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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by IanSFO on September 15, 2001, at 14:17:08
A single cup of coffee in the morning can lift my depression and greatly lower my social phobia. Unfortunately, the effect is very short-lived. Sometimes a second cup of coffee in the afternoon will have a similar short-term effect, sometimes not. A third cup almost never has any effect, so I don't bother with it. Does anyone know what chemistry is involved here and what medication might duplicate and maintain the effect of caffeine?
I've had success with a few SSRIs but with intolerable side effects, and success with Parnate, but I can no longer take it due to conflict with medication for another health problem.
I am currently on Welbutrin, which has been moderately helpful with depression but no help at all with social phobia. Of late it has been growing less helpful with depression, and I very much need to find a viable alternative. I thought if I could find a longer-lasting equivalent to caffeine, that might be an answer. I have too little knowledge of chemistry to know how caffeine works. All I know is that for a very brief period it works extraordinarily well on all my symptoms.
Any suggestions would be appreciated. Thanks.
Posted by SalArmy4me on September 15, 2001, at 15:01:32
In reply to Brain chemistry question, posted by IanSFO on September 15, 2001, at 14:17:08
Moclobemide is good for social phobia.
Versiani M, Nardi AE, Mundim FD, Alves AB, Liebowitz MR, Amrein R. Pharmacotherapy of social phobia: a controlled study with moclobemide and phenelzine. Br J Psychiatry 1992;161:353-60:
"In a double-blind, parallel group trial, 78 subjects with social phobia received moclobemide (a new reversible inhibitor of monoamine oxidase A) phenelzine, or placebo. After eight weeks, both active drugs-phenelzine somewhat more than moclobemide--were clinically and statistically significantly more effective than placebo, as assessed by rating scales. There was some further improvement between weeks 8 and 16, particularly in the moclobemide group; at week 16, 82% of the moclobemide and 91% of the phenelzine-treated patients were almost asymptomatic. Moclobemide was, however, much better tolerated than phenelzine. Patients withdrawn from active drugs had relapsed by week 24, providing additional support for the efficacy of the active drugs..."
Posted by MB on September 15, 2001, at 16:24:47
In reply to Brain chemistry question, posted by IanSFO on September 15, 2001, at 14:17:08
I used to have the exact same response to coffee. My depression would dissolve, I'd feel great, but I'd crash so hard (hopeless and suicidal) by the early afternoon. Sometimes more coffee would help--sometimes it would pull me out of my crash, but a lot of times, it would just make me more tired and depressed. It seemed like the only thing i could rely on to feel better was the *first* cup of the day.
Then I developed a serious intolorance to coffee (it induced panic attacks, mania, paranoia, etc.) but I still relied on it for that morning relief. I'd drink it, feel great for thirty minutes, get agitated and anxious for two hours, then dive into a complete mind-racing, paranoid-delusional, panic state for hours and hours.
Now I drink a mild green tea for the morning lift, then go to the gym *while the lift is STILL in effect*. When I'm done, I'm up, I'm not fatigues, and I'm not panicked. For now, until something changes, that's my prescription. Maybe try drinking your coffee then for that time (before you crash) go work out for an hour. It's helped me.
Posted by Zo on September 15, 2001, at 17:56:19
In reply to Brain chemistry question, posted by IanSFO on September 15, 2001, at 14:17:08
> A single cup of coffee in the morning can lift my depression and greatly lower my social phobia. Unfortunately, the effect is very short-lived. Sometimes a second cup of coffee in the afternoon will have a similar short-term effect, sometimes not. A third cup almost never has any effect, so I don't bother with it. Does anyone know what chemistry is involved here and what medication might duplicate and maintain the effect of caffeine?
>the most likely short answer: dopamine, and wellbutrin or stimulants (sources of)
Zo
> I've had success with a few SSRIs but with intolerable side effects, and success with Parnate, but I can no longer take it due to conflict with medication for another health problem.
>
> I am currently on Welbutrin, which has been moderately helpful with depression but no help at all with social phobia. Of late it has been growing less helpful with depression, and I very much need to find a viable alternative. I thought if I could find a longer-lasting equivalent to caffeine, that might be an answer. I have too little knowledge of chemistry to know how caffeine works. All I know is that for a very brief period it works extraordinarily well on all my symptoms.
>
> Any suggestions would be appreciated. Thanks.
Posted by IanSFO on September 16, 2001, at 2:05:51
In reply to Re: Brain chemistry question » IanSFO, posted by SalArmy4me on September 15, 2001, at 15:01:32
> Moclobemide is good for social phobia.
>
> Versiani M, Nardi AE, Mundim FD, Alves AB, Liebowitz MR, Amrein R. Pharmacotherapy of social phobia: a controlled study with moclobemide and phenelzine. Br J Psychiatry 1992;161:353-60:
>
> "In a double-blind, parallel group trial, 78 subjects with social phobia received moclobemide (a new reversible inhibitor of monoamine oxidase A) phenelzine, or placebo. After eight weeks, both active drugs-phenelzine somewhat more than moclobemide--were clinically and statistically significantly more effective than placebo, as assessed by rating scales. There was some further improvement between weeks 8 and 16, particularly in the moclobemide group; at week 16, 82% of the moclobemide and 91% of the phenelzine-treated patients were almost asymptomatic. Moclobemide was, however, much better tolerated than phenelzine. Patients withdrawn from active drugs had relapsed by week 24, providing additional support for the efficacy of the active drugs..."
I believe Moclobemide has the same medication restrictions as the non-reversible MAOIs. It's only in the food area where restrictions are lifted. But if I'm wrong, I would love to know.
Posted by Grouch on September 16, 2001, at 21:47:35
In reply to Re: Brain chemistry question, posted by IanSFO on September 16, 2001, at 2:05:51
> I believe Moclobemide has the same medication restrictions as the non-reversible MAOIs. It's only in the food area where restrictions are lifted. But if I'm wrong, I would love to know.
I'm pretty sure you're correct, though there might be some rare exception.
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