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Re: Selegiline making ADD worse? Increase dose? » Axmann

Posted by Larry Hoover on May 14, 2016, at 23:42:05

In reply to Selegiline making ADD worse? Increase dose?, posted by Axmann on May 14, 2016, at 21:21:09

> I have been taking the 6mg/24h dose of the Emsam patch for a little over a month.
>
> For some reason, my ADD seems like it is *much* worse than normal. I seem to have incredible difficulty initiating actions and switching my train of thought. My dexedrine doesn't even seem to help very much.
>
> Is it possible that this MAO-B selective dose of selegiline is increasing dopamine too much as the expense of norepinephrine?
>
> Would it be worth increasing the dose of Emsam to the 9 mg dose, or should I just scrap it altogether? My mood is doing fairly well actually, but I'm feeling very "dumb" and just not very sharp at all.

Axmann, I would recommend, first and foremost, that you begin by validating your own personal experience.

No matter what treatment you try, no matter how much you trust the prescribing physician, nor the research and statistics you've interpreted, you must honour you own experience, first and foremost.

Let's look at one sentence you posted. You said: "For some reason, my ADD seems like it is *much* worse than normal."
I would ask you if your observation was simply that your ADD was worse with selegiline, and that you were having trouble accepting that? Your observations are far more important than you expectations.

Rather than upping your selegiline, I would recommend that you go off it, and monitor whether your ADD symptoms return to a lower level. That is part of what is known as a challenge/dechallenge/rechallenge protocol. You would be doing the second stage of a possible three stage experiment, if you do as I suggest. https://en.wikipedia.org/wiki/Challenge%E2%80%93dechallenge%E2%80%93rechallenge

For the record, I am a practising scientist, and I am always testing methodology and assumptions in experiments. That includes my own attempts to manage my own symptoms.

Regards,
Lar

 

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poster:Larry Hoover thread:1088958
URL: http://www.dr-bob.org/babble/20160501/msgs/1088964.html