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Re: Desipramine

Posted by SLS on May 6, 2001, at 18:54:10

In reply to Re: Desipramine, posted by Cindylou on May 6, 2001, at 12:43:44

Hi Cindy.

> The other option my doc and I discussed was the reversible MAOI called Manerix, available in Canada. Do you know anything about that drug?

Yes, some. However, my first question to you is whether or not you have tried Parnate, Nardil, or Marplan. Have you ever combined desipramine with any of these MAOIs?

Oh, before I ask my first question, my first first question is whether or not there is any possibility that you are bipolar. Have you tried adding lithium or any of the anticonvulsant mood-stabilizers along the way?

I am not a big fan of Manerix (moclobemide) when it comes to statistical success rate. However, it has been a miracle drug for some. It is very gentle in terms of side effects. Manerix is used to treat depression and social phobia. Antidepressant effects of Manerix occur rapidly, often producing an improvement within the first week. However, there is a tendency to require a series of dosage increases to maintain the improvement. Although the official recommended dosage range lies between 150mg and 600mg, the effective range observed clinically seems to be higher. 600mg to 900mg is most likely to produce the best results in more severe cases. Some people need as much as 1200mg.

Although the reversibility of Manerix is thought to obviate the need for a special diet, it is advisable to limit the intake of tyramine at any one meal to 50mg. There is also literature indicating that adding an SSRI to moclobemide is both safe and effective in treatment-resistant cases. With regard to both of these contentions, there are multiple anecdotal reports describing serious adverse events. However, I have no idea what the statistical rate of occurrence is.

I don't think you have anything to lose by trying Manerix.

As is the case with every other antidepressant that I am aware of, there is always the potential for it to make you feel worse or experience intolerable side effects. Of course, I'll be hoping that Manerix is your miracle drug. :-)

Good luck.


- Scott

 

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