Psycho-Babble Medication | about biological treatments | Framed
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Posted by paulb on January 9, 2002, at 18:34:45

In reply to WHAT SHOULD I DO RIMA/MAOI OR STICK TO SNRI ???, posted by DINGBAT on January 7, 2002, at 13:25:30

> Hi,
> I'm toying with the idea of switching from Effexor XR 300mg (which I have titrated down to 75mg over a 6 month period)to Aurorix (moclobemide). I want something that effects the whole serotonin-noradrenalin-dopamine complex. I know an 'old' MAOI like Nardil or Parnate is probably a better option than a RIMA but I am put off by the diet restrictions and "scare-stories" of bad reactions and intereactions. Any helpful opinions welcome ...



Both Venlafaxine and Moclobemide are very likely to increase levels of dopamine, norepinephrine and serotonin. However high doses of Venlafaxine would be needed to increase levels of dopamine, higher than you were originally prescribed[300mg]. The problem with Moclobemide is that it is an irreversible MAOI as opposed to the older reversible MAOI's and its binding to the MAO enzyme can be displaced making the drug less effective. However at high dosage Moclobemide may prove to be as effective as the older MAOI's but I wouldnt say for sure.

If you are very careful, following the diet and drug-drug interaction that occur with the reversible MAOI's then they are very effective antidepressants.

I would suggest that you were under the care of a skilled psychopharmacologist if you decided to go with Tranylcypromine or Phenelzine. There is plenty of resource material on using Phenelzine and Tranylcypromose safely

Dosages of Moclobemide have proven to be v-effective at 800mg and and has been used at a dosage of 1200mg. The side-effects can be unpleasant though for some.

I would only add that your other option would be polypharmacy i.e. SSRI and Wellbutrin or SSRI and TCA but unlike the MAOI's neither would raise dopamine, norepinephrine and serotonin. Unsure about the former option SSRI/Welbutrin.

Please note: Just my advice. I am not a medical practioner

Good luck




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