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Re: Let's talk about combing SSRIs and TCAs

Posted by SLS on June 23, 2018, at 0:15:03

In reply to Re: Let's talk about combing SSRIs and TCAs » SLS, posted by TriedEveryMedication on June 22, 2018, at 14:41:02

Many years ago, I researched moclobemide. I read the stuff written by Joffe and Bakish. I ended up taking it, even though I was not impressed with its efficacy as reported by several researchers and the US FDA. I remained in compliance with tyramine food restrictions and avoided mixing it with serotonin reuptake inhibitors. I don't recommend consuming more than 50 mg of tyramine at any one meal while taking moclobemide.


Moclobemide monotherapy is not terribly impressive as an antidepressant. Many people experience a very strong therapeutic effect during the first week at low dosages. Very few side effects are reported. The problem is that depression returns quickly and requires dosage escalations to maintain an antidepressant response. Some doctors will go up to 1200 mg/day without seeing a persistant improvement.

The US FDA rejected moclobemide. The US clinical trials failed to demonstrate efficacy. If you are going to add a SSRI to moclobemide, you might consider having cyproheptadine (Periactin) around to mitigate a serotonin syndrome event.

https://psychotropical.info/moclobemide-s-sris/

I am currently mixing nortriptyline with Trintellix (vortioxetine). If that doesn't work, I will combine nortriptyine with Effexor (venlafaxine). I received a partial response from this combination, but at dosages that were too low. I expect that I will need a minimum of 300 mg/day of Effexor with 100 mg/day of nortriptyline. I am also taking lithium, prazosin, and Lamictal now. I wasn't taking these drugs during my previous Effexor/nortriptyline trial. I would consider taking Abilify or Latuda if necessary.

I am open to all suggestions. I could use a few more.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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poster:SLS thread:1099256
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