain. In no ways different than illegal street drugs do. They just happen to be milder and have much longer half lives.
As long as you follow the dietary restrictions which are no big deal and don't take OTC drugs which I don't anyway, An MAOI is quite actually a much better and safer for your body/brain choice for long term use. Which is what I will be needing, something for long term use. Not a temporary fix me up. They target the problem directly and as a whole, instead of permanently screwing with and altering your brain chemistry like other drugs leaving you cracked out and withdrawn for a very long time. An MAOI withdrawal is 14 days until the enzyme replaces itself and that's it, you are off and back to normal, no biggie. And it corrects the underlying issues first hand all together, no having to play around with this, play around with that, ohh that didn't work lets feel cracked out for a month while we try this, or try that, and try that, oh wow tons of years gone by still not better.
I very much believe as you say an Effexor/Wellbutrin combo would quite possibly be a wonderous working unit for me, especially with the addition only if needed adding a stimulant. But those are all hardcore drugs. Just because they are on the market and FDA approved doesn't make them safe to take for even a single second. As I know how I am, I've finally come to the understand that I will probably need meds for my whole life. So I am thinking long term and those are not long term drugs. On the contrary they are also extremely difficult to get off of unless you are willing to either taper off for a long time and feel less than better for that long time, or quit cold and feel like death for still a long time just not quite as long. Wellbutrin has some issues that are coming to surface lately, but Effexor most especially has a very long rap sheet for being anything but safe and is very physically addicting. Stimulants sure they are great, but any smart person should know first hand those should only be taken as needed and not even be put in the consideration to be a part of some kind of long term treatment.
All that being said though. Because of the profession that I will be getting back into when I come out of this Major Depression I am not going to have the luxury of being picky about my food and I am already VERY VERY VERY underweight as it is and I will be needing to gain that back. So as much as I do want to get started on the proper get to the point kind of treatment, I am going to have to put that on hold until a later date until I will have the opportunity to be able to use it within the guidelines.
And that's fine. I guess I don't have to be miracle cured for now. I am so low beyond low and have been this way for so long that I don't even remember what it's like to live, so anything that helps will be like winning a million bucks. So I'll be trying a softer regimen for now, a small combination of things that worked in the past along with something new. But clean and safe drugs that are easy to get off and don't have a large list of adverse effects. This should most definitely be good for however long I find useful, and if/or the time comes to move on to the MAOI whenever that may be.
This is the end of the thread.
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