Posted by LizinManhattan on February 8, 2006, at 18:52:33
In reply to Re: Selegiline/Deprenyl effective anti-depressant? » LizinManhattan, posted by Larry Hoover on February 8, 2006, at 10:15:42
Hi Lar,
Thanks so much for the information. What you say makes a lot of sense. A bit disappointing to hear that there might still be blood pressure issues though. AS long as it doesn't spontaneously cause hypertensive crisis (as Parnate did for me) I suppose I could deal with it!
Liz> Your psychiatrist is basing his opinion on oral selegiline, which really could be thought of as being a different drug. Selegiline is readily changed by digestive enzymes in the intestinal wall and the liver. This protective net of enzymes is called the first pass metabolism; all oral drugs pass through this gauntlet.
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> If I recall correctly, as much as 60% of oral selegiline can be metabolized before it even gets into general blood circulation. And, the metabolites have activities that are different than the parent drug.
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> In contrast, the patch delivery system allows selegiline to trickle through directly into general circulation, avoiding that significant destruction via first pass enzymes. You get different drug effects, because the selegiline pretty much makes it into the brain unchanged.
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> It remains to be seen that Emsam is similar in effect to other MAOIs. And, individual differences in sensitivity to tyramine makes it hard to predict if food restrictions will apply or not. Some people may still have to watch their diet closely, to avoid BP effects.
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> Lar
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poster:LizinManhattan
thread:607362
URL: http://www.dr-bob.org/babble/20060205/msgs/607639.html