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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by sowhysosad on April 27, 2009, at 15:28:24
I'm pleased to say my med-cynical friend is thinking of giving another AD a try, and the pdoc has suggested moclobemide.
My understanding is that it's a reversible MAOI that's statistically less effective than Nardil/Parnate but perhaps a little milder in terms of side effects and dietary restrictions.
It's a little unconventional on the UK, but she's never tried any MAO-inhibiting meds so it might be worth a shot as he's had no joy with SSRI's, TCA's or atypicals so far.
But does anyone have any real world experiences of it that I can pass on?
Posted by Zana on April 27, 2009, at 15:52:12
In reply to Any moclobemide (Aurorix/Manerix) experiences?, posted by sowhysosad on April 27, 2009, at 15:28:24
Just read the Wiki article on it. Why haven't I ever heard of this med? It sounds like a good anti-depressant. Unusual that it treats social anxiety but has no sedative properties. And no dietary restrictions.
I'll be interested to hear how it works in the real world.Zana
Posted by Phillipa on April 27, 2009, at 17:21:32
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by Zana on April 27, 2009, at 15:52:12
Me too no dietary restrictions? Must look it up also. Phillipa
Posted by sowhysosad on April 27, 2009, at 17:26:49
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by Zana on April 27, 2009, at 15:52:12
> Just read the Wiki article on it. Why haven't I ever heard of this med? It sounds like a good anti-depressant. Unusual that it treats social anxiety but has no sedative properties. And no dietary restrictions.
> I'll be interested to hear how it works in the real world.Looks like the FDA never licenced it because the evidence for its effectiveness is sketchy. Dr Ken Gillman's not at all convinced and still prefers the older irreversible MAOI's:
http://www.psychotropical.com/Antidepressants_Moclobemide.shtml
Posted by bleauberry on April 27, 2009, at 18:46:04
In reply to Any moclobemide (Aurorix/Manerix) experiences?, posted by sowhysosad on April 27, 2009, at 15:28:24
I have been coming to psychobabble for well over a decade. In all that time I have never seen one person do well on Moclobemide for more than a few days.
I don't know what they do in clinical studies or literature to make this med look as good as it looks, but something is really twisted. In the real world, it just isn't much of a med. I'm not saying it doesn't work great for someone, I'm just saying I've never seen it or heard of it happening.
As long as the patient and the doctor are already partially commited to an MAOI trial, they might as well go for the real deal with Parnate and stack some real odds of success on their side.
To prepare everyone involved for that, go to psychotropical.com and read Dr Gillman's articles on his experience with MAOIs on over 1000 patients. Anyone who has any doubts or reservations will be comforted and enthused with the idea. Someone at another forum said it best..."If Parnate or Nardil had been invented AFTER ssris, they would be perceived as an improvement over them". Moclobemide, not. Heck, even St Johns Wort is better than Moclobemide by a long shot.
Posted by sowhysosad on April 27, 2009, at 18:58:46
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by bleauberry on April 27, 2009, at 18:46:04
Thanks bleauberry.
I don't know why this doc keeps insisting on using controversial and (by UK standards) unconventional meds on my friend. So far he's tried or is about to try:
Cymbalta
Mirtazapine
MoclobemideThey're all meds where the hype far outweighs the research.
Why hasn't he tried:
Escitalopram
Sertraline
Clomipramine
Tranylcypromine
Phenelzine???All meds with solid research and proven efficacy, particularly the last three for treatment-resistant depression.
> I have been coming to psychobabble for well over a decade. In all that time I have never seen one person do well on Moclobemide for more than a few days.
>
> I don't know what they do in clinical studies or literature to make this med look as good as it looks, but something is really twisted. In the real world, it just isn't much of a med. I'm not saying it doesn't work great for someone, I'm just saying I've never seen it or heard of it happening.
>
> As long as the patient and the doctor are already partially commited to an MAOI trial, they might as well go for the real deal with Parnate and stack some real odds of success on their side.
>
> To prepare everyone involved for that, go to psychotropical.com and read Dr Gillman's articles on his experience with MAOIs on over 1000 patients. Anyone who has any doubts or reservations will be comforted and enthused with the idea. Someone at another forum said it best..."If Parnate or Nardil had been invented AFTER ssris, they would be perceived as an improvement over them". Moclobemide, not. Heck, even St Johns Wort is better than Moclobemide by a long shot.
Posted by sowhysosad on April 27, 2009, at 19:26:59
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by bleauberry on April 27, 2009, at 18:46:04
Just chatting with my friend again, and this ****ing idiot has told her that moclobemide is his final shot and after that there's nothing he can give her.
WTF????!!!!
So he's saying that if a drug with a 30% success rate doesn't work he's all out of ideas, when there's a class of drugs with a 70% success rate in TRD?!
Is he actually a qualified psychiatrist?!
> I have been coming to psychobabble for well over a decade. In all that time I have never seen one person do well on Moclobemide for more than a few days.
>
> I don't know what they do in clinical studies or literature to make this med look as good as it looks, but something is really twisted. In the real world, it just isn't much of a med. I'm not saying it doesn't work great for someone, I'm just saying I've never seen it or heard of it happening.
>
> As long as the patient and the doctor are already partially commited to an MAOI trial, they might as well go for the real deal with Parnate and stack some real odds of success on their side.
>
> To prepare everyone involved for that, go to psychotropical.com and read Dr Gillman's articles on his experience with MAOIs on over 1000 patients. Anyone who has any doubts or reservations will be comforted and enthused with the idea. Someone at another forum said it best..."If Parnate or Nardil had been invented AFTER ssris, they would be perceived as an improvement over them". Moclobemide, not. Heck, even St Johns Wort is better than Moclobemide by a long shot.
Posted by zana on April 28, 2009, at 9:38:51
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences? » bleauberry, posted by sowhysosad on April 27, 2009, at 19:26:59
How frustrating. It's a good thing your friend has your wise counsel.
Zana
Posted by sowhysosad on April 28, 2009, at 14:21:40
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by zana on April 28, 2009, at 9:38:51
Thanks Zana!
Sadly - as she's in the UK - it's nigh-on impossible to switch pdocs. So it's a case of going with this guy's crazy plans and risking disappointment and unnecessary side effects, or NOTHING.
And now he's talking about giving up on her entirely after 3 not-particularly-effective meds fail to work!
> How frustrating. It's a good thing your friend has your wise counsel.
>
> Zana
Posted by West on May 2, 2009, at 16:45:56
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by sowhysosad on April 28, 2009, at 14:21:40
Moclobemide didn't interfere with the emotional spectrum or blandify my character like the ssris, nor did it cause sexual dysfunction or spaciness and lethargy, but it did fall a long way short of even resembling an effective antidepressant. Maybe my response was dampened in some way by being on ssri's previous to trying it, i honestly don't know.
It might work for somebody with mild depression. It did cause intractable insomnia. I'm pretty sure it's a recognised second/third line alternative where the ssris are ineffective or poorly tolerated on the nhs.
something i did gain from it was the knowledge that a potentially preferable med to the one i was taking at the time (in terms of side effects) would not serve as a suitable alternative and in doing so allaying any niggling doubts.
> Sadly - as she's in the UK - it's nigh-on impossible to switch pdocs. So it's a case of going with this guy's crazy plans and risking disappointment and unnecessary side effects, or NOTHING.
>
> And now he's talking about giving up on her entirely after 3 not-particularly-effective meds fail to work!
>
> > How frustrating. It's a good thing your friend has your wise counsel.
> >
> > Zana
>
>
Posted by sowhysosad on May 2, 2009, at 17:22:51
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by West on May 2, 2009, at 16:45:56
Thanks for the feedback West - I'll pass that on.
Looks like she's not going to bother with the moclobemide trial. It's sad to think the different path her life might've taken if her comedy pdoc had actually offered her an effective antidepressant instead of a series of trendy, largely unproven ones.
> Moclobemide didn't interfere with the emotional spectrum or blandify my character like the ssris, nor did it cause sexual dysfunction or spaciness and lethargy, but it did fall a long way short of even resembling an effective antidepressant. Maybe my response was dampened in some way by being on ssri's previous to trying it, i honestly don't know.
>
> It might work for somebody with mild depression. It did cause intractable insomnia. I'm pretty sure it's a recognised second/third line alternative where the ssris are ineffective or poorly tolerated on the nhs.
>
> something i did gain from it was the knowledge that a potentially preferable med to the one i was taking at the time (in terms of side effects) would not serve as a suitable alternative and in doing so allaying any niggling doubts.
Posted by West on May 4, 2009, at 11:44:17
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences? » West, posted by sowhysosad on May 2, 2009, at 17:22:51
I don't think she necessarily has to put a full stop on the area of treatment. If things are that bad, that black, she will get help. In which case she either asks for a second opinion (which every patient is entitled to do) or contacts a psychiatrist directly at her local mental health trust, relaying the issues. She shouldn't think she hasn't got these options - be positive >
Thanks for the feedback West - I'll pass that on.
>
> Looks like she's not going to bother with the moclobemide trial. It's sad to think the different path her life might've taken if her comedy pdoc had actually offered her an effective antidepressant instead of a series of trendy, largely unproven ones.
Posted by West on May 4, 2009, at 11:46:00
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by West on May 4, 2009, at 11:44:17
Posted by Sigismund on May 4, 2009, at 19:46:53
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences? » bleauberry, posted by sowhysosad on April 27, 2009, at 19:26:59
My mother (74) had serious agitated depression and could not sleep.
So her shrink gave her moclobemide to start with, along with 5mg Valium at night.
Great advantages...she could eat anything and it wouldn't damage her sex drive.
A year later she was still complaining about not sleeping. Of course they thought she was deluded. When she came home with me I gave her 20 mg temazepam and next morning she thanked me for the best sleep in many months.
Truly, anyone here would know better.
Like Zyprexa, opium tincture etc etc
Posted by West on May 5, 2009, at 7:11:13
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by Sigismund on May 4, 2009, at 19:46:53
> Truly, anyone here would know better.
> Like Zyprexa, opium tincture etc etcSince the opium wars, my physician prescribeth not laudenum
Posted by Sigismund on May 6, 2009, at 18:18:05
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by West on May 5, 2009, at 7:11:13
>Since the opium wars, my physician prescribeth not laudenum
Might have been better if we had lost them.
I have a soft spot for laudanum, starting with the name and moving on from there.
In civilised (non-English speaking) countries (like France) you can get camphorated opium tincture OTC still.
We are more virtuous.
Posted by Sigismund on May 6, 2009, at 18:21:34
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences? » West, posted by Sigismund on May 6, 2009, at 18:18:05
Hell, I even bought it in New Oxford St (Collis Browne's Chlorodyne) , but that was way before times like these.
The virtue of our drug laws reflects the virtue of our politics. You had Tony. He was top of the class.
Posted by West on May 10, 2009, at 12:52:09
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by Sigismund on May 6, 2009, at 18:21:34
> The virtue of our drug laws reflects the virtue of our politics. You had Tony. He was top of the class.Quite...Ahem...
Posted by papillon2 on January 30, 2012, at 17:39:40
In reply to Re: Any moclobemide (Aurorix/Manerix) experiences?, posted by West on May 10, 2009, at 12:52:09
I somehow stumbled onto reading about Aurorix (not on PsychoBabble) and thought, "Wow, as effective as TCAs but with less side effects", why have I not heard of this drug?
Because it is useless, damnit! Got my hopes up for a minute.
I mean, take a look at the Wiki article: http://en.m.wikipedia.org/wiki/Moclobemide
What do you reckon, written by a drug rep?Grrrr!
Sorry, in a bad mood about meds.
This is the end of the thread.
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