![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by crazyvash on September 12, 2015, at 22:20:18
As an introduction, my current diagnosis is bipolar II. Which, like most people with the condition, I suffer from mostly the depression aspect. Fortunately, my hypomania and mixed states are under control with a combination of Lamictal and Seroquel. Although, when it comes to the depression, relief from that still alludes me. Unfortunately for me, the only antidepressants that work are the MAOI's. Granted, I am thrilled that something works at all, but the combined hypotension from the Seroquel, and currently EMSAM are making things very difficult. I have already tried switching the Seroquel around with various antipsychotics, but then I run into the situation of either the drug doesn't do the job (Risperdal, Abilify, Loxitane), or I run into hypotension problems again. (Saphris) I could try replacing the EMSAM with something like Nardil or Parnate, but according to my doctor, EMSAM is a little better with hypotension than the other two are. Also, having done this medication dance for a long time now, I am just getting tired of playing whack-a-mole. I have read before that taking salt tablets and/or fludrocortisone can help with this. I have mentioned this to my doctor, as he was unaware of this, so hopefully I'll have a way to "fix" this problem. I guess I'll find out what we'll try at the next appointment. If anyone has any similar experiences, I'd appreciate any information or suggestions.
Now why the subject title of moclobemide? Well, from my research, moclobemide doesn't have the issues with hypotension as much as the traditional MAOI's, so that's why I am interested. Also, if the salt tablets/fludrocortisone idea doesn't work, at least I have an alternative plan that I am working on.
Other than going to Canada and getting a prescription in that fashion, I have another question. Can a doctor from the United States legally write a prescription for an unapproved drug like moclobemide to have it filled at a foreign (Canada) mail order pharmacy? A recent phone conversation with my current doctor basically came down to that if I wanted the drug, then I'll have to go out of the country to get it. I am guessing he said this because he is on the careful side, but then again, maybe legally he can't do it even if he wanted to. I'll make sure to properly grill him next time. I have read about people that have supposedly gotten this medication who are U.S. citizens, so I am curious about how they went about this.
In the end, I guess I am looking for anyone that has gone through this issue of hypotension and any experiences that they have had with treating it. Worst case scenario, if I have to go to Canada to try out moclobemide, then so be it, but I would rather not.
Thanks.
Posted by Christ_empowered on September 13, 2015, at 4:30:05
In reply to Hypotension, MAOI's, and Moclobemide, posted by crazyvash on September 12, 2015, at 22:20:18
Moclobemide is apparently not the best antidepressant, at least in meta-analyses. That said...I think the way the FDA rules work, your doc can write an Rx, as long as its not specifically banned by the FDA or DEA. So...I think it'd be kosher for you to get moclobemide by US doc Rx, but you obviously couldn't get Rohypnol (just an example). I could very well be wrong.
How did loxitane treat you? There's an antidepressant...amoxapine...its sort of a 1-2 punch. First, its an antidepressant, and then a considerable amount is metabolized into...wait for it, wait for it...loxapine (loxitane). Back in the day, it was used a good bit for psychotic depression. Its a TCA, so...that carries certain risks with it and side effects, of course.
Have you ever taken a stimulant? Provigil, a ritalin product (there's lots of them), an amphetamine? One of my acquaintances is doing much better on adderall+seroquel. Just throwing that out there.
I guess you've tried more conventional antidepressant options already? Anyway, I hope things improve for you.
Posted by Lamdage22 on September 13, 2015, at 12:47:14
In reply to Hypotension, MAOI's, and Moclobemide, posted by crazyvash on September 12, 2015, at 22:20:18
How long are you taking??
It should fade
This is the end of the 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.