![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 37 to 61 of 63. Go back in thread:
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 [email protected] 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 [email protected] on September 1, 2001, at 5:38:37
In reply to Re: Most Effective Med for Social Phobia » [email protected], posted by Rick on August 28, 2001, at 18:43:31
From: (Formerly [email protected])
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 [email protected] on September 1, 2001, at 5:39:36
In reply to Re: Most Effective Med for Social Phobia » [email protected], posted by Rick on August 28, 2001, at 18:43:31
From: (Formerly [email protected])
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 [email protected] 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 [email protected] 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 [email protected] on September 3, 2001, at 1:58:46
In reply to Re: Reply to Rick and apology to board » [email protected], 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!!!)[email protected] (formerly rick_number1001)
> Isn't it DHT that is responsible for hair loss?
>
>
> - Scott
Posted by Rick on September 6, 2001, at 2:10:24
In reply to Re: Most Effective Med For Social Phobia: Moclobemide » petter, posted by SLS on August 30, 2001, at 11:47:57
> Befloxatone – Bristol-Myers Squibb: – RIMA – developed for depression and social phobia – “no significant beneficial effect was achieved in phase III.”
>
Scott -I subscribe to Acurian, a free service that keeps track of investigational drugs and clinical trials. Acurian still has befloxatone listed as Phase III despite the article and annual report note about discontinuation.
I wrote Acurian asking about the apparent discrepancy. They tell me they were unable to receive confirmation of befloxatone abandonment after several attempts. Based on the details of the e-mail, it appears we can't be 100% certain that befloxatone is dead and buried. If you'd like to see the full response, e-mail me.
Rick
Posted by SLS on September 6, 2001, at 23:49:46
In reply to Re: Befloxatone » SLS, posted by Rick on September 6, 2001, at 2:10:24
Yay!!!!!!!!
> > Befloxatone – Bristol-Myers Squibb: – RIMA – developed for depression and social phobia – “no significant beneficial effect was achieved in phase III.”
> >
>
> Scott -
>
> I subscribe to Acurian, a free service that keeps track of investigational drugs and clinical trials. Acurian still has befloxatone listed as Phase III despite the article and annual report note about discontinuation.
>
> I wrote Acurian asking about the apparent discrepancy. They tell me they were unable to receive confirmation of befloxatone abandonment after several attempts. Based on the details of the e-mail, it appears we can't be 100% certain that befloxatone is dead and buried. If you'd like to see the full response, e-mail me.
>
> Rick
Posted by mickapoo on February 26, 2009, at 9:57:34
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA! » Lynne, posted by [email protected] on August 25, 2001, at 12:02:17
> Nardil (poop out) is due to doctors not
> knowing about it. Nardil dose needs to escalate
> 1 tablet every 1-3 weeks (when the good effects
> start to diminish). As with a benzodiazepine,
> dose escalation stops at the "therapeutic dose
> level". Usually this is 60-90mg.
>So how can you escalate it with 1 table every 1-3 weeks when you're already at 90 mg? It's pooping out for me but I'm not sure what to do.
Posted by ERMRug on February 27, 2009, at 9:38:18
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA! » [email protected], posted by mickapoo on February 26, 2009, at 9:57:34
Sorry, what does "poop out" mean other than the obvious?
Posted by myco on February 27, 2009, at 11:10:58
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA! » [email protected], posted by mickapoo on February 26, 2009, at 9:57:34
I think it's time to augment. It's possible and safe (for some - although there are always risks) to go above the therapeutic dose max of 90mg. Generally speaking though a gp will not approve this idea...you would need a knowledgeable or understanding pdoc. Some people can actually lower nardil dose with addition of another med that potentiates nardil effects...although this looks better on paper than in the patient. It can work but will take trial and error. I've been looking at augments myself...maoi+tca has/is been done for ages despite 'neon danger lights' of taking tca's with maois. Many studies show desipiramine and nortriptyline as safe with maois.
Look up 'maoi tca' on pubmed for guidance.
myco> So how can you escalate it with 1 table every 1-3 weeks when you're already at 90 mg? It's pooping out for me but I'm not sure what to do.
Posted by myco on February 27, 2009, at 11:22:45
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by ERMRug on February 27, 2009, at 9:38:18
When a psychmed "stops" working. I'm not entirely sure I buy into this fully though...I suspect this has more to do with the patients interpretation of how the med works based on good/great effects noticed within the first few months of treatment. Nardil was a whole different med during early response. I had tons of physical energy/stimulation that was pumping through my body that I could feel in my muscles, I had this strange sensation in my head that was overpowering and made me smile and laugh along with people, the sense that I was successful in talking to someone, eye to eye without anxiety, sent this physical feeling though my body that felt good. This is what people think nardil is supposed to be like...but when this stops after some months or weeks they say hey it's pooped out I need to up the dose to get that back or change meds. But I suspect this isnt nardil working in the long run...it's your bodies/brains adaptation to the med before it 'equilibrates'. For me now it's subtle in how it works, still going strong though. It changes my reactions and behaviours slightly...you have to pay attention to how you react in situations where you would normally react poorly without meds. There is no physical indication that you are taking the med when it's totally stable over the long term..it's just there working 'under the surface'. It is the easiest med, in terms of long term sides, ive ever taken.
> Sorry, what does "poop out" mean other than the obvious?
Posted by Sigismund on March 1, 2009, at 14:54:29
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA! » ERMRug, posted by myco on February 27, 2009, at 11:22:45
>It is the easiest med, in terms of long term sides, ive ever taken.
By 'sides', you mean side effects, hey?
I'm a little surprised.
Posted by myco on March 1, 2009, at 18:44:49
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA! » myco, posted by Sigismund on March 1, 2009, at 14:54:29
Hey Sigismund,
Yes side is side effect. For me this statement is fact. Now it's a hell of ride full of high peaks, plateaus, hard lows with a fog of heavy dizzyness all around and drugged-out behaviour just getting to a stable dose...giving weeks at each step to see how it's working. But ya, once I hit "stable" on 75mg for a number of weeks every side effect except my pot belly and the insomnia cleared. The only indication, physically I have that nardil is working (apart from insomnia which is being theorized by SLS to be an indication of the maoi working - I agree) is a very subtle tingle/stimulating feeling in my leg muscles occasionally and about an hour after each dose...very subtle (early on this was intense) and it makes me grin stupidly when it comes...it's like: "there you are baby, here we go". lol Good med...I feel "normal" (if that makes sense) on nardil. No one can even tell i'm on meds. Just need sleep issues cleared up next.
ciao
myco> >It is the easiest med, in terms of long term sides, ive ever taken.
>
> By 'sides', you mean side effects, hey?
>
> I'm a little surprised.
Posted by sam K on March 2, 2009, at 0:49:38
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA! » Sigismund, posted by myco on March 1, 2009, at 18:44:49
you ever tried doxylamine/UNISOM?? stuff knocks me out hard. coma style. thats my experience. When I was prozacn' lol I couldnt sleep and it sucked.. it was a pain.
Posted by henryo on March 4, 2009, at 1:50:42
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA! » [email protected], posted by mickapoo on February 26, 2009, at 9:57:34
is toastmasters- no lie, look it up
Posted by mickapoo on March 4, 2009, at 10:53:19
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by henryo on March 4, 2009, at 1:50:42
> is toastmasters- no lie, look it up
Thanks, but if you have trouble making phone calls, never mind actually walking in, it's not really an option.
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