Posted by KaraS on August 13, 2004, at 18:17:20
In reply to Selegiline Adam Gracie » KaraS, posted by Ktemene on August 12, 2004, at 0:08:44
> Hi Kara,
>
> I am so glad my post was helpful. I certainly know what it feels like when you try a series of meds that don't work and all hope seems to be draining away. And I am sorry to be getting back to you so late-I was away for a couple of days. That post of Adam’s that you linked to is one of my all time favorite posts. It gave me a lot of hope at a time when I really didn't know where to turn. One of the great things about Adam's post is that he acknowledges how hard it is sometimes to keep trying, and that makes you believe him when he says that it really is worth it to keep trying. I wish there were a place on Psycho-Babble called "Classic Posts" to archive wonderful unforgettable posts like Adam's and Gracie's, because so many new people never get a chance to read them except by accident. (By the way I would include among the classic posts the funny ones that you and Simus reposted on the Alternative board. They were hilarious. After I read them I kept bursting into giggles for the rest of the day…and got some strange looks from my colleagues.)That's an excellent idea about a classics board!!! There could be a section for inspirational posts and another for humorous posts. You can easily do searches on specific meds or treatments, but you can't do a search for inspirational or humorous posts. You just have to get lucky and run into them by mistake when searching for something else in the archives. It would be so helpful for anyone who needs reassurance to go to the inspirational section and read Adam's post or Gracie's post. Wish I had known about them a long time ago. (How about it Dr. Bob?)
I agree that those old posts about the person following his dog Cletus' example and the other one about the person eating Tom's of Maine toothpaste were a hoot. In the first one after the guy talks about eating grass and pigs ears and then says something to the effect of "the embarrassment of riches that the natural world has to offer" I nearly fell off of my chair laughing.
> Adam’s first very positive response was to the Selegiline patch, which finally received an approvable letter back in Febuary and is supposed to be available at the end of this year or in early 2005. But when he wrote the post you mention he was taking oral Selegiline and the dose (I think) was around 30 mg per day. Close to a year after he wrote that post, he went off oral Selegiline because of some odd problems he was having that he thought might have been connected to the insomnia caused by oral Selegiline. After he went off oral Selegiline and began sleeping well the odd problems he had been having did disappear. But he continued to remain depression-free and did not relapse even though he was no long taking Selegiline or any other antidepressant. Here’s a post where he briefly summarizes the whole story: http://www.dr-bob.org/babble/20011123/msgs/85472.html> Adam never really tried to deal with his Selegiline insomnia, because it did not bother him very much, until those odd problems developed. I have similar insomnia, and it does not really bother me either- it just gives me lots more time to catch up on all the work I didn’t do when I was depressed. But I am taking some advice from Adam and trying to find some meds to help with sleep because it may be some time before the patch comes out. I just thought I would mention this because you said that you had found 5 mg Selegiline somewhat activating on the couple of occasions when you tried it, and if you have the response to Selegiline that Adam and I had then you may also have some insomnia as well. Of course some people have a really positive response to Selegiline and don’t have to worry about insomnia. At any rate elleff and Jemma and Ron and some others don’t mention any problems with insomnia.
How can having insomnia for an extended period of time not bother someone? Eventually the bad effects from not getting enough sleep would have to be devastating, wouldn't they? At least there are some things you can take for the insomnia. I'm fully anticipating that I will have to do something.
>
> But to turn to your question. I am not sure which preparations of Selegiline Ron was referring to but there are three preparations that I know of that avoid the first pass effect at least to some extent. The patch avoids the first pass effect altogether and consequently has the fewest side effects. There is also Zydis Selegiline which is a pill designed to dissolve in the mouth and allow some of the med to be absorbed directly into the bloodstream, “buccal absorbtion” as they call it. In addition there is a liquid preparation of Selegiline called Jumax I think, and that also is meant to be held in the mouth so that as much as possible can be absorbed directly into the blood stream. Unfortunately both Zydis and the liquid form are unavailable in the U.S., although they are marketed in Europe. I try to get some “buccal absorption” by opening the Selegiline cap and pouring the powder into my mouth and holding it there for a few minutes.
>Thanks. I had never heard of Zydis selegiline. Good to know. I have read about Jumex and heard that it was superior to pill form but I wasn't sure if that were true or just a result of all of the political hype around it. What kind do you take? I don't recall if you mentioned it or not in earlier posts (other than to say it's in capsule form).
> To my mind Selegiline is an underrated med that has lots of advantages. It is neuroprotective and even at high doses it is much less likely to cause a hypertensive crisis than Parnate and Nardil and it goes well with lots of other meds. But of course I am prejudiced because Selegiline was the med that finally put my pretty much life-long depression into remission. I really hope it works for you. I think your idea of trying Selegiline with DLPA is a good one- taking DLPA has magnified Selegiline’s effect for a lot of people. In fact I think that strategy is recommended in the Psychopharmacological Tips section of Psycho-Babble.
>Yes, I love the fact that it's supposed to be neuroprotective. The claims for life extension are encouraging as well. I wasn't under the impression that it was a medication that mixed well with others though. (That's probably just because of the problems when you're above 10 mg and the MAO-A effects kick in.)
> By the way, I found the place where I read that 5 mg Selegiline after a number of weeks builds up to the point of inhibiting almost all MAO-B. It was AndrewB. Here’s the post: http://www.dr-bob.org/babble/20010310/msgs/56574.html AndrewB has some more interesting info on low-dose Selegiline at this post: http://www.dr-bob.org/babble/20010417/msgs/60824.html
>Thanks. I'll have to read those later this weekend. I love reading AndrewB's posts. I've read a lot of his stuff before and learned so much. Wonder how he is doing...
> If the pdoc that you get is hesitant about prescribing Selegiline, be sure to tell him/her about the patch. A lot of pdocs have never heard of the patch, and think that Selegiline is only used for PD. But there is now a lot of literature on Selegiline as an AD because the patch is so close to being marketed.
>
> Good luck, and keep us posted!
>
> Ktemene
Fingers crossed on the patch being marketed soon. Are you thinking of switching when it comes out or are you perfectly happy with your treatment as is?Yes, telling my doctor about the patch and bringing some literature on it and selegiline as an antidepressant could help. I remember the first time I brought up selegiline to my pdoc and he gave me that blank stare. He really didn't know anything about its use as an ntidepressant. So many of these doctors are so limited in their approaches. If they didn't learn it in medical school and if the big drug companies aren't pushing it to them, then they don't know anything about it. Fortunately this isn't the case with all of them and you can find some who are more proactive and keep up with the literature and the newest ideas in treatment (and are willing to take the considerable risks of new treatment I might add).
Thanks again for all of your help and have a great weekend!
-K
poster:KaraS
thread:373827
URL: http://www.dr-bob.org/babble/20040811/msgs/377354.html