![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6 to 30 of 30. Go back in thread:
Posted by greenwillow on October 31, 2004, at 16:22:17
In reply to Re: Sleep, etc. » Larry Hoover, posted by karaS on October 31, 2004, at 13:47:27
.
>
> I haven't had problems sleeping lately and I'm not taking anything for it. I do have occasional times when it is a problem now (and I have to take something) but most of the time it isn't. This is odd because for 20+ years I couldn't sleep AT ALL without taking something. My pdoc brought up the possibility of my being "soft bipolar". I'm more inclined to think that my occsasional bouts of insomnia are more hormone and/or stress related (since this is a relatively new phenomenon for me) but I haven't dismissed his theory entirely.
>
I would like to share my neat insomnia-sleep story here. I have had insomnia since fall 1997 and had tried many many medications, and had bad luck with most. This summer, I was not working due to an accident and had alot of time to use as I could. My sleep doctor and I decided to find out if I had delayed sleep disorder, since i didn't have much in the order of regular hours to keep. He instructed me to just stay up as long as I wanted and go to bed when I eventually felt sleepy. For me, my circadian rhythm was such that I would go to bed and promptly fall asleep at 5:30 or 6 a.m. then I wake up about 11:30. I felt great and it was the first time in years this was happening naturally. Once that was established after about a 2 week period, the doctor instructed me to start taking melatonin about 2 a.m. to coax my bedtime back to about 3 or 4 a.m. After about a week or two of that, he added bright light box therapy at 9 a.m. for one hour daily. That is when things really started to correct themselves. Within a week, I no longer needed the melatonin, and most nights fall asleep easily about 11:30 or midnight. Then we moved the wake up time to 7:30 a.m. I now awake about 7:30, use the light box 20 - 30 min. and am very happy that I no longer need medication. I have been to resume some work. Maybe this info can help someone.
Posted by karaS on October 31, 2004, at 16:54:57
In reply to Re: Sleep, etc. » karaS, posted by greenwillow on October 31, 2004, at 16:22:17
> .
> >
> > I haven't had problems sleeping lately and I'm not taking anything for it. I do have occasional times when it is a problem now (and I have to take something) but most of the time it isn't. This is odd because for 20+ years I couldn't sleep AT ALL without taking something. My pdoc brought up the possibility of my being "soft bipolar". I'm more inclined to think that my occsasional bouts of insomnia are more hormone and/or stress related (since this is a relatively new phenomenon for me) but I haven't dismissed his theory entirely.
> >
>
> I would like to share my neat insomnia-sleep story here. I have had insomnia since fall 1997 and had tried many many medications, and had bad luck with most. This summer, I was not working due to an accident and had alot of time to use as I could. My sleep doctor and I decided to find out if I had delayed sleep disorder, since i didn't have much in the order of regular hours to keep. He instructed me to just stay up as long as I wanted and go to bed when I eventually felt sleepy. For me, my circadian rhythm was such that I would go to bed and promptly fall asleep at 5:30 or 6 a.m. then I wake up about 11:30. I felt great and it was the first time in years this was happening naturally. Once that was established after about a 2 week period, the doctor instructed me to start taking melatonin about 2 a.m. to coax my bedtime back to about 3 or 4 a.m. After about a week or two of that, he added bright light box therapy at 9 a.m. for one hour daily. That is when things really started to correct themselves. Within a week, I no longer needed the melatonin, and most nights fall asleep easily about 11:30 or midnight. Then we moved the wake up time to 7:30 a.m. I now awake about 7:30, use the light box 20 - 30 min. and am very happy that I no longer need medication. I have been to resume some work. Maybe this info can help someone.
That's a great story. I have read about using melatonin along with a light box for resetting the sleep cycle. I'm surprised, though, that you no longer need to use the light box or the melatonin at all. If you have a delayed sleep cycle wouldn't your body be trying to delay your sleep again once you've reset your clock?K
Posted by greenwillow on November 1, 2004, at 22:15:21
In reply to Re: Sleep, etc. » greenwillow, posted by karaS on October 31, 2004, at 16:54:57
>
> That's a great story. I have read about using melatonin along with a light box for resetting the sleep cycle. I'm surprised, though, that you no longer need to use the light box or the melatonin at all. If you have a delayed sleep cycle wouldn't your body be trying to delay your sleep again once you've reset your clock?
>
> KI do still use the light box. Don't know why it was successful, but it sure was! I am very pleased. This is the first time in years that I feel tired in the evening. I used to still feel wired at bedtime and basically had to drug to get to sleep. It may have to do with the fact the the house we have lived in for the last 9 years gets NO direct sunlight into it and our yard is completely shaded with big trees and our neighbors big houses. Our previous homes always had sunshine somewhere in the house in the morning as well as a sunny backyard. The irony of the whole thing is that now we live in Texas, yet we get no sunshine.
Posted by karaS on November 1, 2004, at 22:29:18
In reply to Re: Sleep, etc., posted by greenwillow on November 1, 2004, at 22:15:21
> >
> > That's a great story. I have read about using melatonin along with a light box for resetting the sleep cycle. I'm surprised, though, that you no longer need to use the light box or the melatonin at all. If you have a delayed sleep cycle wouldn't your body be trying to delay your sleep again once you've reset your clock?
> >
> > K
>
> I do still use the light box. Don't know why it was successful, but it sure was! I am very pleased. This is the first time in years that I feel tired in the evening. I used to still feel wired at bedtime and basically had to drug to get to sleep. It may have to do with the fact the the house we have lived in for the last 9 years gets NO direct sunlight into it and our yard is completely shaded with big trees and our neighbors big houses. Our previous homes always had sunshine somewhere in the house in the morning as well as a sunny backyard. The irony of the whole thing is that now we live in Texas, yet we get no sunshine.
Thanks. I really need to get more disciplined and use the sunlamp regularly. If 15-20 minutes every morning is all you need to maintain the early sleep cycle, then I think I can make that time.
K
Posted by Larry Hoover on November 2, 2004, at 9:09:39
In reply to Re: Sleep, etc. » Larry Hoover, posted by karaS on October 31, 2004, at 13:47:27
> I noticed in another post of yours that you are currently taking some lithium orotate. Do you mind if I ask you why and what, if anything, it is doing for you? My pdoc suggested I try it but I have major reservations - esp. because of my hypothyroid condition.
Despite my intellectual reservations about lithium orotate (expressed in some detail on this board), I was persuaded by personal accounts of efficacy. The actual lithium intake is quite low, relative to therapeutic lithium doses as for mood stabilization. The low dose would most likely keep it from being acutely or chronically toxic to the thyroid, I would think.
I decided to add it in with my a.m. selegiline (5 mg seems to be the dose for me, with 500 mg DLPA), to see if it would take the edginess off. It seems to do so.
> Also, since Ritalin and selegiline put me to sleep, can you see any problem with me taking them as a sleeping aid (once in a while and/or frequently should the need arise)?
>
> Thanks,
> KaraI'm afraid that no amount of thinking will answer the question, Kara. You're going to have to do the experiment. I do recall that you did not previously combine selegiline with DLPA, and that may itself be a critical variable.
Lar
Posted by karaS on November 2, 2004, at 21:47:33
In reply to Re: Sleep, etc. » karaS, posted by Larry Hoover on November 2, 2004, at 9:09:39
> > I noticed in another post of yours that you are currently taking some lithium orotate. Do you mind if I ask you why and what, if anything, it is doing for you? My pdoc suggested I try it but I have major reservations - esp. because of my hypothyroid condition.
>
> Despite my intellectual reservations about lithium orotate (expressed in some detail on this board), I was persuaded by personal accounts of efficacy. The actual lithium intake is quite low, relative to therapeutic lithium doses as for mood stabilization. The low dose would most likely keep it from being acutely or chronically toxic to the thyroid, I would think.
>
> I decided to add it in with my a.m. selegiline (5 mg seems to be the dose for me, with 500 mg DLPA), to see if it would take the edginess off. It seems to do so.Interesting. I would never have thought to do that.
> > Also, since Ritalin and selegiline put me to sleep, can you see any problem with me taking them as a sleeping aid (once in a while and/or frequently should the need arise)?
> >
> > Thanks,
> > Kara
>
> I'm afraid that no amount of thinking will answer the question, Kara. You're going to have to do the experiment. I do recall that you did not previously combine selegiline with DLPA, and that may itself be a critical variable.
>
> LarLarry,
I think you misunderstood my question above. I wasn't asking if I should do the selegiline with DLPA experiment. I was wondering if it would be dangerous in any way for me to use selegiline or Ritalin as a sleeping pill since they put me (with my hypersensitive DA autoreceptors) to sleep rather than stimulate me. I was wondering if using them in this way might ultimately make my DA problems worse or whether I could use them to help me sleep without any long-term repercussions.Thanks,
K
Posted by KaraS on November 3, 2004, at 15:39:07
In reply to Re: Sleep, etc. » karaS, posted by Larry Hoover on November 2, 2004, at 9:09:39
> > I noticed in another post of yours that you are currently taking some lithium orotate. Do you mind if I ask you why and what, if anything, it is doing for you? My pdoc suggested I try it but I have major reservations - esp. because of my hypothyroid condition.
>
> Despite my intellectual reservations about lithium orotate (expressed in some detail on this board), I was persuaded by personal accounts of efficacy. The actual lithium intake is quite low, relative to therapeutic lithium doses as for mood stabilization. The low dose would most likely keep it from being acutely or chronically toxic to the thyroid, I would think.
>
> I decided to add it in with my a.m. selegiline (5 mg seems to be the dose for me, with 500 mg DLPA), to see if it would take the edginess off. It seems to do so.
Also, Larry, if you don't mind, could you tell me how much lithium you are taking? I have a friend on Wellbutrin who got a prescription for Seroquel in order to take the edge off. It was probably overkill and he's going to abandon it. I was wondering after reading your post whether a small amount of lithium might just do the trick for him as well.Thanks,
K
Posted by Larry Hoover on November 4, 2004, at 9:43:05
In reply to Re: Sleep, etc. » Larry Hoover, posted by karaS on November 2, 2004, at 21:47:33
> > I'm afraid that no amount of thinking will answer the question, Kara. You're going to have to do the experiment. I do recall that you did not previously combine selegiline with DLPA, and that may itself be a critical variable.
> >
> > Lar
>
> Larry,
> I think you misunderstood my question above. I wasn't asking if I should do the selegiline with DLPA experiment. I was wondering if it would be dangerous in any way for me to use selegiline or Ritalin as a sleeping pill since they put me (with my hypersensitive DA autoreceptors) to sleep rather than stimulate me. I was wondering if using them in this way might ultimately make my DA problems worse or whether I could use them to help me sleep without any long-term repercussions.
>
> Thanks,
> KNo, that is my answer to the question. I don't think there is any way to know the answer without doing the experiment. I wouldn't suggest that dangerous might describe the risk. It may be unpleasant, if it messes with sleep.
Your hypothesis is that you have hypersensitive DA autoreceptors. You could look at the selegiline/DLPA experiment as a test of the null hypothesis.
Lar
Posted by Larry Hoover on November 4, 2004, at 10:02:51
In reply to Re: Lithium for taking the edge off » Larry Hoover, posted by KaraS on November 3, 2004, at 15:39:07
> > > I noticed in another post of yours that you are currently taking some lithium orotate. Do you mind if I ask you why and what, if anything, it is doing for you? My pdoc suggested I try it but I have major reservations - esp. because of my hypothyroid condition.
> >
> > Despite my intellectual reservations about lithium orotate (expressed in some detail on this board), I was persuaded by personal accounts of efficacy. The actual lithium intake is quite low, relative to therapeutic lithium doses as for mood stabilization. The low dose would most likely keep it from being acutely or chronically toxic to the thyroid, I would think.
> >
> > I decided to add it in with my a.m. selegiline (5 mg seems to be the dose for me, with 500 mg DLPA), to see if it would take the edginess off. It seems to do so.
>
>
> Also, Larry, if you don't mind, could you tell me how much lithium you are taking? I have a friend on Wellbutrin who got a prescription for Seroquel in order to take the edge off. It was probably overkill and he's going to abandon it. I was wondering after reading your post whether a small amount of lithium might just do the trick for him as well.
>
> Thanks,
> K
>I'm using the 120 mg lithium orotate. At that dose, I cannot conceive of an adverse interaction. Niacinamide or taurine might be other options to consider.
Lar
Posted by KaraS on November 4, 2004, at 14:04:15
In reply to Re: Lithium for taking the edge off » KaraS, posted by Larry Hoover on November 4, 2004, at 10:02:51
Posted by KaraS on November 4, 2004, at 15:12:13
In reply to Re: Sleep, etc. » karaS, posted by Larry Hoover on November 4, 2004, at 9:43:05
> > > I'm afraid that no amount of thinking will answer the question, Kara. You're going to have to do the experiment. I do recall that you did not previously combine selegiline with DLPA, and that may itself be a critical variable.
> > >
> > > Lar
> >
> > Larry,
> > I think you misunderstood my question above. I wasn't asking if I should do the selegiline with DLPA experiment. I was wondering if it would be dangerous in any way for me to use selegiline or Ritalin as a sleeping pill since they put me (with my hypersensitive DA autoreceptors) to sleep rather than stimulate me. I was wondering if using them in this way might ultimately make my DA problems worse or whether I could use them to help me sleep without any long-term repercussions.
> >
> > Thanks,
> > K
>
> No, that is my answer to the question. I don't think there is any way to know the answer without doing the experiment. I wouldn't suggest that dangerous might describe the risk. It may be unpleasant, if it messes with sleep.
>
> Your hypothesis is that you have hypersensitive DA autoreceptors. You could look at the selegiline/DLPA experiment as a test of the null hypothesis.
>
> Lar
>
But I have taken selegiline and it does put me to sleep. That confirms the hypothesis, no? My concern is could the continuous taking of selegiline do harm to the autoreceptors perhaps by making them more hypersensitive? I'd rather try to figure that out theoretically than empirically.
Posted by Larry Hoover on November 7, 2004, at 11:23:53
In reply to Re: Sleep, etc. » Larry Hoover, posted by KaraS on November 4, 2004, at 15:12:13
> > Your hypothesis is that you have hypersensitive DA autoreceptors. You could look at the selegiline/DLPA experiment as a test of the null hypothesis.
> >
> > Lar
> >
>
>
> But I have taken selegiline and it does put me to sleep. That confirms the hypothesis, no?I dunno. I don't think you did the DLPA part, right?
Sleep is a very complicated process. If you watch and listen to this flash presentation, you may get one of those intuitive aha's....
http://www.medscape.com/viewprogram/2791?src=search>My concern is could the continuous taking of selegiline do harm to the autoreceptors perhaps by making them more hypersensitive? I'd rather try to figure that out theoretically than empirically.
I don't know that you can. I'd wonder what led to hypersensitivity in the first place. Was it acute? Chronic? Did the situation remit/revert over time? (I.e. has the hypersensitivity gone away again?)
I can only shrug.
Lar
Posted by KaraS on November 12, 2004, at 14:46:38
In reply to Re: Sleep, etc. » KaraS, posted by Larry Hoover on November 7, 2004, at 11:23:53
> > > Your hypothesis is that you have hypersensitive DA autoreceptors. You could look at the selegiline/DLPA experiment as a test of the null hypothesis.
> > >
> > > Lar
> > >
> >
> >
> > But I have taken selegiline and it does put me to sleep. That confirms the hypothesis, no?
>
> I dunno. I don't think you did the DLPA part, right?Even without the DLPA, selegiline shouldn't put me to sleep - if those autoreceptors aren't hypersensitive.
> Sleep is a very complicated process. If you watch and listen to this flash presentation, you may get one of those intuitive aha's....
> http://www.medscape.com/viewprogram/2791?src=search
Ok, I admit it. I have no idea why you sent me that link. No intuitive ahas. No concept of how this relates to my DA autoreceptor problem.
I assume, based on other things you wrote, that I'm supposed to understand from this how selegiline might help me - but I don't see it.
> >My concern is could the continuous taking of selegiline do harm to the autoreceptors perhaps by making them more hypersensitive? I'd rather try to figure that out theoretically than empirically.
I was thinking about this all wrong. The flooding of the synapses with dopamine is exactly what I need.
> I don't know that you can. I'd wonder what led to hypersensitivity in the first place. Was it acute? Chronic? Did the situation remit/revert over time? (I.e. has the hypersensitivity gone away again?)
> I can only shrug.
>
> Lar
I too wonder what lead to my hypersensitivity? Was I born that way? Could years of SSRI usage have given me this problem? Could it have been the CFS? A combination of the all of these things? All I know is that I've had this for the past few months because over that time I've tried several stimulant type meds and supplements that have all, paradoxically, put me to sleep. I doubt it has gone away since my last recent trial but when I start on the selegiline again I will find that out. One thing I am certain of is that I will never know the answers to the questions of how long I've had this problem and what caused it.So the next step is to take measures to lessen the hypersensitivity. I think it makes sense to try the selegiline again with the DLPA this time as you have been urging. It's cheap, I tolerate it and I have all of the ingredients here at home already and if it works, I don't have to worry about the MAOI diet. My next questions to you now are:
1) The P-5-P I have also contains some B2 and 100 mg. of magnesium (in oxide and taurinate form). Is this a problem? Do I need to get pure P-5-P?
2) Can I take them DLPA, P-5-P and selegiline at the same time? (esp. if I take the selegiline sublingually) Or maybe I should take the selegiline at night ('cuz it sedates me) while taking the DLPA + P-5-P in the AM? Does it matter at all when they're taken?
3) Do you know anything about the liquid selegiline citrate? I've read that it's better than the selegiline hydrochloride pills but I have a feeling that's more of a political issue than a therapeutic one.
Thanks,
K
Posted by tealady on November 13, 2004, at 18:36:01
In reply to Re: Sleep, selegiline and autoreceptors » Larry Hoover, posted by KaraS on November 12, 2004, at 14:46:38
> I was thinking about this all wrong. The flooding of the synapses with dopamine is exactly what I need.
>probably but very gradually....like over months or years depending on how long you have had the problem and your age(the older the more gradual, the longer the more gradual)
> 1) The P-5-P I have also contains some B2 and 100 mg. of magnesium (in oxide and taurinate form). Is this a problem? Do I need to get pure P-5-P?
>
I like that one..Now brand..yes it works wellJan
PS. I'm lost with everything else
Posted by KaraS on November 18, 2004, at 1:31:45
In reply to Re: Sleep, selegiline and autoreceptors » KaraS, posted by tealady on November 13, 2004, at 18:36:01
> > I was thinking about this all wrong. The flooding of the synapses with dopamine is exactly what I need.
> >
>
> probably but very gradually....like over months or years depending on how long you have had the problem and your age(the older the more gradual, the longer the more gradual)
>
> > 1) The P-5-P I have also contains some B2 and 100 mg. of magnesium (in oxide and taurinate form). Is this a problem? Do I need to get pure P-5-P?
> >
> I like that one..Now brand..yes it works well
>
> Jan
> PS. I'm lost with everything else
I don't know how long Ive had it but I am 49 years old. To think it might take years is depressing in and of itself - but then what is the alternative?
Posted by Larry Hoover on November 21, 2004, at 12:17:11
In reply to Re: Sleep, selegiline and autoreceptors » Larry Hoover, posted by KaraS on November 12, 2004, at 14:46:38
> > > > Your hypothesis is that you have hypersensitive DA autoreceptors. You could look at the selegiline/DLPA experiment as a test of the null hypothesis.
> > > >
> > > > Lar
> > > >
> > >
> > >
> > > But I have taken selegiline and it does put me to sleep. That confirms the hypothesis, no?
> >
> > I dunno. I don't think you did the DLPA part, right?
>
> Even without the DLPA, selegiline shouldn't put me to sleep - if those autoreceptors aren't hypersensitive.There may be another explanation, why it puts you to sleep.
> > Sleep is a very complicated process. If you watch and listen to this flash presentation, you may get one of those intuitive aha's....
> > http://www.medscape.com/viewprogram/2791?src=search
>
>
> Ok, I admit it. I have no idea why you sent me that link. No intuitive ahas.I thought section 2, the detailed analysis of the complex network of different brain structures and neurotransmitters impinging on sleep, might have made something click.
> No concept of how this relates to my DA autoreceptor problem.
Maybe that's not the problem at all, eh?
> I assume, based on other things you wrote, that I'm supposed to understand from this how selegiline might help me - but I don't see it.
I thought you wanted it to deal with fatigue (which it would do, through stabilization of the mitochondrial membranes). The sleepiness thingie is a side-effect, in the greater scheme of things.
> > >My concern is could the continuous taking of selegiline do harm to the autoreceptors perhaps by making them more hypersensitive? I'd rather try to figure that out theoretically than empirically.
>
>
> I was thinking about this all wrong. The flooding of the synapses with dopamine is exactly what I need.Yes, your brain could have adapted to a deficiency in dopamine by becoming exquisitely autoreceptive. But again, I'm encouraging you to not close your mind on the subject. Theories are just that, theories. What else might explain your symptoms/response to meds? That should always be something being thought about, in parallel to your consideration of this one theory.
> > I don't know that you can. I'd wonder what led to hypersensitivity in the first place. Was it acute? Chronic? Did the situation remit/revert over time? (I.e. has the hypersensitivity gone away again?)
>
> > I can only shrug.
> >
> > Lar
>
>
> I too wonder what lead to my hypersensitivity? Was I born that way? Could years of SSRI usage have given me this problem? Could it have been the CFS? A combination of the all of these things?Combination is most likely, though I lean to genes and CFS. I don't like blaming drugs, because if you weren't sick, you'd not have taken them at all.
> All I know is that I've had this for the past few months because over that time I've tried several stimulant type meds and supplements that have all, paradoxically, put me to sleep. I doubt it has gone away since my last recent trial but when I start on the selegiline again I will find that out. One thing I am certain of is that I will never know the answers to the questions of how long I've had this problem and what caused it.
Have you stayed on the meds for long enough to see if your body re-adapts?
> So the next step is to take measures to lessen the hypersensitivity. I think it makes sense to try the selegiline again with the DLPA this time as you have been urging. It's cheap, I tolerate it and I have all of the ingredients here at home already and if it works, I don't have to worry about the MAOI diet. My next questions to you now are:
>
> 1) The P-5-P I have also contains some B2 and 100 mg. of magnesium (in oxide and taurinate form). Is this a problem? Do I need to get pure P-5-P?I can't see why a little extra nutrition could possibly be a problem.
> 2) Can I take them DLPA, P-5-P and selegiline at the same time? (esp. if I take the selegiline sublingually) Or maybe I should take the selegiline at night ('cuz it sedates me) while taking the DLPA + P-5-P in the AM? Does it matter at all when they're taken?It only matters if you notice a difference. I wouldn't dream of trying to predict how you will react. I try to stay away from limiting my own thinking, in that way, about myself.
I'd suggest you use your intuition, and if you don't get the results you'd hoped for, you try another option from the list.
> 3) Do you know anything about the liquid selegiline citrate? I've read that it's better than the selegiline hydrochloride pills but I have a feeling that's more of a political issue than a therapeutic one.It's moot to me. Only the hydrochloride tablets available in Canada.
I suspect the sublingual preparations are better tolerated, and may avoid first-pass metabolism transformations. In gut uptake, the drugs run an enzyme gauntlet in the intestinal wall and mesentery, and then pass via the portal vein to the liver, where they get another shot at being enzymatically transformed. It looks like selegiline is substantially affected by first-pass metabolism, so I see this as a pharmacological issue, not a political one.
>
> Thanks,
> KWelcome,
Lar
Posted by Larry Hoover on November 21, 2004, at 12:19:57
In reply to Re: Sleep, selegiline and autoreceptors » tealady, posted by KaraS on November 18, 2004, at 1:31:45
> I don't know how long Ive had it but I am 49 years old. To think it might take years is depressing in and of itself - but then what is the alternative?
I like one of the sayings at Narcotics Anonymous. "You didn't become sick in one day, so remember, easy does it."
Lar
Posted by KaraS on November 21, 2004, at 14:32:24
In reply to Re: Sleep, selegiline and autoreceptors » KaraS, posted by Larry Hoover on November 21, 2004, at 12:17:11
> > Even without the DLPA, selegiline shouldn't put me to sleep - if those autoreceptors aren't hypersensitive.
>
> There may be another explanation, why it puts you to sleep.
>
> > > Sleep is a very complicated process. If you watch and listen to this flash presentation, you may get one of those intuitive aha's....
> > > http://www.medscape.com/viewprogram/2791?src=search
> >
> >
> > Ok, I admit it. I have no idea why you sent me that link. No intuitive ahas.
>
> I thought section 2, the detailed analysis of the complex network of different brain structures and neurotransmitters impinging on sleep, might have made something click.It might have had I not gone in looking for something about the DA autoreceptors. :-) I'll have to look at it again but even if other things can impinge on sleep, it has to be related in some way here to what the selegiline does, no? Otherwise how is it relevant? Perhaps my first step is to read up on exactly what selegiline does once you consume it.
> > I assume, based on other things you wrote, that I'm supposed to understand from this how selegiline might help me - but I don't see it.
>
> I thought you wanted it to deal with fatigue (which it would do, through stabilization of the mitochondrial membranes). The sleepiness thingie is a side-effect, in the greater scheme of things.I think I have less of a problem with fatigue than with lack of motivation. (I get bouts of CFS when I'm run down but it's not all that often anymore.) I would be taking the selegiline for depression/motivation. Any other benefits would be gravy. Besides, the sleepiness thingie could be a side effect that is telling me what the nature of the problem is though.
> > > >My concern is could the continuous taking of selegiline do harm to the autoreceptors perhaps by making them more hypersensitive? I'd rather try to figure that out theoretically than empirically.
> >
> >
> > I was thinking about this all wrong. The flooding of the synapses with dopamine is exactly what I need.
>
> Yes, your brain could have adapted to a deficiency in dopamine by becoming exquisitely autoreceptive. But again, I'm encouraging you to not close your mind on the subject. Theories are just that, theories. What else might explain your symptoms/response to meds? That should always be something being thought about, in parallel to your consideration of this one theory.Most of the other theories I've entertained so far have to do with processes around dopamine in some way. Too limiting perhaps?
> > > I don't know that you can. I'd wonder what led to hypersensitivity in the first place. Was it acute? Chronic? Did the situation remit/revert over time? (I.e. has the hypersensitivity gone away again?)
> >
> > > I can only shrug.
> > >
> > > Lar
> >
> >
> > I too wonder what lead to my hypersensitivity? Was I born that way? Could years of SSRI usage have given me this problem? Could it have been the CFS? A combination of the all of these things?
>
> Combination is most likely, though I lean to genes and CFS. I don't like blaming drugs, because if you weren't sick, you'd not have taken them at all.
I suppose if it were the SSRIs there would be a lot more people out there reacting paradoxically to stimulants.
> > All I know is that I've had this for the past few months because over that time I've tried several stimulant type meds and supplements that have all, paradoxically, put me to sleep. I doubt it has gone away since my last recent trial but when I start on the selegiline again I will find that out. One thing I am certain of is that I will never know the answers to the questions of how long I've had this problem and what caused it.
>
> Have you stayed on the meds for long enough to see if your body re-adapts?No, that's why I've just started trying it again. It's not easy to function on it though because it makes me sleepy during the day and then 8-9 hours later makes me feel stimulated. I will probably try taking it at night and hope that taking the DLPA in the morning will work out. If I start to change how I react to it (which is the goal) then I would switch to taking it in the AM.
> > So the next step is to take measures to lessen the hypersensitivity. I think it makes sense to try the selegiline again with the DLPA this time as you have been urging. It's cheap, I tolerate it and I have all of the ingredients here at home already and if it works, I don't have to worry about the MAOI diet. My next questions to you now are:
> >
> > 1) The P-5-P I have also contains some B2 and 100 mg. of magnesium (in oxide and taurinate form). Is this a problem? Do I need to get pure P-5-P?
>
> I can't see why a little extra nutrition could possibly be a problem.
>
> > 2) Can I take them DLPA, P-5-P and selegiline at the same time? (esp. if I take the selegiline sublingually) Or maybe I should take the selegiline at night ('cuz it sedates me) while taking the DLPA + P-5-P in the AM? Does it matter at all when they're taken?
>
> It only matters if you notice a difference. I wouldn't dream of trying to predict how you will react. I try to stay away from limiting my own thinking, in that way, about myself.
>
> I'd suggest you use your intuition, and if you don't get the results you'd hoped for, you try another option from the list.
>
> > 3) Do you know anything about the liquid selegiline citrate? I've read that it's better than the selegiline hydrochloride pills but I have a feeling that's more of a political issue than a therapeutic one.
>
> It's moot to me. Only the hydrochloride tablets available in Canada.
>
> I suspect the sublingual preparations are better tolerated, and may avoid first-pass metabolism transformations. In gut uptake, the drugs run an enzyme gauntlet in the intestinal wall and mesentery, and then pass via the portal vein to the liver, where they get another shot at being enzymatically transformed. It looks like selegiline is substantially affected by first-pass metabolism, so I see this as a pharmacological issue, not a political one.The selegiline citrate is a liquid - not sublingual. It goes through the stomach. So in that respect it would be a more equal comparison. Perhaps I will do the experiment at some point.
Have you given up on the selegiline yourself? The last I read it was bothering your asthma and creating GERD problems again. It's so frustrating when you find something that works but you have problems taking it.
Thanks again,
Kara
Posted by KaraS on November 21, 2004, at 14:34:06
In reply to Re: Sleep, selegiline and autoreceptors » KaraS, posted by Larry Hoover on November 21, 2004, at 12:19:57
Posted by Larry Hoover on November 25, 2004, at 5:17:17
In reply to Re: Sleep, selegiline and autoreceptors » Larry Hoover, posted by KaraS on November 21, 2004, at 14:32:24
> > Yes, your brain could have adapted to a deficiency in dopamine by becoming exquisitely autoreceptive. But again, I'm encouraging you to not close your mind on the subject. Theories are just that, theories. What else might explain your symptoms/response to meds? That should always be something being thought about, in parallel to your consideration of this one theory.
>
> Most of the other theories I've entertained so far have to do with processes around dopamine in some way. Too limiting perhaps?Thinking itself can be too limiting. I know you don't want to waste time, or effort, but as we all know, paradoxical responses are paradoxical only with respect to thinking. They are, in fact, quite natural for the individual so responding.
> > Have you stayed on the meds for long enough to see if your body re-adapts?
>
> No, that's why I've just started trying it again. It's not easy to function on it though because it makes me sleepy during the day and then 8-9 hours later makes me feel stimulated. I will probably try taking it at night and hope that taking the DLPA in the morning will work out. If I start to change how I react to it (which is the goal) then I would switch to taking it in the AM.I did a little "go off the selegiline and see what happens" experiment, and boy howdy, did I go boom. Back on it, and the brain works, but I can't sleep worth a darn. Maybe I should see if I can get some phenobarbitol.
> > > 3) Do you know anything about the liquid selegiline citrate? I've read that it's better than the selegiline hydrochloride pills but I have a feeling that's more of a political issue than a therapeutic one.
> >
> > It's moot to me. Only the hydrochloride tablets available in Canada.
> >
> > I suspect the sublingual preparations are better tolerated, and may avoid first-pass metabolism transformations. In gut uptake, the drugs run an enzyme gauntlet in the intestinal wall and mesentery, and then pass via the portal vein to the liver, where they get another shot at being enzymatically transformed. It looks like selegiline is substantially affected by first-pass metabolism, so I see this as a pharmacological issue, not a political one.
>
> The selegiline citrate is a liquid - not sublingual. It goes through the stomach. So in that respect it would be a more equal comparison. Perhaps I will do the experiment at some point.I cannot see the point of having a liquid preparation of this drug (which is also available as a quick-dissolving tablet for sublingual use), if it is not for sublingual use. It may not say so on the label, but that's how I would use it, without question. And, also without question, sublingual use of the regular tablets has a greater beneficial effect, with fewer side effects. Avoiding first-pass metabolism seems to be an important aspect of omptimizing selegiline's effects.
> Have you given up on the selegiline yourself? The last I read it was bothering your asthma and creating GERD problems again. It's so frustrating when you find something that works but you have problems taking it.
Still trying to figure out how to best use it.
> Thanks again,
> Kara
>Take care,
Lar
Posted by Ktemene on November 25, 2004, at 23:22:54
In reply to Re: Sleep, selegiline and autoreceptors » KaraS, posted by Larry Hoover on November 25, 2004, at 5:17:17
Hi Larry,
I was sorry to read that you were having a problem with acid reflux and Selegiline. Are you still having that problem?
For almost 5 months now I have been taking 5 mg Selegiline HCI powder from a capsule and holding it under my tongue to try to get some sublingual absorption, just as you do. And I also use DLPA (or L-PA) on an empty stomach as you do, and it does seem to increase the good effects of Selegiline. (I also exercise after taking the DLPA while still on an empty stomach, and then take the Selegiline after breakfast.) Selegiline is the most effective medication for my fatigue-ridden atypical depression that I have tried (and I have tried a lot of medications). The biggest problem I have is insomnia, and I noticed that you have it also. You said a while back that your sleep cocktail was 25 mg trimipramine, about .4 mg melatonin, 30 mg temazepam, and about 1.5 grams taurine. I wondered if you had thought about raising the dosage of melatonin? I know that you have reservations about melatonin. But I wondered what you thought about some of the literature that suggests that melatonin and Selegiline work synergistically together? This is one I came across on PubMed: Synergistic effects of melatonin and deprenyl against MPTP-induced mitochondrial damage and DA depletion.Neurobiol Aging. 2003 May-Jun;24(3):491-500.
PMID: 12600724I think I also read somewhere that melatonin stimulates brain glutathione peroxidase activity. Several posters have mentioned that if you are taking Selegiline then you are raising SOD activity, but that to keep antioxidant systems in balance you should take NAC or some other antioxidant for that effect. But could melatonin do just as well?
I also found an article that said that chronic melatonin treatment counteracts glucocorticoid-induced dysregulation of the HPA axis in the rat. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9630434&dopt=Citation) My HPA axis was fried when I was a child, and if any medication change that I would love it.
By the way, I have really enjoyed reading your posts ever since I discovered Psycho-Babble back in 2002.
Ktemene
Posted by Larry Hoover on November 26, 2004, at 10:25:56
In reply to Re: Sleep, selegiline and autoreceptors » Larry Hoover, posted by Ktemene on November 25, 2004, at 23:22:54
> Hi Larry,
>
> I was sorry to read that you were having a problem with acid reflux and Selegiline. Are you still having that problem?I seem to be able to avoid it, mostly, by dissolving the selegiline under my tongue. It's a really sensitive system; the effective selegiline dose and the reflux-inducing dose are not very far apart.
I really want to get some liquid selegiline, but it is not available in Canada. I'm going to see if I can get my doctor to go to the bother of importing it under Special Access guidelines.
> For almost 5 months now I have been taking 5 mg Selegiline HCI powder from a capsule and holding it under my tongue to try to get some sublingual absorption, just as you do. And I also use DLPA (or L-PA) on an empty stomach as you do, and it does seem to increase the good effects of Selegiline. (I also exercise after taking the DLPA while still on an empty stomach, and then take the Selegiline after breakfast.) Selegiline is the most effective medication for my fatigue-ridden atypical depression that I have tried (and I have tried a lot of medications). The biggest problem I have is insomnia, and I noticed that you have it also. You said a while back that your sleep cocktail was 25 mg trimipramine, about .4 mg melatonin, 30 mg temazepam, and about 1.5 grams taurine. I wondered if you had thought about raising the dosage of melatonin? I know that you have reservations about melatonin. But I wondered what you thought about some of the literature that suggests that melatonin and Selegiline work synergistically together? This is one I came across on PubMed: Synergistic effects of melatonin and deprenyl against MPTP-induced mitochondrial damage and DA depletion.Neurobiol Aging. 2003 May-Jun;24(3):491-500.
> PMID: 12600724Thanks for the reference. I might as well try increasing my dose of melatonin. My insomnia is on the verge of making me dysfunctional altogether.
> I think I also read somewhere that melatonin stimulates brain glutathione peroxidase activity. Several posters have mentioned that if you are taking Selegiline then you are raising SOD activity, but that to keep antioxidant systems in balance you should take NAC or some other antioxidant for that effect. But could melatonin do just as well?I think you're onto something here. The combination protects against dopamine auto-oxidation, which was one of Ray's concerns.
Your link has that bit: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12600724
This one shows the glutathione effect:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15521903If you take the microgram/kg ratio and apply it to humans, you're in the ballpark of 4-8 mg/day.
> I also found an article that said that chronic melatonin treatment counteracts glucocorticoid-induced dysregulation of the HPA axis in the rat. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9630434&dopt=Citation) My HPA axis was fried when I was a child, and if any medication change that I would love it.Mine too. OK, you've got good grounds for a melatonin trial. Thanks.
> By the way, I have really enjoyed reading your posts ever since I discovered Psycho-Babble back in 2002.
>
> KtemeneThank you. And thanks for joining in.
Lar
Posted by Larry Hoover on November 28, 2004, at 17:54:32
In reply to Re: Sleep, selegiline and autoreceptors » Ktemene, posted by Larry Hoover on November 26, 2004, at 10:25:56
Did you see what Ktemene posted?
Posted by KaraS on December 1, 2004, at 22:16:16
In reply to Re: Sleep, selegiline and autoreceptors » KaraS, posted by Larry Hoover on November 25, 2004, at 5:17:17
> > > Yes, your brain could have adapted to a deficiency in dopamine by becoming exquisitely autoreceptive. But again, I'm encouraging you to not close your mind on the subject. Theories are just that, theories. What else might explain your symptoms/response to meds? That should always be something being thought about, in parallel to your consideration of this one theory.
> >
> > Most of the other theories I've entertained so far have to do with processes around dopamine in some way. Too limiting perhaps?
>
> Thinking itself can be too limiting. I know you don't want to waste time, or effort, but as we all know, paradoxical responses are paradoxical only with respect to thinking. They are, in fact, quite natural for the individual so responding.I have to admit that I am prejudiced in favor of this theory. I've spent a lot of time on it. I finally understand it and I now know what to do about it. I don't want to start over! <g> But I will try to keep my mind open to other explanations. I have a hard time thinking that this could just be natural for me though. Natural in the sense that I may have been born this way, yes, but not natural in the sense that it should work this way. My depressive symptoms fit the low dopamine mold so something around that process is not right.
> > > Have you stayed on the meds for long enough to see if your body re-adapts?
> >
> > No, that's why I've just started trying it again. It's not easy to function on it though because it makes me sleepy during the day and then 8-9 hours later makes me feel stimulated. I will probably try taking it at night and hope that taking the DLPA in the morning will work out. If I start to change how I react to it (which is the goal) then I would switch to taking it in the AM.I'm taking the selegiline at night and the DLPA during the day. I'm only taking 2.5 mg. right now though. I'm just too groggy during the day with the 5 mg. Hopefully I'll build up to 5 soon. Also, I'll try taking the 2.5 mg in the day after the DLPA. I'm still in the early stages of experimentation with this.
> I did a little "go off the selegiline and see what happens" experiment, and boy howdy, did I go boom. Back on it, and the brain works, but I can't sleep worth a darn. Maybe I should see if I can get some phenobarbitol.So it works for you for both depression and cognition but the ampethamine metabolites are destroying your ability to sleep. How frustrating! Have you tried increasing the melatonin dosage per Ktemene's post? Too bad rasagiline isn't available yet! Does selegiline work better for you than all other ADs that you've tried? Are you still taking Solost?
> > > > 3) Do you know anything about the liquid selegiline citrate? I've read that it's better than the selegiline hydrochloride pills but I have a feeling that's more of a political issue than a therapeutic one.
> > >
> > > It's moot to me. Only the hydrochloride tablets available in Canada.
> > >
> > > I suspect the sublingual preparations are better tolerated, and may avoid first-pass metabolism transformations. In gut uptake, the drugs run an enzyme gauntlet in the intestinal wall and mesentery, and then pass via the portal vein to the liver, where they get another shot at being enzymatically transformed. It looks like selegiline is substantially affected by first-pass metabolism, so I see this as a pharmacological issue, not a political one.There is also a political issue surrounding the difficulty in finding the liquid citrate version here in the U.S. That's another story though.
> > The selegiline citrate is a liquid - not sublingual. It goes through the stomach. So in that respect it would be a more equal comparison. Perhaps I will do the experiment at some point.
>
> I cannot see the point of having a liquid preparation of this drug (which is also available as a quick-dissolving tablet for sublingual use), if it is not for sublingual use. It may not say so on the label, but that's how I would use it, without question. And, also without question, sublingual use of the regular tablets has a greater beneficial effect, with fewer side effects. Avoiding first-pass metabolism seems to be an important aspect of omptimizing selegiline's effects.I tried putting the selegiline under my tongue so as to avoid the first-pass metabolism but it started burning and it tasted so unpleasant. I had to stop it before it completely dissolved. I don't know how you're able to tolerate it that way unless you have one of the special forms that are made to be taken sublingually.
I'm going to see if I can find any more info on the citrate version and why some claim it's so much better.
Kara
Posted by Larry Hoover on December 7, 2004, at 10:12:07
In reply to Re: Sleep, selegiline and autoreceptors » Larry Hoover, posted by KaraS on December 1, 2004, at 22:16:16
> > Thinking itself can be too limiting. I know you don't want to waste time, or effort, but as we all know, paradoxical responses are paradoxical only with respect to thinking. They are, in fact, quite natural for the individual so responding.
>
> I have to admit that I am prejudiced in favor of this theory. I've spent a lot of time on it. I finally understand it and I now know what to do about it. I don't want to start over! <g> But I will try to keep my mind open to other explanations. I have a hard time thinking that this could just be natural for me though. Natural in the sense that I may have been born this way, yes, but not natural in the sense that it should work this way. My depressive symptoms fit the low dopamine mold so something around that process is not right.OK. Your intuition is on target. In my thinking, a "natural response" is my genes interacting with their environment. That's how you got to this place. As we think about it, it seems paradoxical. The solution to the problem may be itself paradoxical. That's the open-minded part, as the experiment that succeeds may not even fit with your primary hypothesis.
> > I did a little "go off the selegiline and see what happens" experiment, and boy howdy, did I go boom. Back on it, and the brain works, but I can't sleep worth a darn. Maybe I should see if I can get some phenobarbitol.
>
> So it works for you for both depression and cognition but the ampethamine metabolites are destroying your ability to sleep. How frustrating! Have you tried increasing the melatonin dosage per Ktemene's post?Yes, and at the dose suggested in those articles, I had vivid hypnogogic hallucinations. That's the almost asleep, brain doing movies thing.
> Too bad rasagiline isn't available yet! Does selegiline work better for you than all other ADs that you've tried? Are you still taking Solost?
No, I don't see the selegiline in an antidepressant light at all. It addresses focus and energy, rather than mood directly. Feeling better about my degree of functioning is antidepressant.
I am far far from Solost. I don't think SSRIs are part of my answer. People were telling me that my personality had changed, for the worse. That's not acceptable, given that the benefits were already tempered with major side effects.
As far as the best AD I've ever used, that is St. John's wort. No close seconds in the competition, either.Moclobemide was a good one at the beginning, but it pooped out rather quickly. I really don't want to have to deal with the MAOI diet, as I have food cravings for many foods which are explicitly forbidden. Mild MAOIs do work. I may have to give a serious trial of e.g. Parnate or Nardil, one of these days.
> > > > > 3) Do you know anything about the liquid selegiline citrate? I've read that it's better than the selegiline hydrochloride pills but I have a feeling that's more of a political issue than a therapeutic one.
> > > >
> > > > It's moot to me. Only the hydrochloride tablets available in Canada.
> > > >
> > > > I suspect the sublingual preparations are better tolerated, and may avoid first-pass metabolism transformations. In gut uptake, the drugs run an enzyme gauntlet in the intestinal wall and mesentery, and then pass via the portal vein to the liver, where they get another shot at being enzymatically transformed. It looks like selegiline is substantially affected by first-pass metabolism, so I see this as a pharmacological issue, not a political one.
>
> There is also a political issue surrounding the difficulty in finding the liquid citrate version here in the U.S. That's another story though.Ya, I looked into it. It looks like some guy tried to set himself up as a pharmaceutical supplier, though. Not a smart move.
> > > The selegiline citrate is a liquid - not sublingual. It goes through the stomach. So in that respect it would be a more equal comparison. Perhaps I will do the experiment at some point.
> >
> > I cannot see the point of having a liquid preparation of this drug (which is also available as a quick-dissolving tablet for sublingual use), if it is not for sublingual use. It may not say so on the label, but that's how I would use it, without question. And, also without question, sublingual use of the regular tablets has a greater beneficial effect, with fewer side effects. Avoiding first-pass metabolism seems to be an important aspect of omptimizing selegiline's effects.
>
> I tried putting the selegiline under my tongue so as to avoid the first-pass metabolism but it started burning and it tasted so unpleasant. I had to stop it before it completely dissolved.It does taste really sucky, I agree. You shouldn't leave the tablet in one place under your tongue. Slowly moving it around under there is best. You're going to swallow some, no question, but I just try to not swallow at all until the pill is dissolved, and maybe another minute more.
> I don't know how you're able to tolerate it that way unless you have one of the special forms that are made to be taken sublingually.
No, just the regular tablet. It actually dissolves more quickly than some sublingual supplements I have. I think your taste buds get used to the bitter taste. It doesn't seem so bad now.
> I'm going to see if I can find any more info on the citrate version and why some claim it's so much better.
>
> KaraThe only way I can get it is if I get my doctor to import it on my behalf. I asked. That ain't gonna happen. Too much paperwork.
Lar
This is the end of the thread.
Psycho-Babble Alternative | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.