I have been taking Moclobemide for 4 years never been at my best now on a real downer...... so Dr has begun to take me off Mocobemide and has said I am going to go on to Mirtazapine I am overweight very.... and this is a big problem and a big part of my depression any one advise me what should i do go back on the moclobemide and put up with this sever depression or try Mirtazapine any one help me
Hi Martyn
Has your doctor told you you need a \"wash out\" period between finishing Moclobomide and starting Mirtazapine? Or is he intending that you take both at the same time?
Reason I ask is that Moclobomide is contraindicated with common Antidepressants (AD)- SSRI's like Citalopram, Sertraline and Prozac and with Tricyclics like Amytriptaline. Mirtazapine is in it's own AD class so he maybe feels that you can be switched to Mirtazapine more easily than having to wait for a wash out period - a time when you can't take any drugs - which you would need to do with some of the common AD's listed above.
There's no getting away from the fact, however, that Mirtazapine (like other AD's) MAY cause weight gain - it contains an appetite stimulant - so if weight is tied up with your depression this may not be the drug for you.
There's no substitute for proper medical support though so my advice would be to speak to your doctor and explain your concerns. Ask his reasons for putting you on to this rather than another AD. I'm assuming the doc wants you to start at 15mg of Mirtazapine so maybe say to him you will give it a week or two and see how you go but if it's not working you want to try something else?
Good luck and best regards.
Thank you..........
The Dr said I only need to wait 48 hrs between stopping Moclobemide and beginning Mirtazapine, start at 15mg then go up to 45 mg over a four week period...... I don't know who to turn to for help my Phsyciatrist has only taken over my care 8 weeks ago and said that off moclobemide and on to Mirtazapine this will help to get me out of the deep depression..... but all the thoughts of getting even fatter than I am now 22 stone It frightens me or should i just stop moclobemide and not take anything see if that helps................ it is getting beyond me i don't know where to turn for trusted help and if you can help with some advice I would appreciate it
PLEASE COULD YOU REPLY
Hi Martyn
First up, your doctor is right. You only need to wait a couple of days before finishing on Moclobemide and starting on Mirtazapine. As I said in my previous post, Mirt is almost unique among antidepressants in that it's potential for dangerous interaction with other AD drugs is very low so I think you don't need to be concerned on that score.
Second, Mirtazapine can be a very effective antidepressant. There can be side effects from it (like all AD's) but generally it is well tolerated once your body has got used to it. My advice, for what it's worth, is that you don't just go \"cold turkey\" and take nothing. If your Psychiatrist has recommended Mirtazapine, he will have done so for a good reason. Trust him and keep talking to him. I have been battling major depression for over two years now. The one thing I am sure of is that all the doc's I have seen have wanted to help.
Totally understand though, your concerns about weight gain. Have you explained to your doc that this is a major concern for you? If you are having trouble explaining that or feel you can't is there a friend or a family member who can maybe help you or accompany you so that you can get your point across? The other point here is that physical exercise can help with depression.
Has your doc suggested an exercise regime for you?
Some Primary Care Trusts have an exercise referral programme which works in conjunction with local gyms. You can get a discounted membership and help and advice from staff who understand and will be very supportive. This really helped me. I am in my mid forties and had never been near a gym until my GP recommended it two years ago. Now it's one of the things that gets me out of the house AND I was able to lose the weight I gained on Mirtazapine. Might be worth asking.
It maybe that right now, your doc feels that the most important thing is to tackle your depression and if Mirt can do that then together you can tackle any unwanted effects like weight gain later. Of course it may be that you don't actually gain any weight. These drugs affect everybody differently so try not to be too worried. Easy to say but more difficult to do, I know. :?
Do remember though that this drug is widely prescribed. It would not be so unless it helped a good number of people. If, ultimately it is not working for you then tell your doc. There are other AD's you can try once clear of moclobomide
Hope the above is some help. Remember though that I'm not a doctor. Just someone that knows a bit about the blackness of depression - more than I ever wanted to know to be honest!!
All the best.