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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Else on July 25, 2001, at 21:01:39
I remember reading somewhere that the good people at McLean were working on MAOI patches that would allow the drug to bypass the liver and thus avoid the cheese effect. They were supposed to work much faster too (one week instead of the usual 2 to 4(or 4 to 6)) I've heard nothing about it since. Does anyone know what is going on? When will these be made availlable to us if ever?
Posted by shelliR on July 25, 2001, at 22:54:44
In reply to MAOI patches, posted by Else on July 25, 2001, at 21:01:39
> I remember reading somewhere that the good people at McLean were working on MAOI patches that would allow the drug to bypass the liver and thus avoid the cheese effect. They were supposed to work much faster too (one week instead of the usual 2 to 4(or 4 to 6)) I've heard nothing about it since. Does anyone know what is going on? When will these be made availlable to us if ever?
Hi Else.
I talked to one of the researchers at McLean a few months ago and he said that it would be another year for FDA approval. The MAOI was selegiline. And I think they are really good people at McLean, at least I was impressed with Dr. Bodkin. He supported my use of opiates for treatment resistent depression. Actually, it was his idea to try the pill form of selgeline and go up to a fairly high dose. He said there were no side effects, but almost everyone on the board who has tried selegiline has felt some shakiness from it. I also started getting leg pains, and gave up on it.
Shelli
Posted by Else on July 26, 2001, at 6:16:20
In reply to Re: MAOI patches » Else, posted by shelliR on July 25, 2001, at 22:54:44
Gosh, I think you're pretty lucky to be living in that area (I'm assuming you are). With Harvard near by and all the brilliant up-to-date doctors living there.
I'm interested in trying Selegiline. I can't imagine it would be worse than Wellbutrin as far as shakiness goes and it is probably more effective. Parnate certainly was. Besides, I'm on Klonopin which anihilates shakiness (except for Effexor) for me. Another year huh...? Well, it's probably worth the wait.
> > I remember reading somewhere that the good people at McLean were working on MAOI patches that would allow the drug to bypass the liver and thus avoid the cheese effect. They were supposed to work much faster too (one week instead of the usual 2 to 4(or 4 to 6)) I've heard nothing about it since. Does anyone know what is going on? When will these be made availlable to us if ever?
>
> Hi Else.
>
> I talked to one of the researchers at McLean a few months ago and he said that it would be another year for FDA approval. The MAOI was selegiline. And I think they are really good people at McLean, at least I was impressed with Dr. Bodkin. He supported my use of opiates for treatment resistent depression. Actually, it was his idea to try the pill form of selgeline and go up to a fairly high dose. He said there were no side effects, but almost everyone on the board who has tried selegiline has felt some shakiness from it. I also started getting leg pains, and gave up on it.
>
>
> Shelli
Posted by shelliR on July 26, 2001, at 8:15:05
In reply to Re: MAOI patches, posted by Else on July 26, 2001, at 6:16:20
> Gosh, I think you're pretty lucky to be living in that area (I'm assuming you are). With Harvard near by and all the brilliant up-to-date doctors living there.
Actually I don't live in that area. I had read several studies that Bodkin conducted and just called him on the phone several times. Then when I went into the hospital early this summer, my hospital pdoc called him to get more information about selegiline. He's a really busy guy, but sometimes he answers his own phone, so I got lucky.
Shelli
Posted by Elizabeth on July 26, 2001, at 23:09:38
In reply to Re: MAOI patches » Else, posted by shelliR on July 25, 2001, at 22:54:44
> I think they are really good people at McLean, at least I was impressed with Dr. Bodkin.
It's a major academic psychiatric hospital, and is very research-oriented. A lot of the staff there have vested interests in certain diagnoses or certain treatments, though; there's a lot of politics. Dr. Bodkin is cool, though, IMO.
> He supported my use of opiates for treatment resistent depression.
He's the one who *suggested* it to me.
-e
Posted by SalArmy4me on July 26, 2001, at 23:12:33
In reply to Re: MAOI patches » shelliR, posted by Elizabeth on July 26, 2001, at 23:09:38
Has any opiate really made that much of a difference in your life? Or are the MAOI's you take the ones that truly have an antidepressant effect?
Posted by Noa on July 27, 2001, at 9:34:56
In reply to Re: MAOI patches » Elizabeth, posted by SalArmy4me on July 26, 2001, at 23:12:33
Adam was in a study of a selegeline patch. He reported here that it worked well for him, without the side effects and food restrictions of the orally administered version. The study ended and he subsequently did continue with selegeline pills.
Posted by shelliR on July 27, 2001, at 18:43:31
In reply to Re: MAOI patches » Elizabeth, posted by SalArmy4me on July 26, 2001, at 23:12:33
> Has any opiate really made that much of a difference in your life? Or are the MAOI's you take the ones that truly have an antidepressant effect?
As hard as it has been for you to accept, opiates have made an enormous difference in my life. Presently I am not taking an MAOI for the first time in about fifteen years (except for a couple of months when "new" meds came out and I tried them, such as effexor, serzone, etc.)
I don't think that opiates are for everyone. I started taking them for pain, not depression, and discovered quite quickly that they were great both for premenstrual pain and for premenstrual depression for me. I was on Nardil the whole time, so I guess I considered the vicidin (which I used then) to be the augmenter. When nardil pooped out, vicidin took over as the main medication.
This last time in the hospital I was seen by a pdoc who generally does not see patients on the unit I was on. It's a much smaller unit, and it is for abuse survivors. It is much more personal and feel safer to me than the larger regular adult unit.
I had already decided that I wanted to try selegiline, but I was so incredibly depressed I didn't think I was going to make it through until the selegine kicked in. So he put me on OxyContin because it would be much smoother than taking vicidin every four or five hours. My depression lifted with the first dose. I dropped the selegiline after about three weeks; I was shakey and got bad pains in my legs.Really the only question that remains is how long I can keep up this dosage and still get the same anti-depressant effects. If I can find something else that also stabilizes me I think there is less likelihood that I will become habituated to the oxy. I did a few week trial of prozac with concerta and that wasn't good for me. So now I am trying estrogen and may (after my waiting period) go back to nardil, or try parnate for the first time.
Lots of people don't like the feel of opiates. And I would not recommend opiates to anyone who has an addictive personality, or has had cravings for any drug in the past. But yes, opiates can be extremely useful for TRD, under a doctor's supervision.
I also think MAOIs are greatly underused. Nardil was a wonderful anti-depressant for me for many years.Shelli
Posted by Elizabeth on July 27, 2001, at 20:49:25
In reply to Re: MAOI patches » Elizabeth, posted by SalArmy4me on July 26, 2001, at 23:12:33
> Has any opiate really made that much of a difference in your life? Or are the MAOI's you take the ones that truly have an antidepressant effect?
Buprenorphine works better than MAOIs have, alleviating symptoms that MAOIs don't touch (in particular, anhedonia and anergia). To say that it's made a difference would be an understatement. It completely relieves the entire depressive syndrome, it doesn't just lift my mood.
I'm hoping that the desipramine I'm taking now (300 mg) will help in ways that MAOIs don't help. Tricyclics are more hit-miss than MAOIs are, but TCAs are clearly indicated for the type of depression I have.
(Just a nitpick: buprenorphine is a synthetic partial agonist at mu receptors, properly called an "opioid," not an "opiate.")
-elizabeth
Posted by SalArmy4me on July 28, 2001, at 0:12:43
In reply to Re: MAOI patches » SalArmy4me, posted by Elizabeth on July 27, 2001, at 20:49:25
If Buprenorphine is working so well, why are you trying other drugs like tricyclics and MAOI's?
Posted by Elizabeth on July 29, 2001, at 14:58:36
In reply to Re: MAOI patches » Elizabeth, posted by SalArmy4me on July 28, 2001, at 0:12:43
> If Buprenorphine is working so well, why are you trying other drugs like tricyclics and MAOI's?
Side effects, inconvenient to get (retail pharmacies don't generally carry buprenorphine), inconvenient route of administration, short duration of action (it needs to be taken three times a day, which is inconvenient to say the least), etc.
I was already taking Parnate with partial success when I first took buprenorphine, incidentally. My experience has been that having a classic AD on board decreases the ups and downs caused by short-acting meds such as buprenorphine, Ritalin, Xanax, etc.
Buprenorphine has been a very effective antidepressant for me, eliminating the entire melancholic-depressive syndrome (if it hadn't worked so well, I wouldn't have put up with the side effects). I've found nothing else comparable. I get the impression that you'd prefer not to believe this, perhaps because it clashes with your world view, but that doesn't change the reality of the situation.
-elizabeth
Posted by SadSuzie on July 30, 2001, at 19:01:54
In reply to MAOI patches, posted by Else on July 25, 2001, at 21:01:39
I too participated in a selegiline patch study (spring and summer of 2000). The patch worked wonders for me. The only negative was some increase anxiety that could have easily been handled with a low dose anti-anxiety med. However, since I was in a clinical trial I couldn't take any other medications.
Prior to the patch I'd tried just about every AD in the book. Nardil was the only one that worked for me. Unfortunately, it eventually "pooped out" and I couldn't handle the side effects of an increased dose.
If the patch is ever approved I believe it will be a life saver for many.
Hope this info is helpful.
ss
Posted by Grouch on July 30, 2001, at 21:25:09
In reply to Re: MAOI patches, posted by SadSuzie on July 30, 2001, at 19:01:54
Hi Suzie,I was wondering if you've also tried oral selegiline. If so, how does it compare to the patch in terms of effectiveness & side effects?
This is the end of the thread.
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