![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 96. Go back in thread:
Posted by Judy on July 19, 1999, at 20:08:38
In reply to Re: Answers to Judy's Selegiline ?'s, posted by Annie on July 3, 1999, at 21:54:00
Annie,
Just a quick question that's been bothering me. When you complete the patch study, why aren't you considering taking Selegeline orally? I KNOW there must be a good reason - just curious as to what it is.
Judy
> Judy,
> Sorry the Nardil treatment crapped out. (couldn't resist) The selegiline patch is only available in research studies right now. Using a 30mg selegiline transdermal patch, the MAOI diet is not necessary. I think taken orally, the diet would be needed at that dose. Marplan is, I think, the better choice until the patch is available by prescription. The side effects the first few weeks were minimal and even when they kicked in at week 6, they are not intolerable. I had gained lots of weight on prior meds but I am finding it possible to lose some on selegiline. The sexual interest is there but it is more difficult to achieve orgasm. Not as bad as some ADs, but still a problem, alas. Yes there are some 'excretory system problems', but they are manageable. You won't need as many bales of alfalfa! And I don't get that bloated swollen feeling with Selegiline. There is some urinary frequency, but that seems to be improving.
> I am hopeful of more improvement but when the study is over, Marplan is also my choice. I think I would have to go higher than 30mg of selegiline anyway and the research pdoc said that the MAOI diet would probably be necessary at any higher dose.
> Good luck with the Marplan. Did you have any problem finding a pharmacy that could get it? Keep us posted with your progress. Annie
>
Posted by Brandon on July 19, 1999, at 20:55:14
In reply to Re: Selegeline ? for Annie, posted by Judy on July 19, 1999, at 20:08:38
Hey everyone,
It's been about two months since I last posted my question about selegiline, I finally convinced my psydoc to let me try it...so far the results have been outstanding! I'm only taking 20mg a day and I definitely feel much better than I ever did. My level of concentration is way up and my mood is pretty darn good, and the best part is there is no pesky sexual side effects...my libido is actually enhanced! I just wanted to say thanks for all the info and was wondering if anyone here had tried the liquid form. I've heard that it is superior in it's lack of side effects, any info would be appreciated.
Thanks,
Brandon
Posted by Annie on July 20, 1999, at 22:31:40
In reply to Re: Selegeline ? for Annie, posted by Judy on July 19, 1999, at 20:08:38
> Annie,
>
> Just a quick question that's been bothering me. When you complete the patch study, why aren't you considering taking Selegeline orally? I KNOW there must be a good reason - just curious as to what it is.
>
> JudyJudy,
Actually, I considered it, but my Pdoc seems to think that I would respond better to Parnate or Marplan at the dose I would need. The 30mg Selegiline patch has really helped many of the symptoms of my depression and the lack of side effects has been great. The best improvements have been a total absence of suicidal thoughts, a much higher tolerance for stress and the fact that I am losing weight without even trying! I haven't felt this good in years. The increase in energy and motivation leveled out after a slight initial improvement. I still have to force myself to do anything or to leave the house. Social activities still feel like a penance. If there were a patch at a higher dose it would be a no-brainer for me, even though the diet would then be required. Remember that with transdermal delivery, lower doses are needed to reach a therapeutic level because it bypasses the liver. Taken orally it is unlikely 30mg would have any effect for me. I usually need to meet or exceed maximum dose to get any benefit(eg 400mg desipramine for several months before my desipramine reached the supposed therapeutic level of 180. Still didn't help though, and side effects were horrendous. My doc says that my liver must be very,very good indeed at metabolizing.) I don't know what the oral equivalent of 30mg transdermally would be,[does anyone know?] but I would probably have to go much higher. There isn't much information about effects of very high doses of Selegiline, so I guess it's safer to try Parnate or Marplan for now. I am a little leery of Parnate because I experienced spontaneous hypertension in my first trial of it. I'm not ruling it out though, if I can start low and build slowly to an effective dose. I'd rather stay on the patch longer but it isn't possible. I'm really frightened that all the relief I've gotten is going to disappear. I don't think I could stand it.Hope the Marplan is going well for you.
Annie
PS If anyone is aware of any studies using selegiline at higher doses, I'd appreciate if you would post the information.
Posted by Elizabeth on July 21, 1999, at 7:25:01
In reply to Re: Selegeline ? for Annie, posted by Annie on July 20, 1999, at 22:31:40
Hi Annie. About selegiline....
> Actually, I considered it, but my Pdoc seems to think that I would respond better to Parnate or Marplan at the dose I would need. The 30mg Selegiline patch has really helped many of the symptoms of my depression and the lack of side effects has been great.
I actually went up to 40mg - interestingly, with no positive effects - and I know of a couple people who've taken as much as 50. It's a little inconvenient because the highest strength pill is 5mg!
>The best improvements have been a total absence of suicidal thoughts, a much higher tolerance for stress and the fact that I am losing weight without even trying!
Do you have an appetite? I didn't - it sapped what little appetite I had at that point!
>I haven't felt this good in years. The increase in energy and motivation leveled out after a slight initial improvement. I still have to force myself to do anything or to leave the house. Social activities still feel like a penance.
For the anxiety, I'd personally suggest Marplan rather than Parnate. Selegiline, like Parnate, is a non-hydrazide MAOI and is related to amphetamine (in fact, it has amphetamine metabolites and can cause you to test positive for amphetamines on a tox screen).
>If there were a patch at a higher dose it would be a no-brainer for me, even though the diet would then be required. Remember that with transdermal delivery, lower doses are needed to reach a therapeutic level because it bypasses the liver.
Well, all drugs go through the liver eventually, but as I understand it, it bypasses first-pass metabolism.
Do you know when they're going to publish the results of this study, BTW?
>Taken orally it is unlikely 30mg would have any effect for me. I usually need to meet or exceed maximum dose to get any benefit(eg 400mg desipramine for several months before my desipramine reached the supposed therapeutic level of 180. Still didn't help though, and side effects were horrendous.
It might also just be that desipramine isn't the drug for you anyway. (BTW I think the maximum recommended therapeutic level for desipramine is 300ng/mL, but don't quote me on that.)
>My doc says that my liver must be very,very good indeed at metabolizing.) I don't know what the oral equivalent of 30mg transdermally would be,[does anyone know?] but I would probably have to go much higher.
I doubt anyone knows. It's hard to gauge the therapeutic level of an MAOI because they are metabolized pretty fast.
>There isn't much information about effects of very high doses of Selegiline, so I guess it's safer to try Parnate or Marplan for now. I am a little leery of Parnate because I experienced spontaneous hypertension in my first trial of it.
How high did your BP go? I think you're the first person I've met (other than myself) who's had this side effect from it.
>I'm not ruling it out though, if I can start low and build slowly to an effective dose.
The key I think is taking it in divided doses.
>I'd rather stay on the patch longer but it isn't possible. I'm really frightened that all the relief I've gotten is going to disappear. I don't think I could stand it.
The washout period might be hard...I'm not sure what to suggest for dealing with it, other than maybe to be sure you have benzodiazepines on hand! Best of luck to you....
> PS If anyone is aware of any studies using selegiline at higher doses, I'd appreciate if you would post the information.
Sunderland T, et al. High-dose selegiline in treatment-resistant older depressive patients. Arch Gen Psychiatry. 1994 Aug;51(8):607-15.
(Bear in mind that the elderly tend to be more sensitive to side effects than younger adults.)
Posted by Annie on July 21, 1999, at 13:55:57
In reply to Re: Selegeline ? for Annie, posted by Elizabeth on July 21, 1999, at 7:25:01
Elizabeth, Thank you for the study info. I'm not certain that the tested 60mg taken orally would be sufficient for me since I am a "super- metabolizer", but I'll copy it for my Pdoc and see what he says.
Yes, I do have an appetite on selegiline and I am eating normally. In my case, the loss of weight is greatly appreciated.
I never considered the lack of motivation and isolating features of my depression as related to anxiety. Interesting thought. Possible. I thought I could use a little amphetamine action to get myself going.
The selegiline study is still on-going in many parts of the country, so it may be quite a while before the final results are published. If I see any preliminary data, I will let you know. I know I saw one article published but it more Rah- Rah hype than scientific data.
I know the hard way that Desipramine was not the drug for me, I used that example because TCA levels can me measured and to illustrate the high dose I needed to get to therapeutic level. I have had many trials of SSRIs et al at high doses with similar (non)results.
Regarding the spontaneous hypertension, after only 3 days on Parnate at minimum dose, my BP went from 127/73 to 200/102.
I usually don't experience withdrawal symptoms during washout periods, but thanks for the advice. I'll have some Xanax ready just in case.
Annie
> Hi Annie. About selegiline....
>
> > Actually, I considered it, but my Pdoc seems to think that I would respond better to Parnate or Marplan at the dose I would need. The 30mg Selegiline patch has really helped many of the symptoms of my depression and the lack of side effects has been great.
>
> I actually went up to 40mg - interestingly, with no positive effects - and I know of a couple people who've taken as much as 50. It's a little inconvenient because the highest strength pill is 5mg!
>
> >The best improvements have been a total absence of suicidal thoughts, a much higher tolerance for stress and the fact that I am losing weight without even trying!
>
> Do you have an appetite? I didn't - it sapped what little appetite I had at that point!
>
> >I haven't felt this good in years. The increase in energy and motivation leveled out after a slight initial improvement. I still have to force myself to do anything or to leave the house. Social activities still feel like a penance.
>
> For the anxiety, I'd personally suggest Marplan rather than Parnate. Selegiline, like Parnate, is a non-hydrazide MAOI and is related to amphetamine (in fact, it has amphetamine metabolites and can cause you to test positive for amphetamines on a tox screen).
>
> >If there were a patch at a higher dose it would be a no-brainer for me, even though the diet would then be required. Remember that with transdermal delivery, lower doses are needed to reach a therapeutic level because it bypasses the liver.
>
> Well, all drugs go through the liver eventually, but as I understand it, it bypasses first-pass metabolism.
>
> Do you know when they're going to publish the results of this study, BTW?
>
> >Taken orally it is unlikely 30mg would have any effect for me. I usually need to meet or exceed maximum dose to get any benefit(eg 400mg desipramine for several months before my desipramine reached the supposed therapeutic level of 180. Still didn't help though, and side effects were horrendous.
>
> It might also just be that desipramine isn't the drug for you anyway. (BTW I think the maximum recommended therapeutic level for desipramine is 300ng/mL, but don't quote me on that.)
>
> >My doc says that my liver must be very,very good indeed at metabolizing.) I don't know what the oral equivalent of 30mg transdermally would be,[does anyone know?] but I would probably have to go much higher.
>
> I doubt anyone knows. It's hard to gauge the therapeutic level of an MAOI because they are metabolized pretty fast.
>
> >There isn't much information about effects of very high doses of Selegiline, so I guess it's safer to try Parnate or Marplan for now. I am a little leery of Parnate because I experienced spontaneous hypertension in my first trial of it.
>
> How high did your BP go? I think you're the first person I've met (other than myself) who's had this side effect from it.
>
> >I'm not ruling it out though, if I can start low and build slowly to an effective dose.
>
> The key I think is taking it in divided doses.
>
> >I'd rather stay on the patch longer but it isn't possible. I'm really frightened that all the relief I've gotten is going to disappear. I don't think I could stand it.
>
> The washout period might be hard...I'm not sure what to suggest for dealing with it, other than maybe to be sure you have benzodiazepines on hand! Best of luck to you....
>
> > PS If anyone is aware of any studies using selegiline at higher doses, I'd appreciate if you would post the information.
>
> Sunderland T, et al. High-dose selegiline in treatment-resistant older depressive patients. Arch Gen Psychiatry. 1994 Aug;51(8):607-15.
>
> (Bear in mind that the elderly tend to be more sensitive to side effects than younger adults.)
Posted by Elizabeth on July 21, 1999, at 23:49:39
In reply to Re: Answer to Elizabeth, posted by Annie on July 21, 1999, at 13:55:57
> Elizabeth, Thank you for the study info. I'm not certain that the tested 60mg taken orally would be sufficient for me since I am a "super- metabolizer", but I'll copy it for my Pdoc and see what he says.
Maybe it's just some general fast-metabolizer thing, but different drugs are metabolized through different pathways, so the high dose of desipramine you needed wouldn't necessarily mean you'd also need a high dose of selegiline (30mg isn't that high for depression).
> Yes, I do have an appetite on selegiline and I am eating normally. In my case, the loss of weight is greatly appreciated.
Cool!
> I never considered the lack of motivation and isolating features of my depression as related to anxiety. Interesting thought. Possible. I thought I could use a little amphetamine action to get myself going.
Well, sometimes anxiety makes people feel kind of "dead," easily fatigued, sluggish, etc., and I could see it sapping motivation as well.
> The selegiline study is still on-going in many parts of the country, so it may be quite a while before the final results are published. If I see any preliminary data, I will let you know. I know I saw one article published but it more Rah- Rah hype than scientific data.
Actually I know a fellow who was conducting the study at McLean, here in Boston - perhaps I'll enquire (I don't even know if it's still going on).
> I know the hard way that Desipramine was not the drug for me, I used that example because TCA levels can me measured and to illustrate the high dose I needed to get to therapeutic level. I have had many trials of SSRIs et al at high doses with similar (non)results.
Well, that might just mean that SSRIs don't work for you. Actually there have been attempts to come up with recommended serum levels for fluoxetine and norfluoxetine at least.
> Regarding the spontaneous hypertension, after only 3 days on Parnate at minimum dose, my BP went from 127/73 to 200/102.
Mine increased by about the same amount, only I had a much lower (~100/60) baseline BP so it didn't get as high (180/100?).
> I usually don't experience withdrawal symptoms during washout periods, but thanks for the advice. I'll have some Xanax ready just in case.
MAOIs can have pretty rough withdrawal symptoms - don't play fast and loose with them! There's also just the difficulty of no longer being on an antidepressant, though for just two weeks that shouldn't matter too much.
Posted by nancy on July 22, 1999, at 17:07:12
In reply to Re: One More "?" About Selegiline , posted by Elizabeth on July 7, 1999, at 22:26:05
LOL, LOL, LOL...You two are cracking me up!
You wouldn't hunt down and kill someone, who is still multiorgasmic and loving it, would you???
:) ;) :)
> > Elizabeth, please take this with the humor I intend it: If I read once more about your not having sex problems with all these different meds, I'm may freak and track you down and slap you silly out of my envy and frustration!!!! (Did I read in one of your posts that you're in the Boston area? I'm on the South Shore - about 20 miles south, so I might just be able to find you!) How the heck to you pull that off?!?!?! Of course, with all the other side effects you're suffering, it's probably not the magical experience for you that I'm imagining.
>
> I wouldn't call it "magical," no! Anyway, I'm not yet in my sexual prime, so to speak, so don't think that sexual bliss comes easily to me even unmedicated! (Was that more information than you needed? :-) I do feel for people who get this disheartening side effect; unlike some other side effects, it's very difficult to deal with, although some pharmacologic add-ons seem to work some of the time (yohimbine, bupropion, sildenafil, etc.). There's also the old "slip some Prozac in your partner's coffee so it takes him forever too" trick. Not that I'm suggesting such a thing. ;-)
Posted by Brandon on July 22, 1999, at 18:34:27
In reply to Re:Judy and Elizabeth : ), posted by nancy on July 22, 1999, at 17:07:12
Hi Elizabeth,
I just wanted to know how you knew wether you were taking the actual med or a placebo in the selegiline patch study. Is it still ongoing and if so is it still possible to register,
thanks
Posted by Elizabeth on July 23, 1999, at 0:05:11
In reply to Question for Elizabeth, posted by Brandon on July 22, 1999, at 18:34:27
> I just wanted to know how you knew wether you were taking the actual med or a placebo in the selegiline patch study. Is it still ongoing and if so is it still possible to register,
Ahh, point of confusion: I was never in the selegiline study, Annie was. (I tried selegiline a year or so before the grant proposal for said study in my locale had been submitted - by the guy who had recommended selegiline to me, in fact.)
So anyway, I was pretty sure I was on "the real thing" because what kind of sicko pharmacist would sell somebody placebo pills? :->
Posted by Adam on July 29, 1999, at 17:27:33
In reply to Re: Question for Elizabeth - wrong person!, posted by Elizabeth on July 23, 1999, at 0:05:11
I just started the selegiline study today at McLean
hospital (actually, I was screened earlier and just
got my first selegiline patch today). It's tough
to say much about this since it's so new. I have
no clue if I'm on the actual drug or a placebo. I
thought I felt a little funny this morning a couple
hours after I put the patch on, but you know how
these things are. The mind can play little tricks
on you, so it's best not to speculate. For those
curious about the study at McLean (in Belmont, MA,
not far from Boston), there is an 8-week period
where you have a 33.3% chance of getting either of
two doses of selegiline or a placebo. Then after
this period, everybody gets a selegiline patch for
six months. One really beautiful thing about this
study is that I can continue with the CBT that I've
been doing, and that I feel is an essential part of
my getting better. Many studies do not allow one
to continue psychotherapy while in a drug trial.I'm hoping this helps me. Selegiline seems to have
some interesting properties that could be really
nice. Then again it might not work at all. We'll
see.
Posted by Annie on July 29, 1999, at 21:22:36
In reply to Study, posted by Adam on July 29, 1999, at 17:27:33
Adam,
What doses are the patches in the study?
Thanks, Annie
> I just started the selegiline study today at McLean
> hospital (actually, I was screened earlier and just
> got my first selegiline patch today). It's tough
> to say much about this since it's so new. I have
> no clue if I'm on the actual drug or a placebo. I
> thought I felt a little funny this morning a couple
> hours after I put the patch on, but you know how
> these things are. The mind can play little tricks
> on you, so it's best not to speculate. For those
> curious about the study at McLean (in Belmont, MA,
> not far from Boston), there is an 8-week period
> where you have a 33.3% chance of getting either of
> two doses of selegiline or a placebo. Then after
> this period, everybody gets a selegiline patch for
> six months. One really beautiful thing about this
> study is that I can continue with the CBT that I've
> been doing, and that I feel is an essential part of
> my getting better. Many studies do not allow one
> to continue psychotherapy while in a drug trial.
>
> I'm hoping this helps me. Selegiline seems to have
> some interesting properties that could be really
> nice. Then again it might not work at all. We'll
> see.
Posted by Elizabeth on July 29, 1999, at 22:31:44
In reply to Study, posted by Adam on July 29, 1999, at 17:27:33
Hey Adam, you're in Boston? Me too. (Actually right now I'm in North Carolina, but I live in Boston.)
Posted by Adam on July 30, 1999, at 15:27:48
In reply to Re: Study, posted by Annie on July 29, 1999, at 21:22:36
I believe the doses are 10mg and 20mg/patch, or, of
course, no selegiline in the placebo group.I'm still trying to figure out if I'm getting the
active drug. I feel, a couple hours after I put
patch on, a little funny, but nothing really
remarkable.10 and 20 mg. are a bit low for selegiline as an
antidepressant if it were being delivered orally,
but for the transdermal delivery system, a lower
dose is a bit more potent.> Adam,
> What doses are the patches in the study?
> Thanks, Annie
Posted by Adam on July 30, 1999, at 15:29:16
In reply to Re: Study, posted by Elizabeth on July 29, 1999, at 22:31:44
Hey, Elizabeth,
Yep, I'm in the Boston area. How are things going
with you in the study?> Hey Adam, you're in Boston? Me too. (Actually right now I'm in North Carolina, but I live in Boston.)
Posted by Elizabeth on July 30, 1999, at 19:14:56
In reply to Re: Study, posted by Adam on July 30, 1999, at 15:29:16
> Hey, Elizabeth,
>
> Yep, I'm in the Boston area. How are things going
> with you in the study?I'm not in the study, but I know Dr. Bodkin (actually I talked to him about it when he was working on the grant proposal - he seemed excited about it) so I'm interested to know how it goes.
I tried oral selegiline (40mg, if I remember correctly) and it caused me nothing but grief (reminded me of Wellbutrin). Oh well. For a lot of people it doesn't have any side effects to speak of. (I sort of feel like I shouldn't tell you what they were for me, so as not to bias you. :->)
Email me if you want (it's shapere@aol.com). I'd be interested to meet "in real life," if you would.
Posted by Robin on July 31, 1999, at 9:16:33
In reply to Selegiline for depression?, posted by Brandon on May 10, 1999, at 23:07:11
> Has anyone heard of selegiline for depression. I have heard that it can be helpful.
Brandon, How is the selegiline working for you? Have you tried Marplan , Nardil or Parnate before? How does the Selegiline compare?
Robin
Posted by Robin on July 31, 1999, at 9:22:40
In reply to Re: Study, posted by Elizabeth on July 30, 1999, at 19:14:56
> > Hey, Elizabeth,
> >
> > Yep, I'm in the Boston area. How are things going
> > with you in the study?
>
> I'm not in the study, but I know Dr. Bodkin (actually I talked to him about it when he was working on the grant proposal - he seemed excited about it) so I'm interested to know how it goes.
>
> I tried oral selegiline (40mg, if I remember correctly) and it caused me nothing but grief (reminded me of Wellbutrin). Oh well. For a lot of people it doesn't have any side effects to speak of. (I sort of feel like I shouldn't tell you what they were for me, so as not to bias you. :->)
>
> Email me if you want (it's shapere@aol.com). I'd be interested to meet "in real life," if you would.Adam, What was the comparison of Wellbutrin and Selegiline? I hated Wellbutrin it made me more depressed. I haven't tried Selegiline, but was considering it.
Robin
Posted by Brandon on August 1, 1999, at 10:28:15
In reply to Re: Selegiline for depression?, posted by Robin on July 31, 1999, at 9:16:33
> Brandon, How is the selegiline working for you? Have you tried Marplan , Nardil or Parnate before? How does the Selegiline compare?
>
> RobinHi Robin, the selegiline so far has been a true life saver. I have tried prozac, serzone and effexor, all of them really gave me no relief and a lot of nasty side effects. I cant't give you a comparison between selegiline and the other MAOI's but the difference is dramatic against the SSRI's. My concentration, motivation and mood are great, I'm actually sleeping better and my sex has been better than ever. I hope this helps.
Posted by Robin on August 1, 1999, at 11:06:22
In reply to Re: Selegiline for depression?, posted by Brandon on August 1, 1999, at 10:28:15
> > Brandon, How is the selegiline working for you? Have you tried Marplan , Nardil or Parnate before? How does the Selegiline compare?
> >
> > Robin
>
> Hi Robin, the selegiline so far has been a true life saver. I have tried prozac, serzone and effexor, all of them really gave me no relief and a lot of nasty side effects. I cant't give you a comparison between selegiline and the other MAOI's but the difference is dramatic against the SSRI's. My concentration, motivation and mood are great, I'm actually sleeping better and my sex has been better than ever. I hope this helps.Brandon, Thank You so much for the info on Selegiline. Could you tell me the dosage you are on and how long it took for you to notice the drug was helping. I would be taking Selegiline for Atypical Depression and Social Phobia. I hope I can get my doc to prescribe it for me. Any problems with weight gain .
Thanks again for the info.
Robin
Posted by Brandon on August 2, 1999, at 18:59:58
In reply to Re: Selegiline for depression?, posted by Robin on August 1, 1999, at 11:06:22
I started taking selegiline in two doses of 5mg a piece. The pills are only offered in that dosage so it makes it a little difficult during the day. I am currently taking 30mg. I take 4 at 5am when I wake up and 2 around noon. I noticed an improvement in mood after only one week. After about a month I really felt it kick in. I have also been diagnosed with atypical depression and it really helped me cope with stress. I hope this helps and good luck!
P.S. One MAJOR drawback with selegiline is the price. I pay about $80 a month for it and thats with insurance.
Posted by Adam on August 2, 1999, at 19:18:56
In reply to Re: Study and Adam, posted by Robin on July 31, 1999, at 9:22:40
Wellbutrin is a bit mysterious in that it's mechanism of action
isn't well understood. It is thought to be an inhibitor of
dopamine reuptake, but its active metabolites also inhibit the
reuptake of serotonin and norepinepherine, albeit weakly. It
tends to be fairly activating, from what I hear. I tried it, and
found that it did essentially nothing at all to me one way or
the other.Selegiline is a very different beast. It is a potent and
irreversible inhibitor of monoamine oxidase B when taken at doses
around 5mg/day. At higher doses, it also is able to inhibit
monoamine oxidase A. MAO-B is primarily responsible for the
breakdown of dopamine in the brain, where MAO-A is primarily
responsible for the breakdown of serotonin and norepinepherine.
Selegiline also mildly inhibits the reuptake of dopamine, and
some of its metabolites are amphetamines, again affecting the
dopamine system.MAO-A is also involved in the breakdown of tyramine in the gut.
At low doses of oral selegiline, there's no need to follow
dietary restrictions, but at higher doses, one needs to avoid
foods rich in tyramine to prevent the "cheese effect", just like
with other irreversible inhibitors of MAO-A. The study I am
involved with now is using a transdermal delivery system (a patch,
like the nicotine patch) to get around the hazards of MAOI use
and hypertensive crises caused by the tyramine pressor effect.
Bypassing the gut allows one to take high doses of selegiline
without having to watch what you eat. At least, that's how it
looks. I've read in one paper that transdermal delivery of
selegiline changes its metabolite profile somewhat, with less
l-amphetamine being produced.The doctors I spoke with at McLean hope the patch delivery system
will be available on the market in a couple of years, or maybe
even less. I don't know if selegiline will work for me yet, but
if it does work for some people, it seems like it would be a
wonderful thing to reap the benefits of a MAOI without having to
deal with some of the hazards.
> > > Hey, Elizabeth,
> > >
> > > Yep, I'm in the Boston area. How are things going
> > > with you in the study?
> >
> > I'm not in the study, but I know Dr. Bodkin (actually I talked to him about it when he was working on the grant proposal - he seemed excited about it) so I'm interested to know how it goes.
> >
> > I tried oral selegiline (40mg, if I remember correctly) and it caused me nothing but grief (reminded me of Wellbutrin). Oh well. For a lot of people it doesn't have any side effects to speak of. (I sort of feel like I shouldn't tell you what they were for me, so as not to bias you. :->)
> >
> > Email me if you want (it's shapere@aol.com). I'd be interested to meet "in real life," if you would.
>
> Adam, What was the comparison of Wellbutrin and Selegiline? I hated Wellbutrin it made me more depressed. I haven't tried Selegiline, but was considering it.
> Robin
Posted by Robin on August 4, 1999, at 9:33:46
In reply to Re: Selegiline for depression?, posted by Brandon on August 2, 1999, at 18:59:58
> I started taking selegiline in two doses of 5mg a piece. The pills are only offered in that dosage so it makes it a little difficult during the day. I am currently taking 30mg. I take 4 at 5am when I wake up and 2 around noon. I noticed an improvement in mood after only one week. After about a month I really felt it kick in. I have also been diagnosed with atypical depression and it really helped me cope with stress. I hope this helps and good luck!
>
> P.S. One MAJOR drawback with selegiline is the price. I pay about $80 a month for it and thats with insurance.
>What brand are you taking? Deprenyl or Eldepryl? How long did it take you to go from 10 mgs to 30 mgs? Thanks for the info
Robin
Posted by MA on August 4, 1999, at 12:12:56
In reply to Re: Selegiline for depression?(Brandon), posted by Robin on August 4, 1999, at 9:33:46
Our dog was on Seliegiline for Cushings disease.
He took one pill a day at the cost of about $3.50, so it is a very expensive drug.Out of curiosity I asked the vet about this because my father had been on it for Parkinson's disease. She said it was the same drug. I was trying to find out if I could substitute the human drug for the animal one to see if I could reduce the cost of treating the dog.
The problem was that I would have had to give the dog many human pills to make up for the one animal pill.Unfortunately our dog passed away about a month ago, so I did not have to pursue the cost issue.
I'm just so amazed that a pill my dog took for one disease was prescribed for my father for another and now I see it is being used for depression, which I have. Maybe, I'll end up taking it myself.
Life is so strange...
Posted by Rick on August 5, 1999, at 3:33:26
In reply to Selegiline is great!, posted by Brandon on July 19, 1999, at 20:55:14
First off, a disclaimer: I've only done a cursory
browsing of the Selegeline posts.As I mentioned in another thread, my pdoc
(surprisingly) gave me Selegeline for Social
Anxiety, after Nardil quickly pooped out but
created troublesome, long-lasting side effects.
The Selegeline was a total bust after four weeks
(at 15mg). No reduction whatsoever in my Social
Phobia (BTW, I am not clinically depressed).There WERE some pleasant (!) side effects, such as
increased libido and intensified sexual sensations
(nice!), as well as some needed (mild) lowering of
my blood pressure. No bad side effects.But since there was zilch improvement in the
Social Anxiety, I went off the Selegeline (Cold
Turkey's O.K. at 15 mg), and insisted he let me
try Klonopin (currently 2mg/day). Fairly
promising results after about a week. But then I
suggested (to my rather perplexed pdoc) that I add
back some low-dose Selegeline for mildly
hypotensive effects and possible sexual/cognitive
effects...and WOW! I don't know if this will
last, but the Social Phobia is virtually gone; my
confidence and concentration are currently through
the roof (despite minimal sleep of late, owing to
ultra-busy-ness, NOT insomnia or mania), libido
sky-high, and BP down (though not quite
enough...may move from 5mg. to 10mg. of
Selegeline...still low enough to avoid the MAOI
food restrictions...OR add pindolol...but I'm
afraid to mess with such success!) Of course,
Selegeline's fabled life-extension and
brain-protection qualities don't hurt either. I
probably shouldn't have written this; I'm rarely
superstitious, but for some reason I'm afraid I'll
jinx the wonderfully effective combination I
concocted!Maybe Selegeline works best for augmenting other
meds in mental problems, just as it serves as a
levodopa (sp?) potentiator for Parkinson's. Just
a thought. (As always, YMMV) Of course, your
doctor would have to carefully assess any possible
adverse reactions/dangerous combinations.In any event, I'm excited about the
Klonopin/Selegeline combo. Has anyone else used
this for Social Anxiety, or have I discovered a
"magic combo"?
Posted by Brandon on August 5, 1999, at 11:21:26
In reply to Re: Selegiline for depression?(Brandon), posted by Robin on August 4, 1999, at 9:33:46
I only take the generic form. There is some debate whether selegiline itself is as bioavailable as eldepryl. I personally have noticed that eldepryl did cause a slight bit more anxiety than the generic form. Otherwise unless you noticed no effect from the generic I would stick with it. The brand name is very expensive. I just ordered the discoverey liquid form from an overseas source in England. It is supposedly far superior in it's efficacy and side effect profile. We'll see! It took about 3wks. to work up to my current dose. I should warn you that selegiline is quite activating and may cause uncomfortable anxiety. Good luck with convincing your doc to prescribe it, most in my area have not heard of its use in psychiatric health. It took a couple of sessions for me to talk him into it. Hope this helps!Brandon
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