Miscellaneous Stop using moclobemide as an MAOI

[red22]

Pirlindole is a better MAOI. As the name suggests, it is an indole, like tryptamines and serotonin.

I have also utilised pharmaceutical MAO-inhibitors like moclobemide, prescribed for depression, but came to feel they were not as beneficial as rue or ayahuasca vine. Most people who took them noticed a strange chemical feeling, and the experiences they provided were good, but after a time I came back to Syrian rue and ayahuasca vine, as the experiences they engendered were richer and seemed more useful to me.

Articulations: On the Utilisation and Meanings of Psychedelics. Julian Palmer (2014). 4. Ayahuasca. The Religion of Ayahuasca

I recognise that chemical feeling, described here. I'm going to look into sourcing pirlindole

talk_to_yourself, 2024-05-17, reddit


I have long been a supporter of pirlindole over the alternatives (moclobemide et cetera.) It has a lot of benefits over the comparable solutions.

In a study directly comparing pirlindole to moclobemide, pirlindole was found to be superior to moclobemide in treating depression and anxiety (according to the HDRS & HARS), with 80% of patients showing improvement on pirlindole compared to only 67% on moclobemide. An 80% improvement rate is amazing for depression; pirlindole appears to be superior to almost all agents used in treating depression. In addition to its superior efficacy, pirlindole also showed itself to be superior in side effects, with significantly less incidents of dry mouth and tachycardia than moclobemide (Tanghe 1997).

Pirlindole also has shown itself to have cognitive benefits as well. Pirlindole has been shown to protect neuronal cells against oxidative stress-induced cell death, while also improving mitochondrial function. These cognitive benefits have been shown to be independent of pirlindole's MAO-A inhibition, suggesting that pirlindole has underlying cognitively-beneficial properties (Boland 2002).

aol_user1,

https://www.reddit.com/r/Nootropics/comments/3qzx52/comment/cwkcqr0/

It is regrettable that other similar MAO-A selective drugs developed as prospective ADs never made the cut and have never been widely or extensively used in clinical practice. It is particularly regrettable because a couple of them were more potent than moclobemide, which is so weak as to be of doubtful utility — even in overdose it cannot do anyone any harm.

23. Dopamine elevation MAO-A, B or both? Ken Gillman, MD, PsychoTropical Research, 2022, 2024

 

[TheFunkeeJunkee]

Maybe Pirlindole is a better option then Moclebemide, but it doesnt really matter because it isnt commonly prescribed and flat out isnt available in the countries I just checked.

As far as Pharmahausca goes, Moclebemide has worked very well for me. It's likely not to important, but Pirlindole is moderately strong SNRI also which could introduce another lay of danger to Pharmahausca.

 

[red22]

There's two vendors that sell it. You can also have it synthesized overseas, but the minimum purchase amount of that is, what, like $5000? You can probably also hit up overseas pharmacies that don't sell it and ask them to order some for you.

B. caapi is similar by way of the fact that tetrahydroharmine is a serotonin reuptake inhibitor.[1] Also, when MAOIs are used for depression, doctors try to disable the majority of MAO.[2] Such is not needed for pharmahuasca, as I got a very potent effect by using oral DMT with only 20 mg of Parnate once. So, weak doses of pirlindole may be satisfactory. But DMT, itself, boosts serotonin, so it's a valid concern.[3]


1. While not a strong inhibitor of MAO, THH possibly contributes neuroactivity by weakly inhibiting the uptake of serotonin (5-hydroxytryptamine, 5-HT) at presynaptic sites, like other 1-methyl-tetrahydro-β-carbolines (Airaksinen et al., 1980). Subsequently, concentrations of 5-HT increase in the body when both its metabolism by MAOA and presynaptic uptake are simultaneously blocked by these harmala alkaloids.

Pharmacokinetics of Hoasca alkaloids in healthy humans. J.C Callaway, D.J McKenna, C.S Grob, G.S Brito, L.P Raymon, R.E Poland, E.N Andrade, E.O Andrade, D.C Mash. Jun 1999. Journal of Ethnopharmacology, 65(3), 243–256. DOI: 10.1016/S0378-8741(98)00168-8 (1. Introduction)

2. It has been suggested that platelet MAO enzyme inhibition may be measured as a surrogate for central nervous system MAO inhibition, with at least 85% (80%–90%) platelet inhibition believed to be required for antidepressant efficacy.9,36–38

The role of monoamine oxidase inhibitors in current psychiatric practice. Fiedorowicz JG, Swartz KL. J Psychiatr Pract. 2004 Jul;10(4):239-48. doi: 10.1097/00131746-200407000-00005 (GENERAL THEORY AND MECHANISM)

3. DMT has been shown to be capable of resulting in carrier mediated release of serotonin, however the capability for induction of serotonin efflux is clearly much different than other serotonin releasing agents that are truly dangerous in combination with MAOIs such as MDMA [25, 27, 40].

A Tale of Two Tryptamines: N,N-DMT and 5-MeO-DMT in Combination with MAOIs. Jaywin Patel, PharmD and Benjamin Malcolm, PharmD, MPH, BCPP. spiritpharmacist.com, Jun 16, 2020

 

[TheFunkeeJunkee]

-snip-

I appreciate the references and your concise reply but I think you may be missing the point of using Moclobemide.

People opt for Moclebemide as a medicine to treat depression and for Pharmahausca because it's very selective for MAO-A, is metabolised well even inpatients with severe renal dysfunction and is regarded as being well tolerated.

When selecting an antidepressant, the only consideration that really matters at the end of the day is "does it work?" because that seems to be very rare among antidepressants.

I'd be very careful in drawing conclusions about antidepressant efficacy based on things as arbitrary (it may not seem so, but it is) total MAO inhibition. As we learn more about depression it's becoming clearer and clearer all our pharmacological treatments for it are awful and our understanding of how monoamines modulate depression are likely totally incorrect. When I read a paper about a new novel monoamine modulating antidepressant I am always amused by claims of being 2% (or whatever) more effective then the current treatments which are at most only mildly more efficacious then placebo.

This may be considered herecy by some more... traditionally minded psychedelic enjoyers but I don't think the specific MAOI chosen as part of Ayahauscs is all that important as far as subjective effects are concerned. It's been proven people can't tell the difference between psychedelic X and Y in double blind placebos so it follows the likelihood of being able to meaningfully differentiate between Ayahausca using different MAOI's is very slim.

The fact that Moclobemide is extremely selective, well tolerated, safe in even enormous overdoses and readily available makes it, in my opinion, the best option for Ayahausca. Yes even better then the Hamala alkaloids. After all, the part of the Ayahausca that is producing the effects were after is the DMT.