How are you guys holding up?
I came back from my 'drug holiday' and continued my MAOi self-experiment and finally started Moclobemide trial after a big motivational down and lack of drive. I started with 150mg in the morning, went up to 150mg x2 a day a few weeks later, then changed to 300mg x once a day (first in the morning, then switched to before bed). My stack is now 18mg of Concerta, 300 of Moclobemide and Rasagiline every 2-5 days.
First some thoughts: Rasagiline has different effects for me compared to Selegiline. Selegiline improved my motivation and drive more while Rasagiline does that only a little. It's a bit odd because Rasagiline seems to be more potent in killing MAO-B than Selegiline, so I'm guessing something else in Selegiline (maybe the metabolites?) does wonders for motivation. The pamflet says:
Platelet MAO activity in clinical studies: Studies in healthy subjects and in Parkinson’s disease patients have shown that rasagiline inhibits platelet MAO-B irreversibly. The inhibition lasts at least 1 week after last dose. Almost 25-35 % MAO-B inhibition was achieved after a single rasagiline dose of 1 mg/day and more than 55% of MAO-B inhibition was achieved after a single rasagiline dose of 2 mg/day. Over 90% inhibition was achieved 3 days after rasagiline daily dosing at 2 mg/day and this inhibition level was maintained 3 days post-dose. Multiple doses of rasagiline of 0.5, 1 and 2 mg per day resulted in complete MAO-B inhibition.
If I had the choice I would say stick to Selegiline. Sadly since Selegiline is scheduled here I don't have the choice, so Rasagiline it is for me.
Because of it's high potency I am only using it every 2-5 days in 0.5mg, to inhibit only a bit of MAO-B irreversibly. Moclobemide itself is also going a little bit after MAO-B according to the wikipedia:
Quote
A single 300 mg dose of moclobemide inhibits 80% of monoamine oxidase A (MAO-A) and 30% of monoamine oxidase B (MAO-B), blocking the decomposition of norepinephrine, serotonin and, to a lesser extent, dopamine. There is also some evidence pointing towards moclobemide possessing neuroprotective properties.
Pharmacodynamics aside, does it actually do anything?
It has now been a few weeks that I added Moclobemide and I genuinely feel better. I can notice a difference on days when I take it and days that I skip (since MAO inhibition is only for 24h). It's very subtle, but I am sure it's not just placebo.
- Emotions feel more solid and less all over the place. I 'feel' less emotionally impulsive
- I am more easy to snap out of distractive thoughts. Like when I obsess over certain things it feels easier to break out of it
- I got out of that motivational down and started pushing myself to do things again that my brain marked as 'really annoying' / 'you don't want to do that' like going to the gym. Now I my thinking patterns are often even "man, I hope I can hit the gym after work today"
- Very small statistic but the amount of unchecked todos in my "to do today" by the end of the day went down from 8 to around 3. Things aren't piling up as much as they have before.
- I think I am enjoying things more. Previously most things I do had to have a purpose otherwise I'd consider them a waste of time. Now it feels like I am able to do things just for the fun of it
- I more often have days where I leave my apartment and think "oh man today is a good day"
- I feel more social. When I'm with friends I am more talkative and just in general in a better mood
- Concerta is (well, no shit?) a lot stronger. Given MAO-A and B inhibition I am good with a single 18mg dosage, that's the lowest dosage available. Previously with just Selegiline I was at 27mg. 18mg might even be too much
- I monitored for some kind of raise in blood pressure but nothing of the likes happened. My average heart rate even went down to 60-75
If I had to make a comparison, the effects are slightly similar to what Strattera did for me without completely killing my impulsiveness and with virtually no sideffects.
For negative things, there is a bit of drowsiness a few hours after taking Moclobemide and I can't take it at the same time with Concerta without potentiating the Methylphenidate too much. I have to leave some time between them, hence why I moved Moclobemide to the evening.
I did a few test days where I skipped the Concerta and only ran off Moclobemide + Rasagiline (on days I took Rasagiline I didn't take Concerta) and had good results. It's no Concerta for sure but it was easier to keep focus and I felt less all over the places compared to when not taking anything.
I don't have a verdict on it yet but wanted to share some experiences. Probably won't touch this combination for a while to see how this performs a month later. I'm curious to try higher dosages of Moclobemide but for now I'm good. Also kind of makes me wish I could try Selegiline in higher dosages to also let it go a bit after MAO-A.
Edited by floweryriddle, 30 May 2019 - 04:59 AM.