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Re: selegiline transdermally » jrbecker

Posted by SLS on August 24, 2004, at 14:41:16

In reply to Re: selegiline transdermally » SLS, posted by jrbecker on August 24, 2004, at 10:53:08

Hi JB.

Have I ever told you how wonderful you are? Well, I'm not about to start now... :-)

In my opinion, the most potent antidepressant in the world is clorgyline. I'm sure you know it to be a selective and irreversible MAO-A inhibitor. While it was still available for human consumption, the NIMH considered it their "ace-in-the-hole" for treating their most difficult cases of depression.

> > Do you think the transdermal delivery of selegiline confers a more potent antidepressant performance to the drug?

> wow, I could only handle 5 mg daily without totally feeling out of my mind.

I hope that is an indicator of your ultimate responsiveness to a drug with the right properties.

> yes, I absolutely do believe that the transdermal medium will equate to a better antidepressant effect --

There was a poster here a few years ago named "Adam" who had participated in a transdermal selegiline trial (at McLean, I think). He had previously used the oral preparation. He said the two felt like completely different drugs, with the transdermal exerting a much more potent and "smooth" antidepressant effect. His description was compelling. I don't remember the dosage used.

> http://www.sciencedirect.com/science?_ob=ArticleURL&_aset=B-WA-A-B-AYV-MsSAYWW-UUA-AUECECCYWU-AUEBCBZZWU-CYVDVCEAC-AYV-U&_rdoc=83&_fmt=full&_udi=B6T0N-3WT2NJX-R&_coverDate=07%2F31%2F1999&_cdi=4867&_orig=search&_st=13&_sort=d&view=c&_acct=C000052790&_version=1&_urlVersion=0&_userid=1458830&md5=0fb78949bfb24159a403cf90d83254ae
>
> " Results demonstrate that (a) selegiline is effective as an antidepressant in the forced-swim test after both oral and transdermal delivery; (b) the antidepressant-like effect of selegiline requires greater than 70% inhibition of MAO-A activity, and inhibition of MAO-B in the absence of MAO-A inhibition was ineffective; and (c) the transdermal delivery of selegiline is 10–20 times more potent (on a mg/kg basis) than oral selegiline in producing both its antidepressant-like effect and inhibiting cortical MAO-A compared to the oral administration of selegiline."

Wow!

> "It is now widely accepted that MAO-A inhibition is required for clinical improvement in depressed patients following the administration of selegiline [3, 14, 15, 16, 27 and 30],"

This is exactly what investigators at the NIMH concluded over ten years ago. It is not surprising how much faith they placed in clorgyline. Too bad the patent has expired on clorgyline. I would take it now and combine it with a desipramine if I had the opportunity.

> Will you and I be in that subset where the tradeoff of antidepressant effect and side effect tolerance is to our favor over other current options? Don't know.

Why not! You know everything else!

:-)


- Scott

 

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