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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 bearfan on May 11, 2010, at 14:08:12
I've read a few reports that Moclobemide is nowhere near as strong as the reversible MOAIs, but I was wondering how it compares to traditional SSRIs (including lower does Venlafaxine). How is the tolerability vs the efficacy?
Posted by Tomatheus on May 11, 2010, at 20:11:41
In reply to Curious about Moclobemide, posted by bearfan on May 11, 2010, at 14:08:12
Bearfan,
The following quotes are from a meta-analysis that was conducted by doctors Francisco Lotufo-Neto, Madhukar Trivedi, and Michael E. Thase in the late 90s.
Please note that MOC=moclobemide, and AT=atypical.
"MOC, which is available throughout much of the world (but not the United States), is significantly more effective than placebo and, at the least, comparable to the SSRIs in both efficacy and tolerability."
"Across inpatient and outpatient settings, eight studies compared MOC with SSRIs. There were two contrasts with fluvoxamine and six against fluoxetine ... In these eight trials, MOC had an ITT response rate of 58.0% (3.4%). In the AT samples, the MOC response rate was 67.9% (3.8%). The difference between MOC and the SSRIs was 6.4% (3.9 %) in the ITT analysis, and, for the AT sample, the difference was of 4.8% (4.1%). In both cases, there was a small but reliable advantage favoring MOC over the SSRIs. However, the clinical significance of these such small differences in response rates is certainly debatable."
Tomatheus
==
REFERENCE
Lotufo-Neto, F., Trivedi, M., & Thase, M.E. (1999). Meta-analysis of the reversible inhibitors of monoamine oxidase type a moclobemide and brofaromine for the treatment of depression. Neuropsychopharmacology, 20, 226-247. Abstract: http://www.ncbi.nlm.nih.gov/pubmed/10063483
Posted by bearfan on May 14, 2010, at 16:27:53
In reply to Re: Curious about Moclobemide » bearfan, posted by Tomatheus on May 11, 2010, at 20:11:41
Hi thanks for that information, but how does Moclobemide work in the real world? All of the experiences I've heard on these types of boards were overwhealmingly neagative. I don't know if they are comparing them to powerful MAOIs (ie Parnate and Nardil) or weaker ones?
Posted by Tomatheus on May 14, 2010, at 18:12:38
In reply to Re: Curious about Moclobemide, posted by bearfan on May 14, 2010, at 16:27:53
Bearfan,
Like you, I have found anecdotal online reports of moclobemide's effectiveness to be negative. When I tried the medication, I felt ok on it for a few days before it lost its effectiveness. SSRIs bought out a rapid-cycling type of response in me when I took them before my psychosis, but now seem to basically make me feel more depressed. Nardil is the only antidepressant that I've taken that's had a strong positive effect for more than a few days.
I'm sorry if I couldn't be of more help. Maybe somebody else will have more to say about how effective moclobemide tends to be in real-world settings.
Tomatheus
Posted by SLS on May 14, 2010, at 18:22:36
In reply to Curious about Moclobemide, posted by bearfan on May 11, 2010, at 14:08:12
> I've read a few reports that Moclobemide is nowhere near as strong as the reversible MOAIs, but I was wondering how it compares to traditional SSRIs (including lower does Venlafaxine). How is the tolerability vs the efficacy?
As best as I can tell, moclobemide is not as efficacious as SSRIs for moderate to severe depression. It can produce an improvement during the first week at a low dose, but this rarely lasts. More often than not, people must raise the dosage again and again in an effort to maintain a response. Eventually, they reach 1200mg and fail to respond further. At one time, moclobemide was one of the most widely prescribed antidepressants. Not anymore.
I tried moclobemide and reacted very badly to it. It severely exacerbated my depression.
Moclobemide does not usually produce significant side effects. It might not hurt to try it if you can afford the time. I cannot guarantee that it won't work.
- Scott
Posted by bearfan on May 16, 2010, at 14:30:38
In reply to Re: Curious about Moclobemide » bearfan, posted by SLS on May 14, 2010, at 18:22:36
Anyone have a positive effect?
Posted by SLS on May 17, 2010, at 12:05:17
In reply to Re: Curious about Moclobemide, posted by bearfan on May 16, 2010, at 14:30:38
> Anyone have a positive effect?
It would be difficult to assess how the lack of positive responses to this question is an accurate representation of the general population. It is probably true that the posting community of Psycho-Babble is skewed towards people who continue to have a lack of success with their treatment. People whom respond to treatment often post less as they improve because they become more engaged in life and need less information and support. It may be that we don't hear from moclobemide non-responders because the response rate is so high. My guess, though, is that it is rarely prescribed anymore because it is of little value.
Again, I will not guarantee that you would not respond to moclobemide. I would not want to accept that responsibility. If you decide to try it, I would recommend that you take at least 300mg, as the therapeutic dosage range seems to be 300-600mg. People often need 900mg and sometimes as much as 1200mg.
Good luck.
- Scott
This is the end of the thread.
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