![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 26 to 50 of 63. Go back in thread:
Posted by rick_number1001@yahoo.com on August 27, 2001, at 2:20:17
In reply to Re: Doesage of Adrafinil - all, posted by SLS on June 18, 2000, at 19:46:54
I haven't heard Mitch.
The Dr. who I was taking 90mg Nardil under told me that Nardil
is statistically safer than penicillin. Also, that those
who develop hypertensive crisis with Nardil normally already
have some sort (I don't remember what) of heart problem and
there likely would be a problem occuring later anyway.I would point out that Medline searches will show that hypertensive
crisis in the last 10-15 years are difficult to find
Much easier to find are all sort of other problems, serotonin syndrome
with SSRI and other serotonin combos (or even Paxil alone),
(serotonin syndrome is often deadly). Viagra alone killed something
like over a 150 in a few months didn't it?Frankly, I eventually tried stimulants, Wellbutrin, yohimbine,
and other dopaminergics/noradrengerics with Nardil and generally
if I got any reaction my blood pressure tended to down a bit.
(Blood pressure cuff).Unfortunately many doctors are so unfamiliar with MAOI's
and often even benzodiazepines.MAOI's are not a first choice for normal depression,
because Prozac frankly usually does the job.It is a shame that MAOI's get such bad press.
The best Dr. (run universities, researchers, etc)
typically are the ones pointing out how much
underused Nardil and Parnate are.Many good Dr. claim there most robust responses
to a variety of disorders with MAOI's, often
Parnate simply with a low dose with if anything
is prosexual.OK - end of babble.
By the way, that Joe Schmoe guy sounds like he
is afraid to go for good results. I would ask
him why he is so negative, critical,
and what his productive ideas are, but I know
how these guys are. They just want attention
for there complaints.BTW, personally I did get fed up with Nardil
after 2 years at 90mg. Only 1 side effect,
sexual side effects but as I said nothing like
most SSRI's, even 20mg Celexa was worse.Now I keep Nardil at 60 and augment. Keeps
side effects minimal, sexual side effects no
problem. Results good.Lots of options, Nardil is not required.
Rick_number1001@yahoo.com
http://www.socialfear.com
> There are transdermal patches of phenelzine, and I believe tranylcypromine (parnate), that are supposed to be in clinical studies right now. I would really want to try an MAOI, but my doc says NO. The patches are supposed to be a way of bypassing the gut so you don't have the diet restrictions, but still would have to be cautious about drug interactions. Does anybody know what the status of these patches is??> > It sounds like the problems Nardil causes are in the body while the benefits are in the brain.
> >
> > The scientists need to develop some way to make a MAOI that only works in the brain and is not utilized by the rest of the body. Maybe some second pill that you take an hour later that destroys the MAOI, but that cannot cross the blood-brain barrier.
>
> > Hi John.
>
> Thanks for such a comprehensive post.
>
> I was wondering what the problem is with combining St. John's Wort with Paxil?
>
> Also, when the comparisons are made between SJW and tricyclics, is there any particular mechanism being referred to, such as reuptake inhibition?
>
> Thanks.
>
>
> - Scott
Posted by Dr. Bob on August 27, 2001, at 13:30:22
In reply to Re: Doesage of Adrafinil - all » SLS, posted by rick_number1001@yahoo.com on August 27, 2001, at 2:20:17
> By the way, that Joe Schmoe guy sounds like he
> is afraid to go for good results. I would ask
> him why he is so negative, critical,
> and what his productive ideas are, but I know
> how these guys are. They just want attention
> for there complaints.Please don't jump to conclusions about others or put them down. Thanks,
Bob
PS: Follow-ups, if any, regarding civility should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
Posted by Rick on August 28, 2001, at 1:32:13
In reply to Re: Doesage of Adrafinil - all » SLS, posted by rick_number1001@yahoo.com on August 27, 2001, at 2:20:17
To Craig:
> Now I keep Nardil at 60 and augment. Keeps
> side effects minimal, sexual side effects no
> problem. Results good.What do you think was the key element in reducing the sexual side effects from Nardil?
To Joe Schmoe:
>It sounds like the problems Nardil causes are in the body while the benefits are in the brain.
Many, if not most, of the physically-expressed side effects are probably brain-driven, as in a stroke victim who can write fluently but has trouble speaking -- even though the muscles that control speech are intact.
To Mitch -
I hadn't heard anything about the Parnate or Nardil patches. That would be great for a lot of people. If the MAOI never enters the gut, I belive there's no chance for tyramine inhibition.
I know that a poster here, Adam, was in the clinical trials for a selegiline patch (at high doses which would necessitate food restrictions if taken orally).To me the most exciting news is the phase II (or is it III) trials of the reversible (no food restrictions, ostensibly low-side-effect) MAOI befloxatone. So far it is reported to be about as effective as Nardil, and much more effective than the currently=marketed reversible MAOI moclobemide.
Rick
Posted by rick_number1001@yahoo.com on August 28, 2001, at 3:22:21
In reply to Re: Doesage of Adrafinil - all, posted by JohnL on June 17, 2000, at 17:52:50
To members: I apologize for my unnessary and
unfriendly comments in my earlier post.(BTW, some follow posts give me a box too short
for my email name so I reply to certain ones
that give a box with enought letters in it, sorry
for confusion caused by that).Rick:
Mainly just the dose is keeping down Nardil related
sexual side effects in my case. Dose is related
to weight and my weight is about 200 at 6'3".
Nardil 60 alone gives me only barely noticable
effects, and adding Klonopin probably reverses
those.I will add that I've been taking 1.25 finasteride
(ie; Propecia) for hair loss for several years.
I've gone lower or off at times and I can tell
that probably I'd have absolutely no sexual side
(or overall prosexual) effects if I dropped
finasteride. I guess I'd
rather not go bald right now, who knows maybe I'll
change my mind one day. I'm pretty certain
efficacy of my SP regimen goes down some too
with the addition of finasteride. Vanity !Finasteride raises testoterone, but lowers
dihydrotestorone by a greater percentage. They
are (I read), the 2 most potent male hormones.I feel that some psychotropics mediate these
and other hormones. Provigil and Wellbutrin,
are 2 prosexual (at least for me, both clearly
enhance libido, and Wellbutrin enhances every
aspect of sexual response), meds that also reverse part or
most (positive and negative) aspects of my
finasteride as well. !! I was not surpirsed
to see the post of the female mentioing that
Provigil was not recommended for use with
contraceptives!!!Also, Klonopin increases my libido and
agression, as does Provigil. Nardil really does
not at 60mg,
but on the other hand also does not sap my energy
and libido the way that Celexa 20mg, Paxil 30mg,
and Zoloft 50mg does.In the last year it has been humbling to realize
for me to realize that probably the biggest
factor reducing overall satisfaction of my
treatment has been my hormone altering hair loss
med!!!> To Craig:
>
> > Now I keep Nardil at 60 and augment. Keeps
> > side effects minimal, sexual side effects no
> > problem. Results good.
>
> What do you think was the key element in reducing the sexual side effects from Nardil?
>
> To Joe Schmoe:
>
> >It sounds like the problems Nardil causes are in the body while the benefits are in the brain.
>
> Many, if not most, of the physically-expressed side effects are probably brain-driven, as in a stroke victim who can write fluently but has trouble speaking -- even though the muscles that control speech are intact.
>
> To Mitch -
>
> I hadn't heard anything about the Parnate or Nardil patches. That would be great for a lot of people. If the MAOI never enters the gut, I belive there's no chance for tyramine inhibition.
> I know that a poster here, Adam, was in the clinical trials for a selegiline patch (at high doses which would necessitate food restrictions if taken orally).
>
> To me the most exciting news is the phase II (or is it III) trials of the reversible (no food restrictions, ostensibly low-side-effect) MAOI befloxatone. So far it is reported to be about as effective as Nardil, and much more effective than the currently=marketed reversible MAOI moclobemide.
>
> Rick
Posted by Mitch on August 28, 2001, at 7:16:32
In reply to Re: Most Effective Med For Social Phobia, posted by Rick on August 28, 2001, at 1:32:13
> To Mitch -
>
> I hadn't heard anything about the Parnate or Nardil patches. That would be great for a lot of people. If the MAOI never enters the gut, I belive there's no chance for tyramine inhibition.
> I know that a poster here, Adam, was in the clinical trials for a selegiline patch (at high doses which would necessitate food restrictions if taken orally).
>
> To me the most exciting news is the phase II (or is it III) trials of the reversible (no food restrictions, ostensibly low-side-effect) MAOI befloxatone. So far it is reported to be about as effective as Nardil, and much more effective than the currently=marketed reversible MAOI moclobemide.
>
> Rick
Thanks for the info. I also asked my doc about selegiline and got another NO. Perhaps befloxatone would be okeedokee. I can't tolerate SSRi's mainly because they worsen my mood cycling and cause dystonia. TCA's have too many cardiovascular sfx. Wellbutrin and pstims have no antipanic efficacy. I wonder if befloxatone has a lot less orthostatic hypotension than the other MAOi's? (I can't handle Remeron primarily because of that)Mitch
Posted by Dr. Bob on August 28, 2001, at 8:31:14
In reply to Reply to Rick and apology to board » JohnL , posted by rick_number1001@yahoo.com on August 28, 2001, at 3:22:21
> To members: I apologize for my unnessary and
> unfriendly comments in my earlier post.Thanks.
> (BTW, some follow posts give me a box too short
> for my email name so I reply to certain ones
> that give a box with enought letters in it, sorry
> for confusion caused by that).Sorry, I shortened the box. You may be the only one affected. What about re-registering as, say, "rick_number1001"? Sorry for the inconvenience,
Bob
Posted by Rick on August 28, 2001, at 17:45:35
In reply to Re: Most Effective Med For Social Phobia, posted by Rick on August 28, 2001, at 1:32:13
>
> To me the most exciting news is the phase II (or is it III) trials of the reversible (no food restrictions, ostensibly low-side-effect) MAOI befloxatone. So far it is reported to be about as effective as Nardil, and much more effective than the currently=marketed reversible MAOI moclobemide.
>
> RickUnfortunately, my info was a little out of date. I found out after posting that befloxatone was abandonded late last year, when Phase III trials for depression failed to show clinically significant results.
Rick
Posted by Rick on August 28, 2001, at 18:43:31
In reply to Reply to Rick and apology to board » JohnL , posted by rick_number1001@yahoo.com on August 28, 2001, at 3:22:21
> I will add that I've been taking 1.25 finasteride
> (ie; Propecia) for hair loss for several years.
> I've gone lower or off at times and I can tell
> that probably I'd have absolutely no sexual side
> (or overall prosexual) effects if I dropped
> finasteride. I guess I'd
> rather not go bald right now, who knows maybe I'll
> change my mind one day. I'm pretty certain
> efficacy of my SP regimen goes down some too
> with the addition of finasteride. Vanity !
>
> Finasteride raises testoterone, but lowers
> dihydrotestorone by a greater percentage. They
> are (I read), the 2 most potent male hormones.Interesting. Were you taking Propecia BEFORE Klonopin? I'm sure you know that many psychotropics, including Klonopin and Wellbutrin, can sometimes cause hair loss.
My understanding was that sexual dysfunction from Propecia was fairly uncommon (1-2% incidence), and that when it occurs it usually goes away after awhile. But I got that mainly from Merck's literature, and you're the second person who I've seen mention anti-sexual effects in just the last few days. I do know one guy who confided to me that he was a little worried about trying it for that reason, but later reported that he needn't have been concerned.
I started Propecia months after stopping Nardil, when I was taking Klonopin and noticed a small but worsening amount of hair loss that didn't seem natural because of the pattern and suddenness. So I started both Propecia and a mineral combo that my pdoc recommended (I had been thinking about starting a multi-vitamin/mineral anyway). It's worked out great, and my strong feeling is that its the Propecia that's doing the trick (I hope so, given that insurance doesn't cover it!)
Propecia didn't affect me sexually, as far as I can tell, but Celexa and high-dose Neurontin certainly did. I've had sexual enhancement on the current med combo, but I don't know how much to attribute to the Provigil vs. the Serzone. I'm leaning toward the Provigil. (I already knew that Klonopin acted as a bit of a sexual enhancer for me overall, as it does for you, although in my case it might be just slighlty inhibitive in terms of the "stamina" aspect.)
> In the last year it has been humbling to realize
> for me to realize that probably the biggest
> factor reducing overall satisfaction of my
> treatment has been my hormone altering hair loss
> med!!!If you have no problem going lower or off the Propecia for awhile, as you mentioned above, maybe you could try Rogaine (topical minoxidil) or the mineral supplement or both for awhile to see if they help without the sexual effects. A couple of weeks ago, someone here reported excellent success with Rogaine. On the otherhand, if you're having a lot of success with Propecia I can see why you might be be hesitant to change.
BTW, re taking 1.25 mg Propecia:
1. How do you split those tiny hexagonal pills??
2. The mfr claims that doses over 1 mg give no add'l benefit (although maybe they're assuming the next step up is 2). Do you find less effectiveness at 1? But with some lessening of sexual impact, perhaps?Rick
Posted by Rick on August 28, 2001, at 20:09:28
In reply to Re: Most Effective Med For Social Phobia » Rick, posted by Mitch on August 28, 2001, at 7:16:32
>Perhaps befloxatone would be okeedokee.
Well, by now you've seen my post about the decision to pull the plug on befloxatone.
> Thanks for the info. I also asked my doc about selegiline and got another NO.
If it was to be used as a primarily agent for any kind of anxiety disorder or anxious depression -- rather than as low-dose augmentor in a safe combo such as with a benzo or BuSpar -- selegiline is probably the LAST thing you should try. Believe me, it ain't no Nardil!
I'm assuming that you're being treated for depression, too. If so, have you tried the lower-side-effects and no-food-restrictions reversible MAOI moclobemide? (If you're in the U.S., you can order it, with your Doctor's prescription, from Canada.) Its success rate isn't nearly as high as Nardil's, but you just never know...it's been great for some people for both Social Phobia and depression. How about Neurontin? It also works for some. (Didn't work for me, and at very high doses caused some sexual dysfunction.)
If you're not depressed, have you tried Klonopin? (Daily, not as-needed.) It's generally the most effective SP med there is, with the highest treatment-effect yet seen in placebo-controlled SP studies. And this is one case where study results actually seem to be mirrored in personal reports. For most people it has none-to-mild side effects after the initial week or two, especially if the dosage is kept reasonably low. In my case it beat a whole series of AD's hands-down with respect to both the SP treatment and lack of side effects (except for a few unexpected GOOD ones and some POSSIBLE memory implications.)
Posted by SLS on August 28, 2001, at 21:09:45
In reply to Re: BefloxaGONE (Most Effectve Med For Soc Phobia), posted by Rick on August 28, 2001, at 17:45:35
> >
> > To me the most exciting news is the phase II (or is it III) trials of the reversible (no food restrictions, ostensibly low-side-effect) MAOI befloxatone. So far it is reported to be about as effective as Nardil, and much more effective than the currently=marketed reversible MAOI moclobemide.
> >
> > Rick
>
> Unfortunately, my info was a little out of date. I found out after posting that befloxatone was abandonded late last year, when Phase III trials for depression failed to show clinically significant results.
>
> Rick*^$#!
What was your source of information? I had planned to call Sanofi tomorrow. A doctor Palumbo was supposed to be directing the project. Damn.
- Scott
Posted by Rick on August 28, 2001, at 21:53:02
In reply to Re: BefloxaGONE (Most Effectve Med For Soc Phobia), posted by SLS on August 28, 2001, at 21:09:45
> > >
> > > To me the most exciting news is the phase II (or is it III) trials of the reversible (no food restrictions, ostensibly low-side-effect) MAOI befloxatone. So far it is reported to be about as effective as Nardil, and much more effective than the currently=marketed reversible MAOI moclobemide.
> > >
> > > Rick
> >
> > Unfortunately, my info was a little out of date. I found out after posting that befloxatone was abandonded late last year, when Phase III trials for depression failed to show clinically significant results.
> >
> > Rick
>
>
>
> *^$#!
>
> What was your source of information? I had planned to call Sanofi tomorrow. A doctor Palumbo was supposed to be directing the project. Damn.
>
>
> - ScottThe 9/18/2000 issue of R & D Focus Drug News says:
"Sanofi-Synthelabo announced at a company presentation in London, UK, that its selective and reversible monoamine oxidase A inhibitor, befloxatone (MD 370503), is no longer in active development. This oxazolidone derivative was being evaluated as a treatment for depression and smoking cessation in Europe and the USA. The company stated that no significant beneficial effect was achieved in phase III studies for either indication."
Also, if you go to Sanofi's website and download the 2000 annual report, you'll see it listed as one of the three development-discontinued drugs, no explanation given.
Posted by SalArmy4me on August 28, 2001, at 22:19:27
In reply to Re: Most Effective Med For Social Phobia » Rick, posted by Mitch on August 28, 2001, at 7:16:32
Moclobemide for Social Phobia: The Best Med?
The British Journal of Psychiatry
Volume 172(5) May 1998 pp 451-452:"Sir: The claim made by Schneier et al (1998) [2] that moclobemide is not indicated as a first-line therapy in social phobia should be challenged. Social phobia is a relatively common anxiety disorder, which rarely presents to psychiatrists even when there is marked impairment in occupational and social functioning (Weiller et al, 1996) [3]. Thus, a first-line therapy for social phobia should be effective, well tolerated and suitable for prescription within primary care.
Addressing the latter two issues, moclobemide has a simple dosing regime and is well tolerated; Schneier et al found eight-week drop-out rates were 24% on moclobemide v. 25% on placebo. Their most serious objection to the use of moclobemide as a first-line treatment is one of efficacy. They found 23% of patients with severe or very severe social phobia treated with moclobemide for eight weeks were rated as much or very much improved (v. 0% in the placebo group), although numbers were too small to reach statistical significance. This finding of greater efficacy in more severe social phobia is also supported by the International Multicenter Clinical Trial Group on Moclobemide in Social Phobia (1997) [1] who found patients with severe social phobia treated with 600 mg moclobemide had a 52% response rate (v. 32% on placebo)."
Dimensional Versus Categorical Response to Moclobemide in Social Phobia: Reply to Letter
University of Iowa College of Medicine; Psychiatry Research; Iowa City, Iowa 52242-1000:"Drs. Blanco and Liebowitz feel that we may have demonstrated efficacy for moclobemide in our social phobia trial that we failed to appreciate. [1] Their letter gives us an opportunity to clarify several points.
First, not all controlled trials have shown efficacy. [1-4] For instance, Schneier and associates [2] observed few differences between moclobemide (mean dose of 728 mg daily) and placebo after 8 weeks, and the International Multicenter Trial [3] indicated modest superiority for 600 mg daily (47% at least moderately improved on moclobemide vs. 34% on placebo) but not for 300 mg.
It is not clear whether the difference between drug (moclobemide 900 mg) and placebo that we observed on the Liebowitz Social Anxiety Scale at 12 weeks (mean +/- SE, 55.7 +/- 3.5 vs. 51.6 +/- 3.5) is clinically, although statistically, significant. When evaluating results it is important to consider all measures, and in this case, few statistically significant differences were observed at the end of 12 weeks for any of the fixed doses ranging from 75 to 900 mg daily.
In our trial the clinical impression of change was used to determine responder status (rating scale of 1 [very much improved] to 7 [very much worse]). As Drs. Blanco and Liebowitz indicate, categorical measures of this kind are often less sensitive to drug-placebo differences. This is not always the case, however, and this measure was selected as the primary measure of efficacy before starting the trial. Such global ratings of change are important because they reflect meaningful change; without them it can be difficult to gain a clinical sense of the outcome of a trial.
Drs. Blanco and Liebowitz noted that in our trial, subjects receiving moclobemide 900 mg daily continued to improve between 8 and 12 weeks, and they attributed this improvement to the drug. Unfortunately, data concerning change in effect size between 8 and 12 weeks were not available, so we could not support their inference.
Had our trial ended at 8 weeks, we might have concluded that the highest fixed dose of moclobemide (900 mg daily) is effective. However, most of the differences seen at 8 weeks disappeared at 12 weeks for unknown reasons. Differences at 8 weeks may have been chance findings; tolerance to early drug effects may have developed by 12 weeks, or robust response to placebo may have overwhelmed the small drug effects seen earlier.
It is certainly possible, as we stated in our report, that moclobemide is effective for social phobia but at doses higher than those used. Nevertheless, the safety of such doses has not, to our knowledge, been established. Given the proven efficacy of standard monoamine oxidase inhibitors (MAOIs) (i.e., phenelzine), [4] reversible MAOIs remain an attractive alternative. Further efforts to establish efficacy or lack of it are warranted."
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Posted by gilbert on August 28, 2001, at 23:39:04
In reply to Most Effective Med For Social Phobia: Moclobemide, posted by SalArmy4me on August 28, 2001, at 22:19:27
I am getting seriously worried about Salarmy4me the posts are getting more and more propagandish in nature and I have really respected alot of sal's opinions and help on drugs before but all this talk about the General and the war cry makes me hope an pray that sal is still seeing someone who is monitoring his medical situation. I am not being synical either I am dead serious.... Sal are you feeling O >K >
Concerned,
Gil
Posted by rick_number1001@yahoo.com on August 29, 2001, at 2:41:45
In reply to Re: Doesage of Adrafinil, posted by michael on June 17, 2000, at 12:28:20
Rick:
Nardil 60mg is low enought at my height/weight
to prevent sexual side effects, especially
adding prosexual meds klonopon and provigil.I also take finasteride (aka propecia) 1.25mg
day for hair loss. I stop at times and can
tell it gives me some mild sexual side effects
I do have and can eliminate prn if desired.Still - it's a tough call - my sp med efficacy
probably also goes down when adding finasteride.Vanity! I've been taking finasteride several
years it has worked very well.Interestingly provigil at 100mg and wellbutrin
50+mg with my nardil and klonoipn tends to
reverse the hair sparing effects of finasteride
as well as the adverse reactions. Wellbutrin
especially.Seems there is often really no way to completely
outwit Mother Nature!!!Craig
great site: http://www.biopsychiatry.com
Posted by SLS on August 29, 2001, at 7:21:00
In reply to Most Effective Med For Social Phobia: Moclobemide, posted by SalArmy4me on August 28, 2001, at 22:19:27
Four years ago, I had a conversation with the director of the US moclobemide project at Roche. At that time, he told me they were trying to get moclobemide approved for social phobia in the US. They had elected not to pursue an indication for depression. He told me that the US trials did not demonstrate enough efficacy to continue the project, and it was dropped.
- Scott
Posted by SLS on August 29, 2001, at 7:58:10
In reply to Re: please stop with propoganda and stick to meds, posted by gilbert on August 28, 2001, at 23:39:04
> I am getting seriously worried about Salarmy4me the posts are getting more and more propagandish in nature and I have really respected alot of sal's opinions and help on drugs before but all this talk about the General and the war cry makes me hope an pray that sal is still seeing someone who is monitoring his medical situation. I am not being synical either I am dead serious.... Sal are you feeling O >K >
>
> Concerned,
>
> Gil
I share your concern. I am not comfortable suggesting interpretations, however, I have at times been struck by pace, focus, and judgment.Hi Sal.
Just making sure...
- Scott
Posted by petter on August 29, 2001, at 13:01:05
In reply to Re: Most Effective Med For Social Phobia: Moclobemide » SalArmy4me, posted by SLS on August 29, 2001, at 7:21:00
> Four years ago, I had a conversation with the director of the US moclobemide project at Roche. At that time, he told me they were trying to get moclobemide approved for social phobia in the US. They had elected not to pursue an indication for depression. He told me that the US trials did not demonstrate enough efficacy to continue the project, and it was dropped.
>
> - Scott
Hi...I really agree with you Scott. But Moclobemide is approved for Social Phobia. I have worked many years in hospital, and talked with many doctors. I can´t rememer none of them had posetive respons in these "weake" meds. I have tried it too. But with no success at all. SSRI are proberly mutch better, or the old mao Nardil.
I reallaly do´nt know whitch place Moclobemide have in generell.
I know that in very resistent social phobias, some very knowledges psychian in these areas add an small amount of ssri. 10 mg Citalopram to monoclbemide can makes dramaticly improvment. But be very carfully, because of the seretonergic syndorom. I have never heare about it in this combo.
Best Wishes//Petter
Posted by Sparkboy on August 30, 2001, at 1:43:11
In reply to Re: Most Effective Med For Social Phobia: Moclobemide, posted by petter on August 29, 2001, at 13:01:05
> Hi...
>
> I really agree with you Scott. But Moclobemide is approved for Social Phobia. I have worked many years in hospital, and talked with many doctors. I can´t rememer none of them had posetive respons in these "weake" meds. I have tried it too. But with no success at all. SSRI are proberly mutch better, or the old mao Nardil.
>
> I reallaly do´nt know whitch place Moclobemide have in generell.
>
> I know that in very resistent social phobias, some very knowledges psychian in these areas add an small amount of ssri. 10 mg Citalopram to monoclbemide can makes dramaticly improvment. But be very carfully, because of the seretonergic syndorom. I have never heare about it in this combo.
>
> Best Wishes//PetterPetter
Hello, just a note, I've used moclobemide for
about 5 years now for atypical depression. I only
use half a 150 mg tab. a day. It doesn't get at
the core of the depression, but it gets me out of
bed, prevents the insomniac/hyper episodes I used to
get in the spring and fall, and keeps me from
lapsing into a more severe oversleeping depression
in the winter. I am pleased with what it does
for these more physical-type symptoms. I get mine
from Canada. I wish the US would just approve it
and let doctors and their patients decide what
it's good for. It's a safe drug that does have
its uses.--John
Posted by petter on August 30, 2001, at 9:04:14
In reply to Re: Most Effective Med For Social Phobia: Moclobemide » petter, posted by Sparkboy on August 30, 2001, at 1:43:11
>
> > Hi...
> >
> > I really agree with you Scott. But Moclobemide is approved for Social Phobia. I have worked many years in hospital, and talked with many doctors. I can´t rememer none of them had posetive respons in these "weake" meds. I have tried it too. But with no success at all. SSRI are proberly mutch better, or the old mao NardilHi John...
Very glad to hear that the drug help your mood. Perhaps it have some benefit in atypical depression. But for Social Phobia, it has probably a limited place. We have had the meds here in Sweden for over 10 years.
I hope you soon will have it in U.S
Best wishes//Petter
> >
> > I reallaly do´nt know whitch place Moclobemide have in generell.
> >
> > I know that in very resistent social phobias, some very knowledges psychian in these areas add an small amount of ssri. 10 mg Citalopram to monoclbemide can makes dramaticly improvment. But be very carfully, because of the seretonergic syndorom. I have never heare about it in this combo.
> >
> > Best Wishes//Petter
>
> Petter
>
> Hello, just a note, I've used moclobemide for
> about 5 years now for atypical depression. I only
> use half a 150 mg tab. a day. It doesn't get at
> the core of the depression, but it gets me out of
> bed, prevents the insomniac/hyper episodes I used to
> get in the spring and fall, and keeps me from
> lapsing into a more severe oversleeping depression
> in the winter. I am pleased with what it does
> for these more physical-type symptoms. I get mine
> from Canada. I wish the US would just approve it
> and let doctors and their patients decide what
> it's good for. It's a safe drug that does have
> its uses.
>
> --John
Posted by SLS on August 30, 2001, at 11:47:57
In reply to Re: Most Effective Med For Social Phobia: Moclobemide, posted by petter on August 30, 2001, at 9:04:14
> Hello, just a note, I've used moclobemide for
> about 5 years now for atypical depression. I only
> use half a 150 mg tab. a day. It doesn't get at
> the core of the depression, but it gets me out of
> bed, prevents the insomniac/hyper episodes I used to
> get in the spring and fall, and keeps me from
> lapsing into a more severe oversleeping depression
> in the winter. I am pleased with what it does
> for these more physical-type symptoms. I get mine
> from Canada. I wish the US would just approve it
> and let doctors and their patients decide what
> it's good for. It's a safe drug that does have
> its uses.
>
--JohnHi John.
I agree with you. The more tools we have at our disposal, the better. I made the comment along another thread that almost every marketed antidepressant in the world is a miracle drug for at least some people. The nice thing about moclobemide is that it most often brings about significant relief from depression during the first week.
I feel demoralized that several newer medications that I would have liked to have tried have been shelved by their manufacturers.
Brasofensine by NeuroSearch: DA reuptake inhibition – developed for Parkinson’s – lack of comittment by co-sponsors.
Brofaromine (Consonar) by Ciba-Geigy: RIMA, 5-HT reuptake inhibition – developed for depression and social anxiety - withdrawn by the company from European markets for unspecified non-medical reasons.
Befloxatone – Bristol-Myers Squibb: – RIMA – developed for depression and social phobia – “no significant beneficial effect was achieved in phase III.”
* NS2389 by NeuroSearch: – DA + NE + 5-HT reuptake inhibition – developed for depression – decision not to appropriate funds for phase II safety requirements.Cool. Update:
“COPENHAGEN (AFX) - NeuroSearch AS said it and GlaxoSmithKline PLC are resuming their collaboration on the antidepressant NS2389.
- Scott
Posted by kregpark@yahoo.com on September 1, 2001, at 5:38:37
In reply to Re: Most Effective Med for Social Phobia » rick_number1001@yahoo.com, posted by Rick on August 28, 2001, at 18:43:31
From: (Formerly rick_number1001@yahoo.com)
Dr. Bob: Thanks for notification about box.
Name changed and can see all messages too!
Great site!Rick:
Yes, actually thinking back, I was taking Propecia while on Nardil 90mg. No difference noted, had moderate side effects already but don't think much difference initially at 1.25mg. Later switched over 4 months to 45mg Nardil and 4.5Klonopin (thanks for the Klonopin article years ago Dr. Bob!!) - I did research and convinced my doc Klonopin used regular could be safe. Anyway, this combo spurred me to 10 first dates in 5 months (a miracle for me!!). Still with propecia no side effects at all sexually.
I switched later to Zoloft + Klonopin (then added Serzone) and trialed many other things as well. So I guess that after rethinking after your question I'm no longer so sure that after 1 year or so finasteride started to affect me more. I never though about it until I stopped it once because of the "reported no sexual side effects over placebo" data from the FDA studies. HA! Similar to SSRI FDA studies!!! :)
> Interesting. Were you taking Propecia BEFORE Klonopin? I'm sure you know that many psychotropics, including Klonopin and Wellbutrin, can sometimes cause hair loss.I know of about 8-10 personal cases, at least 3 or so had side effects. Maybe more if the others didn't mention it. Plus they mostly take 1mg, not 1.25mg.
> My understanding was that sexual dysfunction from Propecia was fairly uncommon (1-2% incidence), and that when it occurs it usually goes away after awhile. But I got that mainly from Merck's literature, and you're the second person who I've seen mention anti-sexual effects in just the last few days. I do know one guy who confided to me that he was a little worried about trying it for that reason, but later reported that he needn't have been concerned.So we are both taking finasteride also!!!??? Interesting the paradoxic effect you got at first. I'd like to hear about the mineral!! Yes, Klonopin never seemed to give me a problem until I added (to Nardil60 + Klonopin2.5) first WEllbutrin 50mg (very effective but rash and hair loss at scalp!! aghh!), then Provigil (less problematic than Wellbutin).
> I started Propecia months after stopping Nardil, when I was taking Klonopin and noticed a small but worsening amount of hair loss that didn't seem natural because of the pattern and suddenness. So I started both Propecia and a mineral combo that my pdoc recommended (I had been thinking about starting a multi-vitamin/mineral anyway). It's worked out great, and my strong feeling is that its the Propecia that's doing the trick (I hope so, given that insurance doesn't cover it!)Celexa was worst SSRI for me, lowest dose fairly devastating. Otherwise I really liked Celexa!!! But no way.
Sounds like you combined meds work well together for low side effects also!
Klonopin is reported to often increase sex drive, though at least 1 study contradicts the more common opinion.
I think that Klonopin and Wellbutrin, if they increase hair loss (and since 1 or likely both) increase dopamine at least at some sites in the brain (Klonopin probably more selective), I think both these meds probably affect male hormones in many, perhaps DHT levels even.
> Propecia didn't affect me sexually, as far as I can tell, but Celexa and high-dose Neurontin certainly did. I've had sexual enhancement on the current med combo, but I don't know how much to attribute to the Provigil vs. the Serzone. I'm leaning toward the Provigil. (I already knew that Klonopin acted as a bit of a sexual enhancer for me overall, as it does for you, although in my case it might be just slighlty inhibitive in terms of the "stamina" aspect.)I'm 34, and I've taken minoxidil since before it was approved for hair loss starting when I was 18. I took finasteride after phase II of Propecia trials came out. I use both in combo now, which in monkeys (ha ha, rats not used for hair loss studies!!) grow more hair with the combo, significantly more!!
> If you have no problem going lower or off the Propecia for awhile, as you mentioned above, maybe you could try Rogaine (topical minoxidil) or the mineral supplement or both for awhile to see if they help without the sexual effects. A couple of weeks ago, someone here reported excellent success with Rogaine. On the otherhand, if you're having a lot of success with Propecia I can see why you might be be hesitant to change.I used to use a razor blade, then I discovered that breaking them in half and each half in half by hand works great and almost no dust.
My response has more robust at 1.25 than 1, and I saw quick sprouts in the front at 2.5 but the sexual side effects more obviously bad, so I stopped that. I think my combo of things is not helping matters either, but all considered side effects are quite minimal and reversible prn as desired.> BTW, re taking 1.25 mg Propecia:
> 1. How do you split those tiny hexagonal pills??
> 2. The mfr claims that doses over 1 mg give no add'l benefit (although maybe they're assuming the next step up is 2). Do you find less effectiveness at 1? But with some lessening of sexual impact, perhaps?
> Rick
Posted by kregpark@yahoo.com on September 1, 2001, at 5:39:36
In reply to Re: Most Effective Med for Social Phobia » rick_number1001@yahoo.com, posted by Rick on August 28, 2001, at 18:43:31
From: (Formerly rick_number1001@yahoo.com)
Dr. Bob: Thanks for notification about box.
Name changed and can see all messages too!
Great site!Rick:
Yes, actually thinking back, I was taking Propecia while on Nardil 90mg. No difference noted, had moderate side effects already but don't think much difference initially at 1.25mg. Later switched over 4 months to 45mg Nardil and 4.5Klonopin (thanks for the Klonopin article years ago Dr. Bob!!) - I did research and convinced my doc Klonopin used regular could be safe. Anyway, this combo spurred me to 10 first dates in 5 months (a miracle for me!!). Still with propecia no side effects at all sexually.
I switched later to Zoloft + Klonopin (then added Serzone) and trialed many other things as well. So I guess that after rethinking after your question I'm no longer so sure that after 1 year or so finasteride started to affect me more. I never though about it until I stopped it once because of the "reported no sexual side effects over placebo" data from the FDA studies. HA! Similar to SSRI FDA studies!!! :)
> Interesting. Were you taking Propecia BEFORE Klonopin? I'm sure you know that many psychotropics, including Klonopin and Wellbutrin, can sometimes cause hair loss.I know of about 8-10 personal cases, at least 3 or so had side effects. Maybe more if the others didn't mention it. Plus they mostly take 1mg, not 1.25mg.
> My understanding was that sexual dysfunction from Propecia was fairly uncommon (1-2% incidence), and that when it occurs it usually goes away after awhile. But I got that mainly from Merck's literature, and you're the second person who I've seen mention anti-sexual effects in just the last few days. I do know one guy who confided to me that he was a little worried about trying it for that reason, but later reported that he needn't have been concerned.So we are both taking finasteride also!!!??? Interesting the paradoxic effect you got at first. I'd like to hear about the mineral!! Yes, Klonopin never seemed to give me a problem until I added (to Nardil60 + Klonopin2.5) first WEllbutrin 50mg (very effective but rash and hair loss at scalp!! aghh!), then Provigil (less problematic than Wellbutin).
> I started Propecia months after stopping Nardil, when I was taking Klonopin and noticed a small but worsening amount of hair loss that didn't seem natural because of the pattern and suddenness. So I started both Propecia and a mineral combo that my pdoc recommended (I had been thinking about starting a multi-vitamin/mineral anyway). It's worked out great, and my strong feeling is that its the Propecia that's doing the trick (I hope so, given that insurance doesn't cover it!)Celexa was worst SSRI for me, lowest dose fairly devastating. Otherwise I really liked Celexa!!! But no way.
Sounds like you combined meds work well together for low side effects also!
Klonopin is reported to often increase sex drive, though at least 1 study contradicts the more common opinion.
I think that Klonopin and Wellbutrin, if they increase hair loss (and since 1 or likely both) increase dopamine at least at some sites in the brain (Klonopin probably more selective), I think both these meds probably affect male hormones in many, perhaps DHT levels even.
> Propecia didn't affect me sexually, as far as I can tell, but Celexa and high-dose Neurontin certainly did. I've had sexual enhancement on the current med combo, but I don't know how much to attribute to the Provigil vs. the Serzone. I'm leaning toward the Provigil. (I already knew that Klonopin acted as a bit of a sexual enhancer for me overall, as it does for you, although in my case it might be just slighlty inhibitive in terms of the "stamina" aspect.)I'm 34, and I've taken minoxidil since before it was approved for hair loss starting when I was 18. I took finasteride after phase II of Propecia trials came out. I use both in combo now, which in monkeys (ha ha, rats not used for hair loss studies!!) grow more hair with the combo, significantly more!!
> If you have no problem going lower or off the Propecia for awhile, as you mentioned above, maybe you could try Rogaine (topical minoxidil) or the mineral supplement or both for awhile to see if they help without the sexual effects. A couple of weeks ago, someone here reported excellent success with Rogaine. On the otherhand, if you're having a lot of success with Propecia I can see why you might be be hesitant to change.I used to use a razor blade, then I discovered that breaking them in half and each half in half by hand works great and almost no dust.
My response has more robust at 1.25 than 1, and I saw quick sprouts in the front at 2.5 but the sexual side effects more obviously bad, so I stopped that. I think my combo of things is not helping matters either, but all considered side effects are quite minimal and reversible prn as desired.Craig
http://www.socialfear.com
> BTW, re taking 1.25 mg Propecia:
> 1. How do you split those tiny hexagonal pills??
> 2. The mfr claims that doses over 1 mg give no add'l benefit (although maybe they're assuming the next step up is 2). Do you find less effectiveness at 1? But with some lessening of sexual impact, perhaps?
> Rick
Posted by kregpark@yahoo.com on September 1, 2001, at 5:53:08
In reply to Re: Most Effective Med For Social Phobia: Moclobemide, posted by petter on August 30, 2001, at 9:04:14
When I took moclobomide I noticed that for me it was
*defitely* pro-sexual and had no adverse side effects
for me.My trial was inadequate because I did sustain my high
dose longer than a week or so. It is very expensive
for me without a prescription.My sense was that I was not responding though. I recall
being disappointed because at that time the only
released studies were *very* positive. I even tried adding
an SSRI to it later, to make it "more like brofaromine" to no
avail. Usually I respond very quickly to meds that work,
in fact I always have. Although I guess I don't know for
sure in cases where I don't stick it out with meds giving
poor results, I did that with some meds (Effexor and Parnate are
examples - Parnate I tried for 4 months), but these meds did little
or no good for me (I could probably augment them now more
appropriately to get a pretty good response, especially Parnate).Anyway - my 2 cents.
> > Petter
> >
> > Hello, just a note, I've used moclobemide for
> > about 5 years now for atypical depression. I only
> > use half a 150 mg tab. a day. It doesn't get at
> > the core of the depression, but it gets me out of
> > bed, prevents the insomniac/hyper episodes I used to
> > get in the spring and fall, and keeps me from
> > lapsing into a more severe oversleeping depression
> > in the winter. I am pleased with what it does
> > for these more physical-type symptoms. I get mine
> > from Canada. I wish the US would just approve it
> > and let doctors and their patients decide what
> > it's good for. It's a safe drug that does have
> > its uses.
> >
> > --John
Posted by SLS on September 1, 2001, at 6:53:45
In reply to Reply to Rick and apology to board » JohnL , posted by rick_number1001@yahoo.com on August 28, 2001, at 3:22:21
> Finasteride raises testoterone, but lowers
dihydrotestorone by a greater percentage. They
are (I read), the 2 most potent male hormones.Isn't it DHT that is responsible for hair loss?
- Scott
Posted by kregpark@yahoo.com on September 3, 2001, at 1:58:46
In reply to Re: Reply to Rick and apology to board » rick_number1001@yahoo.com, posted by SLS on September 1, 2001, at 6:53:45
Yes, the scientists say that excessive DHT levels
at the scalp are responsible for male pattern baldness.
If I recall this correctly, there is an enzyme called
5 alpha reductase that converts testosterone to
dehydrotesterone (DHT). Finasteride (aka Propecia and
Prscar is finasteride 1mg and 5mg respectively)
inhibits the enzyme responsible for conversion.Hopefully I got all that right. There is also
2 types of the enzyme, which have different
reletive effects on conversion and locations of
conversion (the ideal goal is conversion at the scalp,
and not at the prostate!!!)kregpark@yahoo.com (formerly rick_number1001)
> Isn't it DHT that is responsible for hair loss?
>
>
> - Scott
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