Mental Health Moclobemide?

[plumbus-nine]

Moclobemide failed completely for me. It just brought brain fog, and I've challenged its efficacy at MAO-A by a (very) low dose of d-amph which did increase BP, so it was working. Don't know what the fuck was wrong but really I got no effects on mood at all, and discontinuing was easy. So I went back on fucking venlafaxine, seemingly the only AD which work(ed) for me, and now I'm absolutely hooked on it.

Thinking about combining either moclobemide + selegiline or to go straight for high dose selegiline.

How's it going for you?

 

[chrispche]

Moclobemide failed completely for me. It just brought brain fog, and I've challenged its efficacy at MAO-A by a (very) low dose of d-amph which did increase BP, so it was working. Don't know what the fuck was wrong but really I got no effects on mood at all, and discontinuing was easy. So I went back on fucking venlafaxine, seemingly the only AD which work(ed) for me, and now I'm absolutely hooked on it.

Thinking about combining either moclobemide + selegiline or to go straight for high dose selegiline.

How's it going for you?

Well, I'm two and a bit weeks in. I have to say it's far superior to any other anti-depressant I've tried and I have tried most of them including Venlafaxine. So far so good. I feel clear headed, no emotional numbing like you get on SSRI's. Yeah, I'm impressed so far and I'm only on 300mg a day. So if I need it to be stronger I have room to manoeuvre. However, I wonder if there is synergy going on as I do take the maximum daily dose of 30mg of Aripiprazole. So I don't know if that is making a difference. I'll keep this thread on here informed as to any possible poop outs in the future.

 

[chrispche]

@plumbus-nine what dose was you on at the time?

 

[plumbus-nine]

@plumbus-nine what dose was you on at the time?

Dosed up to 600mg/d, and stayed on this for around 4 weeks afair.. it's many years ago so might try moclobemide again first but have little hope, guess prolonged venlafaxine (+ DXM for quite some time) use fucked my 5-HT system. According to wikipedia, moclobemide doesn't even help with SSRI withdrawal and venlafaxine (SNRI + atypical opioid like tramadol) withdrawal is more ugly.

 

[chrispche]

I went through Dihydrocodeine withdrawal on this Moclobemide my Doctor said it doesn't mix well with it so I had to stop. It wasn't comfortable, but only lasted about 4 days. Now I'm clean and I'm feeling pretty good. What about Amitriptyline you tried that? I would rate that as a close second in efficacy to my experience of Moclobemide so far.

 

[plumbus-nine]

I went through Dihydrocodeine withdrawal on this Moclobemide my Doctor said it doesn't mix well with it so I had to stop. It wasn't comfortable, but only lasted about 4 days. Now I'm clean and I'm feeling pretty good. What about Amitriptyline you tried that? I would rate that as a close second in efficacy to my experience of Moclobemide so far.

Back then when I still was visiting shrinks, I asked for amitriptyline but got it denied because of side effects (anti-cholinergic, which I'm not so prone to anyways) ... the only tricyclic I've tried was opipramol which isn't exactly known as potent. Read that it's supposed to act on sigma but got absolutely nothing even when taking like 10 pills but thanks, maybe I'll go get amitriptyline.

Did it sedate you, so take before bed? Any other things to be aware?

 

[chrispche]

Did it sedate you, so take before bed? Any other things to be aware?

Yes, it did. Which was not unpleasant. The worst thing about it was dry mouth. I had to keep drinking liquids or I suffered bad breath and it got a little tiresome in the end. So I stopped and went on to something else. However, in saying that the mood elevation was excellent. As with all meds we all respond differently so yeah... Maybe you'll get on with it.

 

[CFC]

I found MOC to be ok, certainly it had fewer side effects than regular antidepressants, which is what ultimately makes it a viable option for me, and there was zero effect from high doses of tyramine.

However, it reliably kills the positive subjective effects of d-amph for me at any dose over c.75mg, possibly due to its tendency to release prolactin, so I can't combine it with my ADHD meds.

 

[plumbus-nine]

possibly due to its tendency to release prolactin, so I can't combine it with my ADHD meds.

Do you have a source for this? Sounds ugly, maybe could explain what I experienced. I guess to have high prolactin/low dopamine from prolonged S/NRI use but can't say it for sure, just that anything dopaminergic seems to help (albeit only short term..) and antidopaminergics are hell on earth for me.

Did you ever try memantine or dopamine agonists, or ami/sulpiride in low dose? All should go ok with MOC.
Amphetamine like compounds will get only the NE part potentiated (DA gets metabolized by MAO-B while NE and 5-HT by MAO-A, tyrosine by both afaik) which makes them lose their positive effects imho.

 

[CFC]

Do you have a source for this? Sounds ugly, maybe could explain what I experienced. I guess to have high prolactin/low dopamine from prolonged S/NRI use but can't say it for sure, just that anything dopaminergic seems to help (albeit only short term..) and antidopaminergics are hell on earth for me.

Did you ever try memantine or dopamine agonists, or ami/sulpiride in low dose? All should go ok with MOC.
Amphetamine like compounds will get only the NE part potentiated (DA gets metabolized by MAO-B while NE and 5-HT by MAO-A, tyrosine by both afaik) which makes them lose their positive effects imho.

It's a little more complex than that - MAO-A will metabolise many neurochemicals to varying degrees and so DA has the potential to increase as well when you inhibit it, as shown in the studies with MOC. You also have to remember that 99% of waffle on forums assumes that DA is the neurochemical that's most important, when actually it's more likely NE is of at least equal if not more significance, although they can all interact and modulate each other in complex, poorly understood ways.

As for prolactin release, it's a fairly well documented pharmacological effect and there's lots of articles you can read, but handily the first article you get on a google is:

Evidence that the reversible MAO-A inhibitor moclobemide increases prolactin secretion by a serotonergic mechanism in healthy male volunteers

Evidence that the reversible MAO-A inhibitor moclobemide increases prolactin secretion by a serotonergic mechanism in healthy male volunteers - PubMed

The serotonin receptor antagonist methysergide was used to investigate the mechanism mediating stimulation of prolactin release after single doses of the reversible MAO-A inhibitor moclobemide. Eight healthy male volunteers participated in a placebo-controlled cross-over study, where...

pubmed.ncbi.nlm.nih.gov

Other potential reasons MOC could counteract the effects of stimulants include pre-synaptic adrenergic effects (ie: too much adrenergic excitation can cause post-synaptic receptors to 'shut down' and quieten certain parts of the brain in a dose-dependent fashion). It's often hard to predict effects like this because different regions of the CNS and PNS can react in divergent ways, and so the overall subjective effects can differ from person to person.