Posted by yznhymer on October 13, 2004, at 18:17:27
In reply to Re: Selegiline Sexual Side Effects » utopizen, posted by sfy on October 13, 2004, at 15:53:28
> > I'm about to get 10mg/day of Selegiline myself, but don't kid yourself- the reason why it's being developed in patch form is to deliver 20-25mg/day without needing a dietary restriction. 10mg/day of Seligiline alone is not going to do a thing for your depression, I hate to burst your bubble.
> >
> > I'm planning to take it along with 1500mg of DLPA, a supplement found in high-protein foods, 20mg of Celexa, and maybe some 60mg-120mg Cymbalta down the road-- along with my 60mg of Adderall/day and 3mg of Klonopin/day. And during Christmas break, I think I'll finally experiment with Strattera to see if it helps me lower my Adderall dose.
>
> I know all about the effectiveness (or lack thereof) of low-dose selegiline. I'm taking the selegiline with DLPA (and B6) and both clinical studies and anecdotal evidence has shown that some people have gotten relief taking that combo with only 10 mg.
>
> > If you haven't tried Cymbalta between 60-120mg for a few months, Parnate is probably not too wise, IMHO. Cymbalta is a powerful and potent new drug that helps to elevate mood, reduce anxiety, and increase motivation/drive/energy, according to reports here and partially according to insidecymbalta.com.
>
> Cymbalta's actually gotten mixed reviews here but it's a possibility (or the Emsam patch if it ever gets on the market).
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> > Cymbalta, according to Eli Lilly, found signfigigant results within 1-2 weeks of patients taking 60mg/day, and maximum results achieved by the 4th week (you may require up to 120mg/day, and it may take a couple of months before calling it quits).
>
> Although Prozac proved to be a godsend for my major depression at one point, I'd take Eli Lily's reports with a grain of salt. Plus the question is what were these patients being treated for? I have dysthymia/anhedonia/atypical depression and social anxiety disorder.
>
> > You can also always try adding about 300mg of Lithium to Cymbalta if it doesn't work fully for you, as many depressives find success with that. Lamictal also is proven to help boost the efficacy of antidepressants in patients who don't find relief from them. Antipsychotics like Risperdal, while incredibly painstaking to take for the first few weeks, often produces substantial gains when it's added to an antidepressant as well.
>
> Again, there is so little history with Cymbalta having just come to market that playing around with med cocktails seems like even more of a crapshoot to me.
>
> >
> > Parnate, though, gosh- I would have to think, if you tried really high doses of all these things in a sort of combination, and tried them for like 3 months, and you still didn't find relief, MAYBE it's an option. But it's an unlikely one. I doubt many doctors would give it to you before trying to up a dose of an antipsychotic, and if that didn't work, consider ECT.
>
> Actually, considering my history of dysthymia and social anxiety and my prior good response to Nardil, Parnate was recommended after a consult by a top psychopharmacologist - I just wanted to try another option before I took the MAOI plunge again (plus I was on a vacation in the summer that wouldn't have worked with the dietary restrictions). My pdoc has no problem with it if I choose to go ahead with the Parnate.
>
> I don't understand the utter fear of MAOI's - many people here have found relief from them, the dangers are overblown (I had not a single problem in over two years on Nardi), the food restrictions are not onerous, and they are considered one of the most effective meds for SA (few other meds have their dopaminergic effects and dopamine seems to play a big role in both SA and dysthymic disorders).
>
> And I can't understand preferring ECT to MAOI's. While I am not completely anti-ECT, they are generally recommended for deep, long-lasting, dark bouts of depression, not for the chronic low-level of depression and motivation that seem to be my main problems. Definitely not worth taking the risk of permanent memory loss for.
>sfy,
Thanks for your extensive post. We've been down similar paths and share the same diagnosis. I view your assessment of the landscape pretty much the same.
I hadn't really considered the option you chose... I was looking at Parnate or Cymbalta at this juncture, though I sort of felt from what I've read that the EMSAM patch may be my best option. I just couldn't afford to wait for its release.
I chose to try Cymbalta first mostly because it seemed easier than trying parnate first, and I also thought there might be a better chance of no sexual side effects. Ha! I'm expecting the sexual side effects will again be a deal killer.
The selegiline option you chose sounds like a good bet... hopefully a robust nardil-like response without the side effects. I'll be keeping my eyes open to see how you make out. Right now seems like you hit the sexual side effect snag. Sure hope it resolves itself.
poster:yznhymer
thread:402677
URL: http://www.dr-bob.org/babble/20041012/msgs/402782.html