Posted by Adam on February 9, 2000, at 11:22:37
In reply to ADAM PLEASE ANSWER, posted by SadSuzieQ on February 7, 2000, at 20:42:05
Hey, Suzie,
I'm terribly sorry I haven't answered this. The truth is I completely missed the post, and, also, my job has had me super busy the last week or so, and I haven't been able to give much else my attention...
Anyway, as for the whether or not the patch study is a worthwhile thing to try, I would give an emphatic yes, but, of course, there are always things you should be aware of:
I'm not sure if the protocol you will be following is the same as the one I followed, but it went something like this: Six weeks, double-blind segment, where there's an equal chance you will get low dose patch (10mg), high dose patch (20mg) or placebo. I'm pretty sure I got the placebo, which wasn't altogether fun. But I was pretty unlucky, given the odds. The cool thing is after the double-blind segment, you've got six whole months in the open-label segment, which is plenty of time to assess with total knowledge weather or not a high-dose patch (20mg) is doing you any good or not, and also to assess side effects.
Selegiline makes me feel very, very good compared to where I was, but it also gives me a fair amount of insomnia. My only allowed option for a sleep aid is Ambien, twice a week at most. It's not the most helpful solution, since Ambien seems to wear off in like two hours for me. That's a good 7.5 months of insomnia if you're like me and you get selegiline and not placebo to begin with. This has been the only physically unpleasant side-effect I have experienced, and, frankly, with some exercise to tire me out, it's not so bad these days.
Now, for the memory thing: My doctors seem to think this is an unusual side effect. Selegiline at low doses actually has been shown to enhance some memory functions in animal models, and if you look a little towards the fringe, various "Life Extension"-types hail it as a nootropic with anti-aging properties. However, this is low dose. High dose might be a completely different story, and there's some evidence that selegiline's behavior can be biphasic, meaning some responses to selegiline look a bit like a bell-curve when you plot magnitude of response vs. increasing dose.
BUT, I will reiterate: The memory difficulties I think I am having (and it's tough to know really where they are coming from) seem to be unusual for selegiline recipients. Big emphasis on "seem to be" since there's little or no empirical evidence one way or another in the literature that I'm aware of on the subject. There's scant information anywhere on the patch delivery system.
My advice: If you feel you don't have many options (I sure didn't) but an MAOI, I think the selegiline study is a very worthwhile thing to try. Full responders show GREAT improvement, and, if you get the high dose, the time it takes to respond using the patch delivery system can be VERY fast. A week to go from bad to wonderful is not all that uncommon. It sounds pretty incredible, but it's true, and I literally went from severly depressed to a brief wave of hypomanic euphoria (which seemed to resolve itself in a couple of weeks to just plain euthymia) in about three days. If this stuff works for you anything like it did for me, you will be a happy camper indeed. If not, you'll lose at most three months before you can give up and move on to something else. If memory deficits give you problems you can't live with, you can always drop out. It's that simple.
I hope this helps, Suzie, and best of luck to you. Let us all know how it goes, OK?
Adam
> Hi Adam,
>
> I have the chance to participate in selegiline patch study in the near future. Having read your posts on your experience over the past few months, I was very excited about the prospect. Also, the only AD I've ever responded to is Nardil, but had to stop taking it due to the side effects.
>
> I read your November posting about the memory problems, and they do seem related to the selegiline. Now I'm not so sure. I don't have the greatest memory in the world anyway,and don't want it to get worse!
>
> Would you mind sending me an e-mail and letting me know your experience to date- both pro and con? Have you discussed this side effect with the doctors involved in the study? I can use all the help I can get here.
>
> To participate in the study would requrie me to travel 6 hours every week, and I'm willing to do so if the drug offers real hope. But if I'm going to experience memory problems, I'll stick with my depresssion. At least I'm use to it.
>
> Sorry this is so long, but I really need some help here.
>
> Thanks,
>
> sq
poster:Adam
thread:20709
URL: http://www.dr-bob.org/babble/20000209/msgs/20911.html