Posted by Elizabeth on February 22, 2002, at 13:01:49
In reply to WELL HERE'S WHAT HAPPENED...., posted by Jason911 on February 21, 2002, at 20:38:57
Hi. Here's the best information I have that might apply to your situation.
At higher doses, selegiline i a nonselective MAOI. At lower doses, I'm not sure it will do much for you, although it's worth trying.
The MAO-B isoenzyme acts preferentially on dopamine, as you surmised; and selegiline is a MAO-B inhibitor at low doses (and becomes nonselective at higher doses). In contrast, nobody really knows what Wellbutrin does, although it's pretty well known that Wellbutrin exacerbates anxiety.
> My anxiety attacks have actually gotten a little worse.
That could easily be from the increased Wellbutrin. Ritch also has a good point; if you're raising the WB, you might want to wait on the selegiline, or vice versa. Selegiline and its active metabolites (l-amphetamine and l-methamphetamine) can certainly have sympathomimetic effects. Monitoring your blood pressure and heart rate seems warranted.
The seizure risk is not so much of a concern; selegiline actually has been found to have marked anticonvulsant effects (this has been studied in lab animals using pentylenetetrazole-induced seizures).
> Past 4 days I've been taking 2mg at one time at noon. I begin to feel quite good and I feel a balance with my mood and anxiety now but wears off my 6 or so.
That's odd. I've found that Klonopin lasts a good 8 hours, at least. (Or do you mean 6 am?)
> So I think I still need more klonopin.
Or maybe you need to divide the dose more? For example, 0.5 in the morning, 0.5 in the afternoon, 1 at bedtime. I found 4 mg/day (1 morning, 1 afternoon, 2 bedtime) to be optimal for me when I was taking it.
The vision thing is weird and could be caused by the Wellbutrin. That's just a guess, of course.
> I'm getting the impression that selegiline plus benzos actually benefit from each other and leaves you feeling great.
I'd expect them to complement one another, with the benzos alleviating the jitters from selegiline. Anyway, low-dose selegiline (5-10 mg) might well be of help to you, although IIRC there's much more evidence for high-dose selegiline (in depression, at least).
> Everybody reply and tell me if I'm going the wrong way or something, because I also think the Wellbutrin with deprenyl won't hurt.
The cardiovascular risk would be my main concern. Serotonin syndrome isn't a problem (as it can be with other ADs -- it even occurs occasionally with low-dose selegiline, I think); one thing that is known about Wellbutrin's mechanism of action is that it's not a serotonergic drug.
I'll be interested to hear how the selegiline works for you. I never tried taking a low dose, although I did once try a high dose (too jittery).
-elizabeth
poster:Elizabeth
thread:95046
URL: http://www.dr-bob.org/babble/20020222/msgs/95113.html