Moclobemide and hayfever, any advice?

Posted , 5 users are following.

I have been suffering from depression since childhood, and tried every single SSRI, SNRI etc and nothing worked until I read about MAOI Moclobemide, which has literally saved my life. Unfortunately I also have a pollen allergy/hayfever which without prescribed pills and nasal spray (the otc stuff never worked) is actually pretty disabilitating, consisting of almost constant sneezing and coughing. The allergy always kicks in early in the year (which has always confused me in regards to what I am actually allergic to) but has always been fine when I take cetirizine and mometasone furoate nasal spray. Moclobemide seems to have a crazy amount of bad interactions with other meds, antihistamines being one of them, but little to no available information about these interactions. I've just started on the allergy meds and the combination has destroyed me in terms of drowsiness, and I don't know if it's a coincidence, but also mood-wise. Bizarrely, I've had two days of pure rage in my head, but been so drowsy i can barely sit upright.

Does anyone know of any allergy drugs that work with moclobemide? Is it also possible that the drowsiness might dissipate if I persevere with this combination? My GP is utterly useless in advising me, as is my psych. It feels like the options are either to have what is essentially a constant heavy cold, but not feel depressed and suicidal, or vice versa, neither of which is acceptable. 

Thank you in advance for any help or advice anyone can provide

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  • Posted

    Sorry I can't offer any help about your medication and you mentioned Orc products don't help,have you tried speaking to somebody at the alternative health shop (Holland and Barrett ) is one . These guys are really well informed and may well be able to recommend a possible solution,it's worth a try. Good luck .
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  • Posted

    Hello

    Have you asked your pharmacist? We are there to help with this sort of query all the time! Please don't bother asking Holland and Barrett as the staff at my local store are always sending in customers having bought their herbal products, then they ask me for advice on safety and drug interactions as they are not in any way qualified to answer those questions. I'm also surprised your gp is unable to help, it should be straightforward!

    Antihistamines are ok with moclobemide, according to the uptodate summary of product characteristics. You may just get more dry mouth.

    What you must definitely avoid is Sudafed type products (all decongestants).

    I would suggest going to ask your local pharmacist just to confirm what I've said.

    Good luck! Hayfever is so annoying and disabling I know!

    Hope you get some relief.

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    • Posted

      Meant to also say, cetirizine that you mention is fine to take, but there is one antihistamine you shouldn't take with moclobemide, and that's chlorphenamine. Sorry, forgot to mention earlier: toddler under my feet!

      Also, you'll need to tell the pharmacist exactly what meds you are taking, a whole list, to make sure what they give you is safe.

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    • Posted

      Hello Sarah, 

      Thank you for your advice. Yes, I agree with you about Holland and Barrett, and also find their products suspiciously expensive. It seems like there is not much information about moclobemide, and it just gets lumped in with older MAOIs even though it is newer and reversible. GP and pharmacists have all told me no antihistamines, and I did find the citirizine made me sleep all day yesterday. I will talk to the pharmacist. Thank you so much 

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    • Posted

      Sorry, one last question. Do you think the cetirizine might just take a period of adjustment? As in the dowsiness might wear off after my body getting used to it? I know this can happen with some antidepressants, but is it the case with other meds?

      Thank you!

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  • Posted

    That's tricky because a lot of antihistamines are not selective enough and also can affect the uptake of the manaomines. This is what can cause problems.

    As another poster said, Speak to the pharmacist as they know much better than doctors about drug interactions as that's their specific area and will be able to give you the correct information.

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    • Posted

      Hi Tony, 

      I hope you are well. Sorry to bother you, and I know you might feel it irresponsible to answer this question, but I can't get an appointment with my psychiatrist for another month, I can't find any information online and I just wanted to ask your advice because you mentioned antihistamines affecting the efficacy of MAOIs. Is that what you meant when you said they can 'affect the uptake of the monoamines?' 

      Ive just been sinking mood wise since I started taking the antihistamines, started thinking the old dark thoughts that the moclobemide had made me feel were out of reach, and today especially felt pretty desperate, although just about keeping it all under control. I am wondering if it's just a coincidence, but I was in such great shape before taking the antihistamines.

      I was thinking of increasing the moclobemide dose starting tomorrow morning (I'm on the lowest dose prescribed, so I have room to manoeuvre). I'm apprehensive in doing so, but don't want to wait a month to find out it was something the psychiatrist will suggest anyway. I'm worried I'm about to have a month of staedily increasing dysfunction, as I know how these episodes progress for me and can feel it starting. Are you in a position to advice at all about this? I fully understand if you can't. Thank you for your help

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    • Posted

      Hi Elias,

      If you started to get these moods after you started taking antihistamines it is possible they are interacting with your medication. The interaction occurs sometimes because some antihistamines also block the uptake monoamines like serotonin. Not a problem normally but may cause problems if your taking MAOI.

      You should speak to your pharmasist straight away. They will know exactly which drugs interact and are usually more knowledgable than the GPs in this area. They will also be able to give good qualified advice on another antihistamine you may be able to take instead.

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    • Posted

      Hi

      Which antihistamines have you tried? You mentioned cetirizine, but loratadine is a good non-drowsy alternative. I am a pharmacist but I'm on maternity leave and have post natal depression (fun!) so I'm probably not much help to you, but do go and see a pharmacist - they'll have access to a reference I don't have at home called Stockley drug interactions. Get them to check loratadine with moclobemide. I was under the impression antihistamines were ok with this modern maoi (apart from chlorphenamine). Avoid cough and cold remedies though. If it's just a plain antihistamine you want for an allergy, I'm sure one can be found that won't cause you hypertensive crisis! To be really sure, get the pharmacist to call the hospital medicines information (MI) dept who can help further. Ceterizine has very few interactions.

      Hope you get on ok, would love to hear the outcome!

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    • Posted

      Thank you Sarah, and I'm sorry to hear what you're going through. I really appreciate you taking the time to give me advice and my thoughts are with you (that sounds weird, being that I don't know you, but I mean genuinely)

      I remember when I first started getting the allergy they tried me on lots of stuff, and mizolastine was the one that worked. I can't remember what the others were, but I will follow your suggestions. I'm less worried about the hypertensive crisis than the moclobemide losing it's life-changing power! However, as is usual with my awesome tendency to mentally self-sabotage, I'm not sure if the change ive experienced is 'real' or out of worry/psychosomatic/etc.  

      I will let you know what happens, and please do feel free to message if you ever need to talk

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    • Posted

      No problem! It's a nice distraction for me and it's reminded me I miss work and all that goes with that. That's part of the depression, loving your baby but feeling guilty. If I find anything else useful I'll post on here. Did u try the Lloyds pharmacy allergy reliever? Was very good for my hayfever when couldn't take antihistamines during pregnancy! What's the nature of the allergy?
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    • Posted

      Hi Sarah, 

      Yes, that sounds like a very confusing mix of emotions, I can't imagine how hard that must be for. I feel I understand guilt quite a bit, for different reasons obviously (well actually for reasons I've never understood), but Ive had that knotted guilty feeling deep in my gut for as long as I can remember, since i was a kid and it never really goes away. It is a very hard sensation to deal with, so I do feel for you. 

      My allergy used to just be incessant sneezing and itchy eyes, but this year it has also been this itchy throat and viscious dry cough as well. This is making me severely worried, as I'm a bit of a hypochondriac, but also I kind of self-medicated with cannabis for about 10 years (although I don't smoke anymore) and am terrified to have a throat or lung check. I've convinced myself in the last two days that actually I've got emphysema or throat/lung cancer!  

      I will check out the Lloyds allergy reliever. Problem is as well, that I'm a bit broke to be trying lots of different stuff right now, so am being selective. Thanks again Sarah

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