Posted by Ken Blades on February 20, 2007, at 5:41:11
In reply to Are MAOIs ever ineffective?, posted by UgottaHaveHope on February 19, 2007, at 11:51:48
Nothing will work for everyone, every time;
some people respond well to things and some not at
all. You just have to try this-or-that and
see what works for you.Over the period of 30+ years I've been
on various antidepressants and antianxiety
drugs, Parnate has been the only thing that
has helped to any significant degree. I've
tried benzos; they work but the doses they
took to be effective also impaired my thinking
and reflexes. TCA's didn't do much for depression but caused a lot of bothersome side effects.
Serzone..Wellbutrin...nothing.
SSRI's either didn't work or in the case of Effexor, had an antidepressant effect in the
sense that it made me so emotionless that I
didn't feel depressed...or happy, or cared
about much of anything. I was no longer 'me'.I participated in a drug trial sponsored by
CIBA-Geigy[now Novartis]in the early 90's
for a drug, brofaromine, a type of MAO inhibitor
in the class with moclobemide[see below]. It
was the first time I knew I had social phobia..
prior to that, I was being treated for GAD and
depression.This drug really worked...I could FEEL it...I
couldn't believe the situations I could handle
where prior to this I would leave in a panic.
The trial went on for about nine months, and
then I was told the drug company was abruptly
stopping the trial...because of an error on
the part of CIBA-Geigy. They had intended to
have simultaneous trials for the drug in
depression going in the US; starting them
after these trials were over would delay the
FDA phases to approval of the drug. They
decided that they could not recoup their
costs through sales in the US. My supply
was gone..cold turkey. Very unpleasant
withdrawal.So, this was my way of finding out that
MAO inhibitors worked for me. It took
four years but I found a psych who would
prescribe Parnate and have been on it
ever since.
--------------------------------
"Another RIMA[reversible inhibitor of MAO - A] , brofaromine, has been showing good therapeutic results.
The first double-blind trial
with brofaromine
in 30 patients with SAD[Social anxiety disorder] was a 12-week
placebo controlled design. A significant improvement was
seen in 80% of the brofaromine group (150mg daily) but
not on placebo. Most common side effect was middle sleep
disturbance. During a follow-up period of 12 weeks a fur-
ther improvement was found in patients treated with
brofaromine. In another double-blind trial
77 patients
were randomized to treatment with brofaromine (n=37)
or placebo (n=40) for 12 weeks. In the brofaromine group,
78% of the patients scored much or very much improved
on the Clinical Global Impression scale, compared with
23% in the placebo group. The drug group improved fur-
ther during 9-month follow-up treatment period, whereas
60% of the placebo responders who continued long-term
treatment relapsed. The most frequent side effects in the
brofaromine group were sleep disturbances, dry mouth
and nausea.
Brofaromine was also analyzed in an another double-
blind study with placebo.
After one week of placebo,
102 patients were treated for 10 weeks (50 with placebo
and 52 with brofaromine). Brofaromine started with a 50
mg/day dose and was progressively increased up to 150
mg/day according to therapeutic response. Brofaromine
was significantly superior to placebo in the utilized evalu-
ation methods. 14 patients using brofaromine dropped
from the study precociously, 11 due to adverse effects.
The most commom adverse effects were insomnia, dizzi-
ness, dry mouth, anorexia and shaking.""Although it is also a RIMA, brofaromine (Conosar) differs from moclobemide
by having serotonin reuptake properties as well. There are 3 published studies
of brofaromine in patients with SAD,34–36 all of which have shown brofaromine
to be an efficacious treatment. Unfortunately, the development of brofaromine was
stopped by the manufacturer due to reasons unrelated to its safety or efficacy in SAD, and
it is not available for treatment. However, the effect size of brofaromine in the published
trials is similar to that of the MAOIs and SSRIs, suggesting that its clinical
development may have been stopped prematurely."
poster:Ken Blades
thread:734115
URL: http://www.dr-bob.org/babble/20070219/msgs/734392.html