New anti depressant? Less sexual side effect?

Hi,

This really follows on from the discussion I had on the previous thread

see http://pssd.forumotion.com/t34p60-cured-i-think-so

which I hijacked really.

Briefly. 20 years of being on various SSRIs has left me with PSSD.

I have tried 5htp for the last month but it has not really treated my issues which I have had for 30 years - i.e. OCD, Depression, fibromyalgia and which seem pretty permanent to affect me.

It looks like I have to change to another anti-depressant. Fortunately it seems I finally now have a good Psychiatrist who thinks 'outside the box' and she has suggested the drug Moclobemide, a mono-amine oxidase inhibitor drug.

I've looked this up on Wikepedia for example and it looks very good!!!

http://en.wikipedia.org/wiki/Moclobemide

Is this perhaps an alternative to SSRIs?

In Wikepedia for example I can quote.


"Moclobemide is widely underprescribed due to mis-informed physicians who wrongly equate the side effect profile of moclobemide with the potentially dangerous irreversible and non-selective older MAOIs."


"A concern of antidepressant adverse effects is sexual dysfunction, however moclobemide has actually been found to increase in libido and impaired erection, ejaculation and orgasm."

"Many antidepressants have an adverse effect on sexual function, however, treatment with moclobemide has actually been found to improve sexual dysfunction"

"Moclobemide is tolerated to a similar degree to the SSRI antidepressants, although unlike SSRIs moclobemide does not cause sexual dysfunction "


Am I right to be optimistic here?

They may be helpful. I do remember researching them a few years back. However I stopped due to the warnings about it. I think if you follow the restrictions they are ok though. Riluzole might be good for you as well, if you can actually get someone to prescribe it. Here is an article that talks about research into that type of drug.

http://www.npr.org/blogs/health/2012/01/31/146096540/i-wanted-to-live-new-depression-drugs-offer-hope-for-toughest-cases?sc=fb&cc=fp

I've taken both moclobemide and the older MAOIs - I'm currently taking Parnate, the most sensitive to the oft-advertised side effects, at quite a high dose, and drinking a bottle of red wine, which should kill me according to medical opinion. Well, medical opinion means squat.

Moclobemide wasn't a bad drug but it's renowned for being a little weak and I found it almost completely ineffectual. However, it's guaranteed to not give you something like PSSD, and I can't really remember too well but I'm 90% sure I had zero problems with libido when I was taking it (I had PSSD already at the time). If you can convince your doc to let you try it - you may specifically have to voice your concerns regarding sexual dysfunction - then it's definitely worth a try.

Well I hope it is effectual otherwise there is no point.

My Psychiatrist suggested it because of the the good reports about sexual dysfunction.

Btw if you had PSSD at the time how can you say you had "zero problems with libido"?

I mean comparatively - it didn't make it any worse.

If your psych suggested it you should definitely give it a try. It was less effective for me because I have fairly treatment-resistant depression.

Ok thanks Gumpy

I'm not sure if this is working. Im still suffering deep depression and severe chronic pain.

Has anyone got any suggestion for a realistic alternative?

The last thing that worked for me in this respect was an SSRI. (Effexor I think)

If I have to go on SSRIs or SNRIs. Any suggestions.

I want take Requip/Ropinerole also and am hoping this may counter the effects of the anti depressant I take?

For SSRI and tricyclic, you want Symbalta, and amitriptyline, but only as a last resort.

I have found pramipexole is effective for pain disorders including fibromyalgia, and ropinirole is even more effective. I have also discovered that a creatine monohydrate supplement is quite effective too. Bupropion may also be good for that.

Hi Sonny,

Thanks Sonny. As always I appreciated your informed input.

Cymbalta/Duloxetine would be the obvious choice. I think my Psychiatrist suggested this before, but I have heard so many bad things regarding Libido.

I am hoping maybe the Requip/Ropinerole that I definately intend to take will compensate?

I have considered Pramipexole but heard that the side effects can be really hard. Especially if you are managing alone as I am going have to do in the crap Country where the NHS doctors won't help me.

Amitriptoline I have tried before for Fibro (unsuccessfully) but only at very low dose.

Funny thing is, the last couple of days I have been a bit better so maybe there is still hope for the Moclobemide?

I am coming up to 4 weeks tommorrow on the full (600mg) dose. Maybe I should wait longer??

I would add creatine for sure. Then check with your doctor and see if ropinirole would be alright. I think that would greatly reduce your pain. I have even heard of doctors proscribing bupropion(Welbutrin) for pain disorders. People seem to have the most success stacking a few medications together for a cumulative effect.

Thanks Sonny.

OK, now 6 weeks on the Moclobemide and still pain.


I was never in this pain, nor such a weak mental state under the dreaded SSRIs (Prosac, Effexor). So unfortunately it looks like I may have to try the SNRI Cymbalta next.

I have to get some kind of stability back into my life. The last 3 years have been absolute hell.

My Roninerole have arrived from India and I am taking them.

Sonny, a questiion. Is it still possible for Ropinerole or anything else to compensate for any sexual dysfunction caused by medication such as Cymbalta while I am still on them.

It looks like I have no choice to take Cymbalta but I am hoping the Ropinerole can counteract the libido issues?

Thanks.

Adam.

That I am not sure about. I don't have any experience with that.

Ok well maybe I can report back if it happens.