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Moclobemide Causing Paradoxical Somnolence

I used to dose 200mg Modafinil with Moclobemide, and it was quite euphoric. I called it my emergency anti depressant kit.
Never failed to lift me out of a horrible day.

Maybe once you've reached a level dose, the somnolence will again go away, then you could look at adding Agomelatine perhaps. It's an ideal choice with Moclo since it only behaves as a 5HT2C antagonist and with sleep improving properties.
 
Thought I'd briefly follow up on this as I came across some literature a while back that could much more easily explain my reaction to MOC: increased melatonin synthesis.

It would seem selective MAO-A inhibitors can produce some remarkable increases in serum melatonin levels:

https://www.ncbi.nlm.nih.gov/pubmed/2089086
https://www.ncbi.nlm.nih.gov/pubmed/3097249

And it would appear I may be much more like a rat:
https://www.ncbi.nlm.nih.gov/pubmed/2089086

Than a human:
https://www.ncbi.nlm.nih.gov/pubmed/2300680
 
To play devil's advocate - if oral melatonin and agomelatine did not replicate the effects that you're experiencing, that would lend some doubt to this melatonin theory

Theoretically melatonin receptors shouldn't take long to desensitize either

edit: I forgot to mention the consensus seems to be that agomelatine is super weak, even in sleep doc's opinions
 
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Oh I'll definitely concede a degree of straw clutching with this ;)
 
Hey I always enjoy a good straw-clutching

How?s the drug working anyways, if you?re still taking it? I feel like I haven?t heard many reports on MAOIs but plenty of reports on SSRIs
 
Don't MAOIs eventualy cause a depletion of NA in synaptic vesicles and replacement with the trace amine octopamine? which would be weaker at activating adrenergic receptors. Could that be playing a part? IIRC it does in irreversible MAOIs.
 
Somnolence is a side effect I have experienced from certain dopamine agonists, perhaos that is playing a part.
 
Can't the likes of pramipexole do that? I might try now, although I've just taken morning pain meds, although not in a huge dose, just enough to go back to sleep and not WD. And chlormethiazole, but again, only a couple of 192mg caps (always wondered why they made it such a weird number and not just 200mg) ...192...just a weird number for something not so super-sensitive in dosing, active in the 100s of mg range, why 192? weird. Anyway soon as I've finished my morning cigar, I'll swallow a few pramipexole tabs and see what happens when I go slither back under the covers out of the cold and stick my blindfold on, say a quick prayer to the gods of verboten chemistry, a 'blessed bee' so to speak=D, and see what cooks up in this particular autie meat-cauldron of witches pharmacological brew.
 
I think the somnolence associated with certain dosages of DA agonists has to due with preferential activation of pre-synaptic autoreceptors, while Parkinson's disease patients tend not to get the somnolence because they lack the autoreceptors (the dopamine cells on which they would normally be located have died off, while the post-synaptic DA receptors are on non-DA cells)
 
Yes, pramipexole was the main one I had in mind, and that explanation makes sense as it mostly occured when first starting daily dosing and was still taking a very low dose while titrating up to avoid nausea. I don't know if its has utility as a sleep aid, I didn't feel like I was going to fall asleep but I definitely noticed that when I would lay down on the couch/recliner in the afternoon to watch a movie I would fall asleep without trying very quickly, and even when trying to stay awake it would be very hard to keep my eyes open, but if I stayed up and walking around I never felt weak or lethargic, which is completely out of character for me(sleep ever coming easy or being hard to resist, that is).
 
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I?d really love to find an answer for this problem with MAOIs. I?ve taken Moclobemide all the way up to doses of 1200mg and experienced the same somnolence. I switched to Tranylcypromine which for a while had me really energetic and motivated before those particular effects totally bombed out and it is now causing me the same somnolence. I?ve tried using Nortriptyline as an augment to TCP but this seemed to make me very irritable, liable to mood swings and crushed my stress tolerance.

I really wish I could find a solution to this MAOI fatigue/somnolence as I don?t know what my options are from here and I?m starting to feel a bit hopeless.
 
Just dropped by to say loving reading about MOC; apparently I had obtained 30 x 300mg tablets almost a decade ago (for whatever reason) but never ended up using them and since finding them, I've been researching nonstop! Hoping this will help with social anxiety and light depression and mood disorder; currently only on tianeptine sulfate (100mg/day) and caffeine which helps keep me motivated and working hard for 12+ hours a day but still have issues with social anxiety. Anyway, keep up the great convo and I'm learning something new all the time.
 
Cotcha Yankinov said:
Hey I always enjoy a good straw-clutching

How?s the drug working anyways, if you?re still taking it? I feel like I haven?t heard many reports on MAOIs but plenty of reports on SSRIs
Click to expand...

It's much more pleasant than any SS/NRI I ever took, or Bupropion or any of those. The mood uplift is immediate and once the wave of somnolence passes or I take a 1-2 hour nap, it's pretty decent. The daytime somnolence does wear off in time, though not completely, as does the night-time insomnia, but I don't feel my sleep quality is quite as high.
 
doxylamine said:
I?d really love to find an answer for this problem with MAOIs. I?ve taken Moclobemide all the way up to doses of 1200mg and experienced the same somnolence. I switched to Tranylcypromine which for a while had me really energetic and motivated before those particular effects totally bombed out and it is now causing me the same somnolence. I?ve tried using Nortriptyline as an augment to TCP but this seemed to make me very irritable, liable to mood swings and crushed my stress tolerance.

I really wish I could find a solution to this MAOI fatigue/somnolence as I don?t know what my options are from here and I?m starting to feel a bit hopeless.
Click to expand...

How long did you try the various MAOIs for?
 
Increased 5HT causes sedation. The anoretic fenfluramine caused somnolence - it was the most frequent reason people discontinued medication. I believe the patient insert lists it as a common side-effect. Even though it's a RIMA, do be careful. I've seen someone end up in an ICU after drinking tyramine-containing beer (bitter). They suffered organ failure and it really was touch-and-go. Please read the insert and be aware that meclobemide is a medicine you need to treat with respect. Eat a packet of Prozac and throw up, eat a packet of that stuff and you could ended up being planted next to Nick Drake (yes, I'm aware ND died from tricyclic overdose hence NEXT to).
 
So I started taking melatonin pretty religiously every evening at a high dose (3mg, then 1.5mg, now 750mcg) after reading about that as a potential cause of the somnolence (to hopefully desensitize). And after about a month it's pretty much gone! This is really great, as I find MOC otherwise very pleasant and tolerable.

Massive simultaneous consumption of red wine, ripe cheese and cured meats (ie high tyramine foods) cause no measurable effect on my BP or heart rate at 600mg/day.
 
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