Psycho-Babble Medication Thread 89184

Shown: posts 1 to 11 of 11. This is the beginning of the thread.

 

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 ...

 

Moclo DINGBAT

Posted by CalvaryHill on January 7, 2002, at 18:50:37

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

The RIMA moclobemide is a "super" antidepressant because it affects serotonin, norepinephrine, and dopamine. And its side-effect profile is benign--even in high doses such as 1000 mg. Its definitely worth a try. Your doctor will tell you whether or not you can take moclobemide with Effexor...

Have a good day...

 

Re: Moclo

Posted by ben on January 8, 2002, at 12:27:44

In reply to Moclo DINGBAT, posted by CalvaryHill on January 7, 2002, at 18:50:37

Moclobemide (Manerix/Aurorix) shouldnt be taken with Venlafaxine (Efexor) because of a rare (but possible !) serotonine syndrom. Discuss this very carefully with you doc. I know one who took Efexor 450 mg with 20 mg Prozac a day and this combo is theortically contraindicated. It depends on your metabolism (liver: CYP450, brain: MAO) how much this to drugs interact.

> The RIMA moclobemide is a "super" antidepressant because it affects serotonin, norepinephrine, and dopamine. And its side-effect profile is benign--even in high doses such as 1000 mg. Its definitely worth a try. Your doctor will tell you whether or not you can take moclobemide with Effexor...
>
> Have a good day...

 

Re: WHAT SHOULD I DO RIMA/MAOI OR STICK TO SNRI ??? DINGBAT

Posted by jimmygold70 on January 8, 2002, at 18:30:45

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

Moclobemide is pretty useless. I have tried it, and physicians I have spoken with see it as a drug with little effects if any. Of course MAOIs are much more effective.

Anyway, why do you want to switch ? What symptoms do ou have, and how do they respond to Effexor ? MAOIs are not for everyone (though the SE are not as bad as described). There are many other options too.

Jimmy

 

Re: Manerix/Aurorix useless - jimmygold70 ??

Posted by ben on January 9, 2002, at 1:49:54

In reply to Re: WHAT SHOULD I DO RIMA/MAOI OR STICK TO SNRI ??? DINGBAT, posted by jimmygold70 on January 8, 2002, at 18:30:45

Why do yo say its useless ? Only because it doesent work for you ? There are people with great success on moclobemide (esp. atyp. depression). And the biggest problem is that a lot of pdocs titrate only up to 450-600 mg. My pdoc has used it up to 1200 mg with great results. And it is possible to combine with tricyclics which doesnt affect serotonin too much.

> Moclobemide is pretty useless. I have tried it, and physicians I have spoken with see it as a drug with little effects if any. Of course MAOIs are much more effective.
>
> Anyway, why do you want to switch ? What symptoms do ou have, and how do they respond to Effexor ? MAOIs are not for everyone (though the SE are not as bad as described). There are many other options too.
>
> Jimmy

 

Re: WHAT SHOULD I DO RIMA/MAOI OR STICK TO SNRI ???

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 ...

------------------------------------------------

Hi,

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
PaulB

 

Re: paulb

Posted by ben on January 10, 2002, at 1:37:40

In reply to Re: WHAT SHOULD I DO RIMA/MAOI OR STICK TO SNRI ???, posted by paulb on January 9, 2002, at 18:34:45

Please dont wright false things: ...Moclobemide is that it is an irreversible MAOI as opposed to the older reversible MAOI's and its binding to the MAO enzyme ....thats false !!! Moclobemide is a Reversible Inhibitor of the MonoAminooxidase (called RIMA). Phenelzine, Isocarboxazide and TranylcyPROMINE are irreversibles inhibitors (and mostly unselective to the isoenzymes A and B of the monoaminooxidase) ! And thats why there is theoretically no cheese effect (no diet restriction) under RIMAs like moclobemide. If you have a high blood pressure some carefully watching is indeed needed under moclobemide therapy.

> > 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 ...
>
> ------------------------------------------------
>
> Hi,
>
> 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
> PaulB

 

THANKS for the advice that's rolling in ...

Posted by DINGBAT on January 10, 2002, at 4:21:15

In reply to Re: paulb, posted by ben on January 10, 2002, at 1:37:45

Thanks to all who have offered opinions. Just to clarify: I am NOT considering taking Effexor AND and MAOI/RIMA (for obvious reasons). I know that Effexor has a (relatively weak) dopaminergic effect at very high doses but I am not prepared to tolerate the side-effects associated with higher doses of Effexor. In general, I find that Effexor has lifted my long-standing depression but also has an "emotional blunting" effect on me that I no longer wish to tolerate. Anybody else noticed this?

 

Re: paulb

Posted by paulb on January 10, 2002, at 18:02:29

In reply to Re: paulb, posted by ben on January 10, 2002, at 1:37:40

> Please dont wright false things: ...Moclobemide is that it is an irreversible MAOI as opposed to the older reversible MAOI's and its binding to the MAO enzyme ....thats false !!! Moclobemide is a Reversible Inhibitor of the MonoAminooxidase (called RIMA). Phenelzine, Isocarboxazide and TranylcyPROMINE are irreversibles inhibitors.
mostly unselective to the isoenzymes A and B of the monoaminooxidase) ! And thats why there is theoretically no cheese effect (no diet restriction) under RIMAs like moclobemide. If you have a high blood pressure some carefully watching is indeed needed under moclobemide therapy.

You are correct. I made a mistake. However I would appreciate it if you were civil. Also when registering at this website as a member of this site you agree to accept that not everything that is written is accurate therefore I do not believe I am at fault.

I would suggest you check you posts before submitting them and be sure to press the submit button once.

I hope some of what I have written has been helpful,
Good luck
Paulb

 

Redirect: paulb

Posted by Dr. Bob on January 10, 2002, at 19:12:09

In reply to Re: paulb, posted by paulb on January 10, 2002, at 18:02:29

> You are correct. I made a mistake...

I've posted a response at Psycho-Babble Administration:

http://www.dr-bob.org/babble/admin/20011216/msgs/2603.html

which is where I'd like any further discussion of civility to continue, thanks.

Bob

 

Re: Emotional Numbness... DINGBAT

Posted by IsoM on January 11, 2002, at 0:48:01

In reply to THANKS for the advice that's rolling in ..., posted by DINGBAT on January 10, 2002, at 4:21:15

Dingbat, I tried Effexor a few years ago but couldn't use it as it killed my appetite & hunger so completely, I would've literally starved to death if I continued. But that aside, it seems that for many people, & perhaps the majority, SSRIs seem to blunt their emotions. I've heard others say they weren't depressed any longer but neither did they feel compassion or excitement or other more intense feelings. It's almost like a mild chemical lobotomy. You are not alone.


> Thanks to all who have offered opinions. Just to clarify: I am NOT considering taking Effexor AND and MAOI/RIMA (for obvious reasons). I know that Effexor has a (relatively weak) dopaminergic effect at very high doses but I am not prepared to tolerate the side-effects associated with higher doses of Effexor. In general, I find that Effexor has lifted my long-standing depression but also has an "emotional blunting" effect on me that I no longer wish to tolerate. Anybody else noticed this?


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