![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by k23d on December 18, 2002, at 2:08:09
Hey All,
I'm starting moclobemide for moderate social anxiety, low energy levels and some supposed depression. I'm starting at 150mg morning, 150mg lunch and quickly titrating the morning to 300 if tolerable.
What can I expect in the way of side effects in the first few days? (I've read the inserts etc but wondering about others experiences.)
Specifically I'm curious as to whether I'm going to get the same panic paxil and effexor gave me and whether it's going to give me that drugged up pupil dilation thing. If so I'm going to have to start on a weekend due to work.
Also, anyone got a success story to share with this drug? Seems most old posts are fairly negative...
FYI- I also take bromazepam 1.5mg bid also (low dose but hey, it's better than nothing)
Currently on Remeron 30mg that will be stopped prior to the moclobemide.Thanks in advance.
Posted by cubbybear on December 18, 2002, at 10:37:23
In reply to Starting Moclobemide - What to expect?, posted by k23d on December 18, 2002, at 2:08:09
I don't have too much to offer because I just started taking Moclobemide (Aurorix) myself about 3 weeks ago. I'm in a very unique situation, in that I'm using it to see if it will PREVENT a relapse of depression in the future. I'm currently taking 300 mg./day and incredibly, have had absolutely no side effects. This AD has a very good side effect profile compared to all the other meds and I can see this for myself. I've done an enormous amount of reading about Moc. and some of it is negative while much of it is highly positive. It's nice to know that there are other people out there who are taking it, because we're certainly in the minority these days, with the SSRI monopoly going full blast. and making life miserable for a lot of people. So good luck to you and--don't worry about side effects.Hopefully you won't have any either or they (dizziness, headache, sleep disruption) will be quite tolerable,according to the literature.
Posted by worrier on December 18, 2002, at 19:37:32
In reply to Starting Moclobemide - What to expect?, posted by k23d on December 18, 2002, at 2:08:09
> Hey All,
>
> I'm starting moclobemide for moderate social anxiety, low energy levels and some supposed depression. I'm starting at 150mg morning, 150mg lunch and quickly titrating the morning to 300 if tolerable.
>
> What can I expect in the way of side effects in the first few days? (I've read the inserts etc but wondering about others experiences.)
>
> Specifically I'm curious as to whether I'm going to get the same panic paxil and effexor gave me and whether it's going to give me that drugged up pupil dilation thing. If so I'm going to have to start on a weekend due to work.
>
> Also, anyone got a success story to share with this drug? Seems most old posts are fairly negative...
>
> FYI- I also take bromazepam 1.5mg bid also (low dose but hey, it's better than nothing)
> Currently on Remeron 30mg that will be stopped prior to the moclobemide.
>
> Thanks in advance.>I can't offer any info about your new med. but have a question regarding your reaction to paxil...you mentioned it caused panic when you took it. Same for me...and it was prescribed for my panic disorder. The long and short of it has been that 6 months after stopping the paxil I still have lots of anxiety, which I never had before (I just had panic attacks that had become more frequent). I'm taking xanax which has probably saved my life, but I'm still not back to my pre-paxil self. How long did the effects last for you. Anyone out there had the anxiety thing seemingly become permenant? To be honest, I'd go back to the frequent panic attacks if I could. The way I feel now is so irritating. It's not mental worrying,its just the physical anxiety/agitation. Suggestions or similar experiences?
Posted by k23d on December 18, 2002, at 22:02:49
In reply to Re: Starting Moclobemide - What to expect?, posted by worrier on December 18, 2002, at 19:37:32
Hi Worrier,
My general anxiety increased at the start with Paxil but it did subside over time on the medication and my anxiety was well managed. I quit becuase of other S/E, mainly apathy, weight gain and sexual probs.
As for how I was post paxil it's hard to say. I had bad withdrawals during the taper and for the following 2 weeks. Mainly dizziness, nausea and brain zaps. I went straight on to remeron afterwards and althought it has only helped my anxiety minimally, it is hard to say what I'd be like post-paxil without it.
Generally though, other than weight I still have to lose, I don't feel any after-effect of paxil that I'm aware of.
Posted by ZeeZee on December 23, 2002, at 13:40:31
In reply to Starting Moclobemide - What to expect?, posted by k23d on December 18, 2002, at 2:08:09
I too am interested in the effects as this will likely be my next drug to try. I'd like to keep this thread going for the current week and beyond so as to welcome more responses from those of you with experience with this drug.
Thanks
Posted by jimmygold70 on December 25, 2002, at 11:24:21
In reply to Re: Starting Moclobemide - What to expect? » k23d, posted by ZeeZee on December 23, 2002, at 13:40:31
Not much. It is rarely prescibed and rarely effective. Why should you switch to it ? What have you taken so far and how do you feel?
Posted by ZeeZee on December 25, 2002, at 11:56:36
In reply to Re: Starting Moclobemide - What to expect? » ZeeZee, posted by jimmygold70 on December 25, 2002, at 11:24:21
I'm not on anything right now except St.John's Wort (not effective enough although a little helpful) and am supposed to experiment with adding Buspar when my family returns from the holidays. My reason for interest is that the MAOI's have been the only med's to help me with panic/agoraphobia (although I can no longer tolerate Parnate -weird side effects the second time around) and can't handle the increased anxiety/panic storms I experience from the SSRI's.
If Buspar doesn't work or isn't tolerable my pdoc wants me to try Paxil again (caused a nightmare of panic attacks for me in the past) at a very low dose and ramp slowly. I'm not hopeful about either.
Posted by jimmygold70 on December 25, 2002, at 17:51:11
In reply to Re: Starting Moclobemide - What to expect? » jimmygold70, posted by ZeeZee on December 25, 2002, at 11:56:36
1. Try Effexor XR - it is more effective than SSRIs for Panic Disorder. I'd recommend a dose higher than 150mg/day, since up to 150mg it acts like an SSRI.
2. You can use some Klonopin for your first month on Effexor. Take the Effexor dose up fast till 225mg/day and wait a couple of weeks. It should do.Jimmy
> I'm not on anything right now except St.John's Wort (not effective enough although a little helpful) and am supposed to experiment with adding Buspar when my family returns from the holidays. My reason for interest is that the MAOI's have been the only med's to help me with panic/agoraphobia (although I can no longer tolerate Parnate -weird side effects the second time around) and can't handle the increased anxiety/panic storms I experience from the SSRI's.
> If Buspar doesn't work or isn't tolerable my pdoc wants me to try Paxil again (caused a nightmare of panic attacks for me in the past) at a very low dose and ramp slowly. I'm not hopeful about either.
Posted by ZeeZee on December 25, 2002, at 19:27:26
In reply to Re: Starting Moclobemide - What to expect? » ZeeZee, posted by jimmygold70 on December 25, 2002, at 17:51:11
Tried it one time at a low dose this summer, only to have it trigger constant panic which catapulted me backwards in my disorder by years. I am hyper sensitive and my anxieties and fears about taking medicine (typical of those of us with this disorder)create anxiety attacks as soon as I ingest them - so I'm quite a difficult patient. In just a few days I will start with the Buspar and have my fingers crossed.
However, your kind advice is appreciated.
Thanks
Posted by jimmygold70 on December 26, 2002, at 13:08:04
In reply to Re: Starting Moclobemide - What to expect? » jimmygold70, posted by ZeeZee on December 25, 2002, at 19:27:26
Again - with added Klonopin you WILL NOT have panic attacks while starting Effexor. Take the klonopin dose down slowly and you're 90% likely having complete remission from panic attacks.
> Tried it one time at a low dose this summer, only to have it trigger constant panic which catapulted me backwards in my disorder by years. I am hyper sensitive and my anxieties and fears about taking medicine (typical of those of us with this disorder)create anxiety attacks as soon as I ingest them - so I'm quite a difficult patient. In just a few days I will start with the Buspar and have my fingers crossed.
> However, your kind advice is appreciated.
> Thanks
Posted by Jumpy on December 26, 2002, at 20:48:38
In reply to Re: Starting Moclobemide - What to expect? » ZeeZee, posted by jimmygold70 on December 26, 2002, at 13:08:04
Funny .... I have never actually seen an SSRI and especially not Effexor effective at blocking panic attacks. The only meds I have seen prevent panic attacks are benzos. Also I have seen phenelzine/nardil work multiple time at extinguishing general anxiety and phobia and lessening panic attacks. I think MAOIs are believed to be the single most effective ADs for anxiety and severe depression. I just assumed all this about SSRIs/effexor being good at panic was hype pushed by the drug companies. But this is my personal experience and I could be completely wrong.
Jumpy
Posted by ZeeZee on December 26, 2002, at 21:00:56
In reply to Re: Starting Moclobemide - What to expect?, posted by Jumpy on December 26, 2002, at 20:48:38
Since I moved to this new city I have not been able to find a pdoc knowledgeable enough to consider using MAOI's. I agree with you regarding the hype and hate the SSRI's because of how they exacerbate the anxiety and panic. Nardil was great, but couldn't handle the side effects and Parnate which was also great "turned on me". I don't like taking benzo's except "as needed" because to be effective enough to break through my invisible agoraphobic boundaries I have to take enough to sedate me - not very functional. I'm pretty stuck and frustrated because I hate living like this and want my life back! My anticipatory anxiety was so great that I backed out of taking a trip with my family to visit relatives and friends 1200 miles away - I couldn't handle being "that far" from home, and have spent the holiday alone - since they went without me (and I don't blame them).
I was hoping that maybe Moclobemide might be a good alternative.
Posted by cybercafe on December 27, 2002, at 2:19:30
In reply to Re: Starting Moclobemide - What to expect? » Jumpy, posted by ZeeZee on December 26, 2002, at 21:00:56
> Since I moved to this new city I have not been able to find a pdoc knowledgeable enough to consider using MAOI's. I agree with you regarding the hype and hate the SSRI's because of how they exacerbate the anxiety and panic. Nardil was great, but couldn't handle the side effects and Parnate which was also great "turned on me". I don't like taking benzo's except "as needed" because to be effective enough to break through my invisible agoraphobic boundaries I have to take enough to sedate me - not very functional. I'm pretty stuck and frustrated because I hate living like this and want my life back! My anticipatory anxiety was so great that I backed out of taking a trip with my family to visit relatives and friends 1200 miles away - I couldn't handle being "that far" from home, and have spent the holiday alone - since they went without me (and I don't blame them).
> I was hoping that maybe Moclobemide might be a good alternative.I think if you take benzos on a regular basis for a while you will no longer feel sedated
just anecdotal evidence + personal experience
Posted by Ritch on December 27, 2002, at 9:30:07
In reply to Re: Starting Moclobemide - What to expect?, posted by Jumpy on December 26, 2002, at 20:48:38
> Funny .... I have never actually seen an SSRI and especially not Effexor effective at blocking panic attacks. The only meds I have seen prevent panic attacks are benzos. Also I have seen phenelzine/nardil work multiple time at extinguishing general anxiety and phobia and lessening panic attacks. I think MAOIs are believed to be the single most effective ADs for anxiety and severe depression. I just assumed all this about SSRIs/effexor being good at panic was hype pushed by the drug companies. But this is my personal experience and I could be completely wrong.
>
> Jumpy
>
Jumpy, I haven't had any success with SSRI's/Effexor preventing panic attacks from ocurring either. However, they definitely reduced obsessiveness about future attacks and allowed me to be reasonably comfortable in situations that commonly triggered them. I was taking Prozac when I was going to college (no benzo, however), and had panic attacks sometimes daily for weeks and weeks. But, I still showed up for classes despite them. Klonopin is the only med that has successfully *prevented* the panic attacks. SSRI's probably reduce the frequency of the attacks for the average person. But having half as many doesn't cut it, if you are having problems with panic....
Posted by worrier on December 28, 2002, at 17:44:01
In reply to Re: Starting Moclobemide - What to expect? » Jumpy, posted by Ritch on December 27, 2002, at 9:30:07
> > Funny .... I have never actually seen an SSRI and especially not Effexor effective at blocking panic attacks. The only meds I have seen prevent panic attacks are benzos. Also I have seen phenelzine/nardil work multiple time at extinguishing general anxiety and phobia and lessening panic attacks. I think MAOIs are believed to be the single most effective ADs for anxiety and severe depression. I just assumed all this about SSRIs/effexor being good at panic was hype pushed by the drug companies. But this is my personal experience and I could be completely wrong.
> >
> > Jumpy
> >
>
>
> Jumpy, I haven't had any success with SSRI's/Effexor preventing panic attacks from ocurring either. However, they definitely reduced obsessiveness about future attacks and allowed me to be reasonably comfortable in situations that commonly triggered them. I was taking Prozac when I was going to college (no benzo, however), and had panic attacks sometimes daily for weeks and weeks. But, I still showed up for classes despite them. Klonopin is the only med that has successfully *prevented* the panic attacks. SSRI's probably reduce the frequency of the attacks for the average person. But having half as many doesn't cut it, if you are having problems with panic....
>
>Just want to add a nod of agreement about the SSRI's. I've tried several and had horrible increases in the frequency and intensity of panic attacks. The last adventure (Paxil) sent me to the ER...I really felt like I was going to shatter into a million pieces, couldn't sit still for 5 minutes...literally had to be up pacing in order to keep any sense of sanity. My GP kept telling me to increase the dose because I was just experiencing "breakthrough anxiety". Funny how before the meds all I had were panic attacks at night when I tried to relax. Six months later I still have tons of anxiety but am functioning o.k. thanks to finding a psychiatrist who recognized the problem and isn't afraid of benzos. Xanax keeps the anxiety at bay and will stop an impemding panic attack in its tracks. Being phobic of meds, I have trouble making myself take enough to really feel normal, but this sure is tons better than anything else I've tried.
Posted by ZeeZee on December 28, 2002, at 17:48:28
In reply to Re: Starting Moclobemide - What to expect?, posted by worrier on December 28, 2002, at 17:44:01
>Being phobic of meds, I have trouble making myself take enough to really feel normal, but this sure is tons better than anything else I've tried
Boy can I relate to that! I need medication for my phobia's but my phobia's keep me from taking them!
Posted by cybercafe on December 28, 2002, at 18:27:30
In reply to Re: Starting Moclobemide - What to expect? » Jumpy, posted by Ritch on December 27, 2002, at 9:30:07
> > Funny .... I have never actually seen an SSRI and especially not Effexor effective at blocking panic attacks. The only meds I have seen prevent panic attacks are benzos. Also I have seen phenelzine/nardil work multiple time at extinguishing general anxiety and phobia and lessening panic attacks. I think MAOIs are believed to be the single most effective ADs for anxiety and severe depression. I just assumed all this about SSRIs/effexor being good at panic was hype pushed by the drug companies. But this is my personal experience and I could be completely wrong.
> >
> > Jumpy
> >
>
>
> Jumpy, I haven't had any success with SSRI's/Effexor preventing panic attacks from ocurring either. However, they definitely reduced obsessiveness about future attacks and allowed me to be reasonably comfortable in situations that commonly triggered them. I was taking Prozac when I was going to college (no benzo, however), and had panic attacks sometimes daily for weeks and weeks. But, I still showed up for classes despite them. Klonopin is the only med that has successfully *prevented* the panic attacks. SSRI's probably reduce the frequency of the attacks for the average person. But having half as many doesn't cut it, if you are having problems with panic....
>I don't think I've met anyone online who has used SSRIs successfully for panic attacks.
However the results of most trials seem to indicate that they are successful in a number of patients.Strangely, I just moved into a place where my housemate said he has no more panic attacks on 200 mg of Zoloft.
But you'd never catch him online or at a support group.I guess those of us who are motivated to look for answers are those who are having really really bad luck with meds :(
Posted by ZeeZee on December 28, 2002, at 18:40:38
In reply to Re: Starting Moclobemide - What to expect?, posted by cybercafe on December 28, 2002, at 18:27:30
I have read some posts online from those who've found relief with SSRI's from their panic disorder and agoraphobia. I also have friends who are succeeding as well with their use. It amazes me that they are able to tolerate these drugs.
I am dumbfounded by the fact that I have such an intense unpleasant reaction to them. The fact that every psychiatrist I've seen since moving here pushes them on me and gives me anecdotal and scientific explanations for their effectiveness makes me feel even more alone. Between not responding well to SSRI's and not benefiting enough from CBT, I'm beginning to wonder if there is any hope for me.
Everyone keeps telling me to just take Klonopin along with the SSRI and I'll get through the anxiety part and then do well. However, my phobia about taking new med's interferes with this and in addition I also don't believe it'll work.
Thanks for listening.
Posted by worrier on December 28, 2002, at 20:18:15
In reply to Re: Starting Moclobemide - What to expect? » cybercafe, posted by ZeeZee on December 28, 2002, at 18:40:38
> I have read some posts online from those who've found relief with SSRI's from their panic disorder and agoraphobia. I also have friends who are succeeding as well with their use. It amazes me that they are able to tolerate these drugs.
> I am dumbfounded by the fact that I have such an intense unpleasant reaction to them. The fact that every psychiatrist I've seen since moving here pushes them on me and gives me anecdotal and scientific explanations for their effectiveness makes me feel even more alone. Between not responding well to SSRI's and not benefiting enough from CBT, I'm beginning to wonder if there is any hope for me.
> Everyone keeps telling me to just take Klonopin along with the SSRI and I'll get through the anxiety part and then do well. However, my phobia about taking new med's interferes with this and in addition I also don't believe it'll work.
> Thanks for listening.>Hey ZeeZee...we seem to have a bit in common.Including having major problems with posting stuff tonight. It's taking ages to get anything to work. What meds are you taking now? Are you on an SSRI? Is anxiety your main problem or is it depression? Just curious...SSRIs are poison to me, though I know they work for lots of folks.
Posted by ZeeZee on December 28, 2002, at 20:32:44
In reply to Re: Starting Moclobemide - What to expect?, posted by worrier on December 28, 2002, at 20:18:15
I believe we've communicated before when I was posting under LLL.
My DX is panic disorder and agoraphobia. I'm taking St. John's Wort and was feeling that it was helping to some degree. My new pdoc, whom I like, agreed not to mess with the St.John's Wort. I was planning on taking a long road trip over the holidays to visit family and she understood that my past adverse reactions to med's. could interfere with my plans to take the trip. She advised me to add Buspar to the SJW, but since I experienced insomnia the one time I took it I decided I'd wait until after the trip to try that as well.
Well it wasn't any med's that interfered with this trip it was my agoraphobia - I backed out at the last minute and caused my family to scramble to get plane tickets on short notice so they could see relatives as planned. I remain at home -ALONE, and quite upset with myself and discouraged.
Now, I'm waiting for their return so I can try the Buspar (don't like to experiment with things that might exacerbate my anxiety when I'm alone).
If that doesn't work my pdoc wants me to try Paxil - again. However, I'd prefer to try Moc or even Marplan since MAOI's have helped in the past and I'm so dreadfully scared of SSRI effects.Sorry for being so wordy - that's what happens when one is bored to tears.
Posted by worrier on December 28, 2002, at 20:49:08
In reply to Re: Starting Moclobemide - What to expect? » worrier, posted by ZeeZee on December 28, 2002, at 20:32:44
>Perhaps we have talked before....Wow, scary how similar our experiences are. I canceled out of an all expense paid trip to Martha's Vineyard to see my sister this spring due to overwhelming anxiety. Felt like an absolute fool, cost her the price of my plane ticket,etc. Am going to try again next spring. Have you tried any of the benzos? I'm not suggesting they are a cure all but I can go to work, even went on a long weekend with my husband last month (only begged to go home once ) and can actuall y read again. When the anxiety really gets going, my ability to concentrate enough to read is the first thing to go.Just a thought and maybe you've already been down that road. But if you haven't and it's drug phobia that's stopping you, take a deep breath and ask your doc.(and you thought you were wordy...I could carry on all night to avoid my frozen pizza and boring T.V.)
Posted by worrier on December 28, 2002, at 21:02:10
In reply to Re: Starting Moclobemide - What to expect?, posted by worrier on December 28, 2002, at 20:49:08
Hey ZeeZee, lest you think I'm totally out there, it just occurred to me that you responded to my question about klonopin vs xanax in another thread...therefore ignore the questions in my previous post. Let me ask instead, do the benzos not work adequately enough? or does your doc oppose monotherapy? Again, just curious.
Posted by ZeeZee on December 28, 2002, at 21:26:13
In reply to Re: Starting Moclobemide - What to expect?, posted by worrier on December 28, 2002, at 21:02:10
When I'm faced with one of my agoraphobic boundaries, such as being far from home, my anticipatory anxiety becomes so intense that I'd have to be zonked out on xanax 24 hours a day. My anxiety is so great that I don't even believe the xanax will work.
The thing is though, when I live within the invisible boundaries or am accompanied by a companion for shorter journeys, I feel completely comfortable and normal. My usual day to day life (although a small life) feels perfectly OK. It's difficult for me to accept the use of a benzo (and the subsequent sedation) on a daily basis when I don't need it everyday.
I just can't forget how good I felt and how quiet my anxious thoughts became while on the MAOI's - and without feeling drugged. I'm hopeful I can find something like that again.Regards
ZeeZee
Posted by ZeeZee on December 28, 2002, at 21:33:50
In reply to Re: Starting Moclobemide - What to expect?, posted by worrier on December 28, 2002, at 21:02:10
Also, I've always worked, in professional positions and am currently employed. I've always managed to do what I've needed for the most part.
This whole thing about being "too far from home" is a new symptom for me. In the past, during the 17 yrs I've had this disorder, my husband and children and I have made that long journey to visit family on many prior occassions.
Thank you for sharing your experiences with me, your support and understanding is much appreciated.Regards,
ZeeZee
Posted by ZeeZee on December 29, 2002, at 10:19:05
In reply to Starting Moclobemide - What to expect?, posted by k23d on December 18, 2002, at 2:08:09
So how is it going so far? I'd be interested in hearing how you're doing on the Moc and any side effects you may have experienced.
Thanks
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.