Posted by zeugma on February 11, 2004, at 20:13:42
In reply to Re: strattera vs. selegilene for ADD » zeugma, posted by Chairman_MAO on February 10, 2004, at 20:07:45
> >but I wonder if there isn't something better out there, and this selegilene patch is the only plausible possibility. How does selegilene compare to Strattera as an ADD med?
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> Selegiline has myriad mechanisms of action (I mean, one could easily write 4 pages _summarizing_ everything it does) in addition to MAO inhibition; I wouldn't be surprised if in the higher doses the patch allows for it would be a robust ADD med. My guess is that the patch would be better for inattentive ADD/adult AD[H]D whereas Strattera is better as a chemical straightjacket for children in classrooms. Or, to phrase it differently, I found selegiline to be a mood-brightening cognitive enhancer that increased my "joi de vivre" whereas atomoxetine dampened my emotions and allowed me to "zone in" more easily without feeling distracted. Atomoxetine is good for melancholic depression, probably, but I doubt it provides the coarse effect that 20-40mg/day of selegiline does.
FWIW, I don't find that atomoxetine dampens my emotions. On the contrary, its effect on me is something I would describe as 'emotional stimulation.' It didn't feel like a physical stimulant except at the very beginning. Things seem more important, emotionally speaking, on it, and so I'm more likely to concentrate on something instead of regard it wih indifference (and lose my focus- since focus requires so much effort).Nortriptyline's emotional effect was similar, so I'm guessing this has to do with NE reuptake inhibition. The difference between atomoxetine and nortriptyline seems to be that while nortriptyline is emotionally stimulating, it doesn't promote the clarity that atomoxetine does.
I probably have these favorable effects from the NE reuptake inhibitors because I have melancholicdepression. What I am wondering about is whether there is really any special benefit that TCA's and other NRI's have over MAO inhibitors when it comes to this form of depression. Or were TCA's used for this type of depression simply because MAOI's were considered too risky? Some of the evidence I have seen suggests the former but it isn't clear to me what effect the differences in mechanism could play.
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> >what about its antidepressant properties?
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> see above
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> >Does selgilene help with social anxiety as well?
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> It probably helps with the motivational "oh-I-think-I'll-talk-to-those-people" and cognitive "I-feel-like-I-know-what-to-say-and-enjoy-saying-it" aspects of social PHOBIA. Insofar as the actual "I-feel-physically-anxious-and-it-makes-me-uncomfortable" is concerned, that probably depends upon the individual and/or requires 30mg/day or more of selegiline (so you get some serotonergic effect). But who knows, this is wild conjecture on my part.
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> >Does it cause problems with insomnia?
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> Unless amphetamine puts you to sleep, it will.
I need something to put me to sleep every night. If I was on selegilene, I would continue to supplement with a TCA for sleep and IBS.
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poster:zeugma
thread:311818
URL: http://www.dr-bob.org/babble/20040210/msgs/312246.html