Posted by Donna Louise on June 20, 2006, at 18:39:34
In reply to Re: Are Family Doctors prescribing EMSAM?, posted by jealibeanz on June 20, 2006, at 17:20:21
> Does anyone know the answer to this question?
I was hoping what I wrote earlier about the difference between oral and transdermal delivery and skipping first pass metabolism so that more of the parent drug (selegiline) enters the blood, would answer that question for you. What is 6mg orally is about 20mg transdermally. I don't know how else to say it. Anyone else able to explain it better? Help.
I take the 9mg patch which is equal to about 30mg of actual selegiline due to the bypass of metabolism in the liver the first time around. I took 6 mg for about 4 weeks and have been on 9 for about 4 weeks I think. I am much better on the 9mg. It is a stimulating drug due to the increased norepinephrine and dopamine levels and also in part by the amphetamine metabolites (although these are much less because there is less metabolism in the liver to create them. More parent compound, less metabolites with the transdermal system. The increase in serotonin helps the anxiety. But because I have ALOT of anxiety I also take klonopin .25 twice a day and either .25 or .5 at night before bed. I take 100mg provigil twice a day which is half the dose I took before the patch. I find it mood elevating and socially enhancing. I just added lamictal, I am only at 25 mg but it has from the get go made a huge difference in my irritability. That may be all the higher dose I need to take. That is all. I am feeling better than I have in a long time. I have taken all the sri's, wellbutrin, strattera, buspar, I can't remember what all. No TCA;s and this is my first MAOI. I will not go back to those others again.
I hope you can get a med or combo of meds that works for you.donna
poster:Donna Louise
thread:647686
URL: http://www.dr-bob.org/babble/20060617/msgs/659393.html