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Patent for "new" meds used to treat ME debilitating fatigue

Messages
95
don't think antidepressants generally help ME/CFS, although there is a study to show that moclobemide can increase the sense of energy in ME/CFS. And Dr David Bell found amantadine 25 mg to 50 mg twice daily helps reduce fatigue ME/CFS.

If course if you have depression, which many ME/CFS patients do, then some sort of antidepressant treatment might be useful.

Thanks for your reply.

I thought about it because of this:
The present inventors have unexpectedly found that the clinical outcome of treatment of disorders characterized by debilitating fatigue is significantly improved by the combination of a dopamine stabilizing agent and an anti-depressive agent.
 
Messages
95
I believe it is only third generation antipsychotics that are classed as dopamine system stabilizers. Third generation antipsychotics include Abilify.

Quetiapine is a second-generation antipsychotic.

Oh ok. Maybe I was wrong then. Thank you very much Hip!
 
Messages
36
I don't think antidepressants generally help ME/CFS, although there is a study to show that moclobemide can increase the sense of energy in ME/CFS. And Dr David Bell found amantadine 25 mg to 50 mg twice daily helps reduce fatigue ME/CFS.

I have just started moclobemide. I went down from 300mg/day because it made me feel crazy, over-energised (still tired though! Just ramping up the wired aspect). I've been on 75mg a few days now. That over-energising feeling is subsiding somewhat, but if it doesn't subside more I'll stop as it's a bit scary. It seems to increase brain pressure/pain too, which is one of my main symptoms and maybe jaw pain also. Hard to say though, perhaps I would have got the brain pressure regardless. Great for sex drive though - rare to find something that increases that. I can see possible recreational benefits there as that part happens pretty quickly.
 

Hip

Senior Member
Messages
17,464
I have just started moclobemide. I went down from 300mg/day because it made me feel crazy, over-energised (still tired though! Just ramping up the wired aspect). I've been on 75mg a few days now.

I think the highest dose I tried was 150 mg once or twice, but I settled on a 75 mg daily dose (for antidepressant purposes rather than as an ME/CFS treatment). I don't want to push it higher, because ME/CFS patients often find that the beneficial effects of drugs they take stop working after some months, and I don't want that to happen.
 
Messages
36
I think the highest dose I tried was 150 mg once or twice, but I settled on a 75 mg daily dose (for antidepressant purposes rather than as an ME/CFS treatment). I don't want to push it higher, because ME/CFS patients often find that the beneficial effects of drugs they take stop working after some months, and I don't want that to happen.

Oh really, did you get the over-energising start-up effects like I did? and waking in the night with strange brain feeling??
 

Hip

Senior Member
Messages
17,464
Oh really, did you get the over-energising start-up effects like I did? and waking in the night with strange brain feeling??

I did not notice any side effects like that at the 150 mg dose, but I only tried this dose level once or twice.

The trouble I am having with moclobemide is that it may be causing some mild gynecomastia, but it's hard to tell. Moclobemide causes prolactin secretion, which can lead to gynecomastia; and because I am also taking another drug (very low-dose amisulpride) which also causes prolactin secretion, the effect is increased.

So I am looking to switch to another MAO inhibitor, such as rasagiline.
 

leokitten

Senior Member
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Location
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@Canned quetiapine is not a dopamine modulating or stabilizing agent.

When an antipsychotic gets the “atypical” classification it only requires some atypical action on one or more serotonin or dopamine receptors compared to the older generation typical drugs, which basically reduced function of everything at dopamine and serotonin receptors (so depending on receptor type antagonism or agonism to reduce function)

Most of the atypical labeled antipsychotics are only atypical at one or more serotonin receptors but reduce function at all other receptors. I wouldn’t expect an atypical antipsychotic that antagonizes all dopamine receptor types to be that helpful in ME? Could be wrong but seems counterintuitive.

The only atypical antipsychotics I see so far as having pharmacology that could be helpful to ME are:

aripiprazole
cariprazine
brexipiprazole
brilaroxazine
 

leokitten

Senior Member
Messages
1,494
Location
U.S.
I have just started moclobemide. I went down from 300mg/day because it made me feel crazy, over-energised (still tired though! Just ramping up the wired aspect). I've been on 75mg a few days now. That over-energising feeling is subsiding somewhat, but if it doesn't subside more I'll stop as it's a bit scary. It seems to increase brain pressure/pain too, which is one of my main symptoms and maybe jaw pain also. Hard to say though, perhaps I would have got the brain pressure regardless. Great for sex drive though - rare to find something that increases that. I can see possible recreational benefits there as that part happens pretty quickly.

I think it’s really common to get these somewhat overpowering symptoms when you start antidepressants and many other psychoactive drugs, particularly if you are antidepressant naive.

It takes some time to adjust, so I’m wondering if these symptoms would subside after a week or two while to antidepressant effects slowly start to increase over the weeks that follow. The mechanism by which antidepressants work isn’t due to their immediate effects on the brain, but by their longer term anti-neuroinflammatory, hippocampal neurogenesis, BDNF inducing, and other properties. I imagine any positive effects they would have on ME would be due to this as well.
 
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