Posted by Dr. Bob on November 19, 2003, at 0:13:55
In reply to Depression w/ fatigue / moclobemide / narcolepsy??, posted by VelocideX on November 17, 2003, at 23:36:17
> Hey all,
>
> I've been treated for depression for about a year (having had it longer than that).
>
> I tried citalopram, fluvoxamine and found them to be too sedating. I tried effexor (venlafaxine), and found it too to be sedating at 75mg/day (I couldn't handle higher doses due to nausea). I also found that all of these medications only marginally improved my depression, and I couldn't tolerate higher doses due to nausea and/or excessive sedation.
>
> My depression manifests with a large fatigue (somnolence) component already, and so I don't want to touch anything sedating (e.g. any of the NaSSa s)
>
> I'm currently on 450mg/day of moclobemide (Aurorix/Manerix, etc). I've found this to be much more helpful with my depression. I've been on it for about 3.5 weeks now, and I feel a lot closer to normal than I have in a long time. I probably feel about 75% or so. I was put on this due to the relative ineffectiveness of the SSRIs and my fatigue, as it tends to be activating/stimulating.
>
> My response to a RIMA (reversible inhibitor of MAO-A) leads me to believe that my depression is noradrenic or dopaminergic in origin, rather than serotonergic.
>
> My fatigue component, though somewhat alleviated, still remains significant. I wake up in the mornings feelins so tired that I feel drunk. It eases a bit throughout the day, and some days its not so bad, but I still feel excessively tired, to the point of falling asleep in lecturers. I've tried using / not using caffeine and found that caffeine makes only a mild difference.
>
> I've started to wonder if I have borderline narcolepsy. I get the sleep paralysis on waking up a lot of the time and the hypnagogic hallucinations before falling asleep, but not the cataplexy.
>
> Funnily though, several times an hour I get the feeling you get when you stand up too quickly... I feel like I'm on the verge of passing out and i lose sensation in my limbs (they feel tingly-numb), and then suddenly its all gone again. This lasts all of about 2 or 3 seconds.
>
> What do you guys think? Any recommendations?
poster:Dr. Bob
thread:281113
URL: http://www.dr-bob.org/babble/20031116/msgs/281113.html