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    Please Dr Goldberg?
    neutralino posted:
    Dear Dr Goldberg,

    My bipolar depression is pretty much permanent and treatment resistant. For the last 10 years I've been on 900 mg of moclobemide, 300 of bupropion, 50 of trazodone, as well as 600 of lithium, 600 of oxcarbazepine, 5 of trifluoperazine, and 20-30 of Ritalin for concentration. My big problem is that I'm coming to the US to do a PhD (in neuroscience) and moclo is not available there. We (my psychiatrist and I) have tried to replace it with all sorts of stuff and nothing works. I want to die. My question is are US physicians allowed to prescribe moclobemide for me to get it from Canada? Or is there any legal way to get it? Please help, I'll be ever so grateful. By the way, can you recommend a good psychiatrist in College Station, Texas?

    Many thanks,

    Joseph F Goldberg, MD responded:
    Dear Neutralino,

    Moclobomide,a reversible inhibitor of MAO-A (RIMA), isn't available in the US, but patients can order it from Canada with the assistance of a US doctor. There is a general perception here though that RIMAs are not as effective as irreversible MAOIs such as tranylcypromine or phenelzine or isocarboxazid, so most US psychiatrists I think are not too keen on going to great lengths to get it. Particularly if you're finding your existing depression to be treatment-resistant, there may be better options out there.

    College Station is driving distance from Houston, and Baylor/Menninger is one of the finest treatment centers to be found in psychiatry. Check their website for possible referrals/evaluations:

    Good luck.

    Dr. G.
    neutralino replied to Joseph F Goldberg, MD's response:
    Dear Dr. G.

    I'm truly grateful! I think I'll stick to moclobemide as I'm partial to cheese to risk irreversible MAOIs. If, however, my academic success comes to depend on a more effective antidepressant, then so be it, off with cheese too (booze was banned long ago and luckily I hate chocolate)!

    Thank you so much!


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