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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on May 18, 2001, at 21:07:23
Hi.
My doctor has suggested the use of Moban (molindone), an antipsychotic, to be used like Zyprexa to augment antidepressants to treat my bipolar depression.
I would like to know if anyone has heard of Moban being used this way.
I also want to know how Moban compares to other antipsychotic with respect to EPS and tardive-dyskinesia.
Any comments would be appreciated.
Thanks.
- Scott
Posted by SalArmy4me on May 18, 2001, at 22:34:49
In reply to Moban (molindone) for depression? EPS?, posted by SLS on May 18, 2001, at 21:07:23
I speculate that Molindone has an antidepressant effect because of its greater affinity for 5HT1a receptors than clozapine. I'm not sure about the EPS part, but I think it will be good for you to know that you have less of a chance of gaining weight on molindone:
Allison DB et al. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry 1999; 156:1686-1696:
"This is the most comprehensive meta-analysis of weight gain associated with different antipsychotic agents conducted to date, and allows for a comparison among various old and new agents. Clozapine and olanzapine are associated with greatest weight gain, and molindone and ziprasidone are associated with the least."
Posted by Cam W. on May 18, 2001, at 23:20:07
In reply to Moban (molindone) for depression? EPS?, posted by SLS on May 18, 2001, at 21:07:23
Scott - I don't have much experience with Moban™ (molindone), as it is not available in Canada, but I have heard it mentioned by our head psychiatrist and by some visiting lecturers that molindone doesn't seem to be an effective antipsychotic. I believe it was Dr.Herbert Meltzer who said that the reason no one gained weight with molindone because they were too psychotic to eat (not positive on the quote; two days of lectures and they begin to blend together). I have heard that it is a safe drug, but I do not know it's propensity for causing EPS, if at all.
As for trying molindone as an andepressant augmenter in bipolar depression, I think that this might be worth a try. I would be interested to see molindone's secondary-receptor binding profile. Since it binds with high affinity to the 5-HT1A receptor, it should have a potent anxiolytic effect, possibly a lot like BuSpar™ (buspirone). Molindone is an FDA-approved drug looking for a new indication, much like Desyrel™ (trazodone) did when it switch from an antidepressant to a hypnotic.
Go for it, dude and keep us updated on your progress. - Cam
This is the end of the thread.
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