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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by pseudonym on December 16, 2004, at 11:50:19
Hello,
I am pleased to report that selegiline (5mg bid) is working well. I take it in combination with 800mg of phenylalanine in the morning, and by itself in the midafternoon. I have been given SSRI's, but they just didn't do the trick for my diagnosis (generalized + social anixety). I can tell you this though, I've been doing so well, that I don't bother reading Psycho-Babble. So, in my case, there is truth to the notion that if you're feeling well, there not much motivation to read or post.
Posted by Ritch on December 16, 2004, at 12:32:31
In reply to Selegiline working well, posted by pseudonym on December 16, 2004, at 11:50:19
> Hello,
>
> I am pleased to report that selegiline (5mg bid) is working well. I take it in combination with 800mg of phenylalanine in the morning, and by itself in the midafternoon. I have been given SSRI's, but they just didn't do the trick for my diagnosis (generalized + social anixety). I can tell you this though, I've been doing so well, that I don't bother reading Psycho-Babble. So, in my case, there is truth to the notion that if you're feeling well, there not much motivation to read or post.Are you taking the tablet, sublingual or EMSAM patch form? Do you take any other meds with it?
Posted by ravenstorm on December 16, 2004, at 16:43:19
In reply to Re: Selegiline working well » pseudonym, posted by Ritch on December 16, 2004, at 12:32:31
Wow, so selegeline isn't too activating for your anxiety? I think since I couldn't handle WB, selegeline is probably out for me. It actually helps your anxiety?
Posted by ed_uk on December 17, 2004, at 4:32:27
In reply to Re: Selegiline working well, posted by ravenstorm on December 16, 2004, at 16:43:19
I expect that some people who can't tolerate Wellbutin do well on selegiline, the two meds are very different pharmacologically.
Regards,
Ed.
Posted by darkhorse on December 17, 2004, at 8:59:15
In reply to Re: Selegiline working well » ravenstorm, posted by ed_uk on December 17, 2004, at 4:32:27
> I expect that some people who can't tolerate Wellbutin do well on selegiline, the two meds are very different pharmacologically.
>
> Regards,
> Ed.Yes,this is very true. I could not tolerate Wellbutrin;agitation,irritation,depression...yuck!!
However,I tried Seligiline at 5mg solo,and it gave a pleasant stimulation and well-being,but,unfortunatly,after several days nothing.I raised it to 10mg and it gave more side effects with no benefit at all.
Posted by ravenstorm on December 17, 2004, at 9:07:11
In reply to Re: Selegiline working well, posted by darkhorse on December 17, 2004, at 8:59:15
Good to know. Maybe the patch still is an option for me if it ever comes out. I didn't get all the bad effects of WB until at least five to six weeks in, though.
Posted by Ktemene on December 17, 2004, at 10:36:50
In reply to Selegiline working well, posted by pseudonym on December 16, 2004, at 11:50:19
> Hello,
>
> I am pleased to report that selegiline (5mg bid) is working well. I take it in combination with 800mg of phenylalanine in the morning, and by itself in the midafternoon. I have been given SSRI's, but they just didn't do the trick for my diagnosis (generalized + social anixety). I can tell you this though, I've been doing so well, that I don't bother reading Psycho-Babble. So, in my case, there is truth to the notion that if you're feeling well, there not much motivation to read or post.Hi pseudonym,
It is great that Selegiline is working for you. I did not know that Selegiline was good for anxiety, so it is especially good news to hear that it does. I have been taking 5mg Selegiline + varying amounts of DLPA since June, and it has helped my anergic anhedonic depression more than any other med ever has. But I still have problems with insomnia. Do you have insomnia with Selegiline, and if so how have you dealt with it? I seem to remember that you tried Amisulpride for a while. I am thinking of asking my doctor to add it to Selegiline (I am going through a stressful period right now). What was your experience with Amisulpride? Do you think it would work well with Selegiline?
Ktemene
Posted by ravenstorm on December 17, 2004, at 16:34:24
In reply to Re: Selegiline working well, posted by Ktemene on December 17, 2004, at 10:36:50
Oh my, DLPA sent me right through the roof in terms of anxiety. I think you all do a lot better with the activating drugs than I do.
Posted by jclint on December 19, 2004, at 16:10:55
In reply to Selegiline working well, posted by pseudonym on December 16, 2004, at 11:50:19
Hi pseudonym I've read your s. anxiety posts in the past and have been interested in your experimenting. I'm glad that this seems to be working.
So do you notice a definite anxiolytic effect with the selegiline? Or are you just more motivated etc? I know you used to use clonazepam, has this combo meant you don't need it anymore?
J :)
Posted by Elroy on January 11, 2005, at 21:22:56
In reply to Re: Selegiline working well, posted by Ktemene on December 17, 2004, at 10:36:50
Anyone have any follow-up on this? Find this combination to be quite interesting. I wonder how this would work in combination with Xanax XR (something like 0.5 mg x 2 daily) at least for initial anxiety effects.... I have both anxiety and depression with the anxiety somewhat stronger - but being controlled by the Xanax to an extent. Doing nothing for the depression so far. That's why this combo sounded so interesting.
Elroy
> > Hello,
> >
> > I am pleased to report that selegiline (5mg bid) is working well. I take it in combination with 800mg of phenylalanine in the morning, and by itself in the midafternoon. I have been given SSRI's, but they just didn't do the trick for my diagnosis (generalized + social anixety). I can tell you this though, I've been doing so well, that I don't bother reading Psycho-Babble. So, in my case, there is truth to the notion that if you're feeling well, there not much motivation to read or post.
>
> Hi pseudonym,
>
> It is great that Selegiline is working for you. I did not know that Selegiline was good for anxiety, so it is especially good news to hear that it does. I have been taking 5mg Selegiline + varying amounts of DLPA since June, and it has helped my anergic anhedonic depression more than any other med ever has. But I still have problems with insomnia. Do you have insomnia with Selegiline, and if so how have you dealt with it? I seem to remember that you tried Amisulpride for a while. I am thinking of asking my doctor to add it to Selegiline (I am going through a stressful period right now). What was your experience with Amisulpride? Do you think it would work well with Selegiline?
>
> Ktemene
>
>
Posted by KaraS on January 11, 2005, at 21:54:34
In reply to Re: Cymbalta, posted by Elroy on January 11, 2005, at 21:22:56
> Anyone have any follow-up on this? Find this combination to be quite interesting. I wonder how this would work in combination with Xanax XR (something like 0.5 mg x 2 daily) at least for initial anxiety effects.... I have both anxiety and depression with the anxiety somewhat stronger - but being controlled by the Xanax to an extent. Doing nothing for the depression so far. That's why this combo sounded so interesting.
>
> Elroy
>
>
>
>
> > > Hello,
> > >
> > > I am pleased to report that selegiline (5mg bid) is working well. I take it in combination with 800mg of phenylalanine in the morning, and by itself in the midafternoon. I have been given SSRI's, but they just didn't do the trick for my diagnosis (generalized + social anixety). I can tell you this though, I've been doing so well, that I don't bother reading Psycho-Babble. So, in my case, there is truth to the notion that if you're feeling well, there not much motivation to read or post.
> >
> > Hi pseudonym,
> >
> > It is great that Selegiline is working for you. I did not know that Selegiline was good for anxiety, so it is especially good news to hear that it does. I have been taking 5mg Selegiline + varying amounts of DLPA since June, and it has helped my anergic anhedonic depression more than any other med ever has. But I still have problems with insomnia. Do you have insomnia with Selegiline, and if so how have you dealt with it? I seem to remember that you tried Amisulpride for a while. I am thinking of asking my doctor to add it to Selegiline (I am going through a stressful period right now). What was your experience with Amisulpride? Do you think it would work well with Selegiline?
> >
> > Ktemene
> >I don't have an answer for you. I'm just changing the title so that you'll draw the appropriate people to your post.
Good luck.
K
Posted by Ktemene on January 12, 2005, at 8:28:30
In reply to Re: Selegiline+DLPA (pseudonym, Ktemene, others) » Elroy, posted by KaraS on January 11, 2005, at 21:54:34
Hi Kara and Elroy,
When I wrote that post I had some hope that amisulpride would come to the United States. But it looks as if it won’t. I found an old (1999) article in the Psychiatric Times that was already saying that amisulpride would not be available in the U.S. Here is the quotation:
Psychiatric Times May 1999 Vol. XVI Issue 5
Two other drugs that are unlikely to come to the United States are amisulpride (Solian, Sanofi-Synthélabo), a D2 and D3 antagonist licensed in France that is used both as an antidepressant and as an antipsychotic, and moclobemide (Novartis Pharmaceutical Corp.), a reversible monoamine oxidase inhibitor licensed in most parts of Europe and in Canada.
"They are like orphan drugs," [Ira D.] Glick said, "It's hard to say if they will be profitable."But after thinking about it for a while I decided it was just as well. Amisulpride seems to have a lot of side effects, even for men. And it can cause nasty hormonal problems in women. So I have put it at the bottom of my list for possible things to try. (By the way, I had a physical recently and discovered that I have abnormally low testosterone levels. My doctor suggested that I try taking 30mg-90mg DHEA for a few weeks and then have my testosterone level checked again. I am wondering whether this low testosterone level might not be a big factor in the severe episode of depression I suffered five years ago. I noticed at the time that my muscle mass seems to melt away as my depression deepened. Anyway, I started 50mg DHEA a few days ago, and I seem to have lots more energy,but then it could be the mighty power of Placebo.)
Concerning Selegiline and anxiety, I do think that Selegiline is apt to increase anxiety, although not everyone has experienced increased anxiety with Selegiline. It certainly causes insomnia in a lot of people, and I am one of them. I have been taking Remeron for the last few weeks in addition to Selegiline +DLPA or Tyrosine. The dose that works best for me is fairly high, 60mg. But it is a very effective medication for sleep and anxiety. I have had no weight gain from it at all. This may be because the dose I take is so high, or because Selegiline and Adderall (which I also take) both tend to suppress appetite. Or it may be that Remeron just does not have the side effect of increasing appetite in me (since not everyone gains weight on Remeron).
I was doing some searching for Remeron in the Babble archives and I noticed that JRBecker has had some success with Remeron, despite his having the same sort of anergic anhedonic atypical depression that I have. He also says that medications that enhance dopamine function tend to help him but that they also tend to make him sleepy. That made me think of you, Kara. I don’t know what he is currently taking, but maybe his symptoms are enough like yours that his reactions to medications might give you a sense of what would work for you.
If you don’t mind my putting my two cents worth in, I think that it might be worthwhile for you to take the Parnate plunge. You would not have to begin with a big dose. David Burns in his "Feel Good Handbook" says that many of his patients thrive on just 10mg Parnate per day. Burns speaks very highly of the MAOI class of antidepressants. He also mentions that very few of his patients have had trouble with the diet. I suspect that worries about the diet are overemphasized by some pdocs, because they think it would be tactless to mention the real reason that they hesitate to prescribe MAOI’s, namely that it is risky to give severely depressed patients an easy way to kill themselves. And MAOI’s are particularly risky because it is easy for patients to kill themselves in a way that makes it look like an accident. Of course this is just the speculation of an overly cynical person. And I should confess that I sort of wish that I had decided to try Parnate instead of Selegiline. At the time I had the idea that since I am the Queen of ADD (all lesser incompetents should bow to me) I would forget about the diet and carelessly ingest something that would send me to the hospital. But I find that I do automatically keep track of MAOI-incompatible foods and medicines, and so I doubt that I really would have had a problem. Anyway, YMMV, as always, but I think Parnate might well be a good medicine for you.
By the by, I tried Beyond A Century’s cheap Rhodiola Rosea a few days ago. (It has been sitting on my medicine shelf since last summer.) And I was astonished to find that it did give me a lift in both energy and mood. I remember that you tried the most highly recommended version from a company in Sweden, and you did not notice any good effect. It might be worth trying the cheap stuff, just to see how you do. Who knows, maybe there is some chemical in the plant that enhances the active compounds for some of us that gets filtered out in the expensive version. I thought I would mention it because most OTC’s have no effect on me at all. But just in the last few weeks I have tried two OTC’s, Taurine and Rhodiola, that both produced good effects for me.
Best of luck to you,
Ktemene
Posted by KaraS on January 16, 2005, at 15:35:40
In reply to Re: Selegiline+DLPA (Kara and Elroy), posted by Ktemene on January 12, 2005, at 8:28:30
Hi Ktemene,
Sorry it has taken me so long to get back to you on this. Hope you're still around to see this post.>When I wrote that post I had some hope that amisulpride would come to the United States. But it looks as if it won’t. I found an old (1999) article in the Psychiatric Times that was already saying that amisulpride would not be available in the U.S. Here is the quotation:
>
> Psychiatric Times May 1999 Vol. XVI Issue 5
> Two other drugs that are unlikely to come to the United States are amisulpride (Solian, Sanofi-Synthélabo), a D2 and D3 antagonist licensed in France that is used both as an antidepressant and as an antipsychotic, and moclobemide (Novartis Pharmaceutical Corp.), a reversible monoamine oxidase inhibitor licensed in most parts of Europe and in Canada.
> "They are like orphan drugs," [Ira D.] Glick said, "It's hard to say if they will be profitable."
>
> But after thinking about it for a while I decided it was just as well. Amisulpride seems to have a lot of side effects, even for men. And it can cause nasty hormonal problems in women. So I have put it at the bottom of my list for possible things to try. (By the way, I had a physical recently and discovered that I have abnormally low testosterone levels. My doctor suggested that I try taking 30mg-90mg DHEA for a few weeks and then have my testosterone level checked again. I am wondering whether this low testosterone level might not be a big factor in the severe episode of depression I suffered five years ago. I noticed at the time that my muscle mass seems to melt away as my depression deepened. Anyway, I started 50mg DHEA a few days ago, and I seem to have lots more energy,but then it could be the mighty power of Placebo.)I was thinking of trying Amisulpride some day down the road (and was bemoaning the fact that it was no longer available through the UK) but after reading yor post I am not so sure I'd be missing much by skipping this medication altogether.
> Concerning Selegiline and anxiety, I do think that Selegiline is apt to increase anxiety, although not everyone has experienced increased anxiety with Selegiline. It certainly causes insomnia in a lot of people, and I am one of them. I have been taking Remeron for the last few weeks in addition to Selegiline +DLPA or Tyrosine. The dose that works best for me is fairly high, 60mg. But it is a very effective medication for sleep and anxiety. I have had no weight gain from it at all. This may be because the dose I take is so high, or because Selegiline and Adderall (which I also take) both tend to suppress appetite. Or it may be that Remeron just does not have the side effect of increasing appetite in me (since not everyone gains weight on Remeron).I suspended my selegiline + DLPA trial because of the severe anxiety (and possibly asthma) I was experiencing. The anxiety came BEFORE the trial but was afraid of making it worse so I discontinued it early on. Also, I needed to get on something that would actually help the anxiety. It's incapacitating right now. I would still like to try it someday. I keep thinking of how I could address the anxiety yet still take the selegiline +DLPA. Can it be combined with a small amount of a tricyclic like maprotiline? I suppose that Remeron might be an answer though I'm thinking that the combination might be extremely sedating for me. Might be worth a try though. Do you watch your diet at all on 10 mg. or do you not even think about it?
I'm glad the Remeron is working so well for you. I wonder if you would gain weight if you weren't taking the selegiline and Adderrall. At any rate, it sounds like you are doing really well with your medications. I'm so glad.
> I was doing some searching for Remeron in the Babble archives and I noticed that JRBecker has had some success with Remeron, despite his having the same sort of anergic anhedonic atypical depression that I have. He also says that medications that enhance dopamine function tend to help him but that they also tend to make him sleepy. That made me think of you, Kara. I don’t know what he is currently taking, but maybe his symptoms are enough like yours that his reactions to medications might give you a sense of what would work for you.That's so good to know about JrBecker doing well on dopaminergics even though they made him tired. After reading your post I tried to find previous messages from him about this but was not successful. I did read, however, that he seems to be doing well on Cymbalta. I started on a small dosage of that but found it too difficult to take. I was grogged out yet also had this extreme anxiety (probably tachycardia too). The combination was very frightening for me.
> If you don’t mind my putting my two cents worth in, I think that it might be worthwhile for you to take the Parnate plunge. You would not have to begin with a big dose. David Burns in his "Feel Good Handbook" says that many of his patients thrive on just 10mg Parnate per day. Burns speaks very highly of the MAOI class of antidepressants. He also mentions that very few of his patients have had trouble with the diet. I suspect that worries about the diet are overemphasized by some pdocs, because they think it would be tactless to mention the real reason that they hesitate to prescribe MAOI’s, namely that it is risky to give severely depressed patients an easy way to kill themselves. And MAOI’s are particularly risky because it is easy for patients to kill themselves in a way that makes it look like an accident. Of course this is just the speculation of an overly cynical person. And I should confess that I sort of wish that I had decided to try Parnate instead of Selegiline. At the time I had the idea that since I am the Queen of ADD (all lesser incompetents should bow to me) I would forget about the diet and carelessly ingest something that would send me to the hospital. But I find that I do automatically keep track of MAOI-incompatible foods and medicines, and so I doubt that I really would have had a problem. Anyway, YMMV, as always, but I think Parnate might well be a good medicine for you.Thank you for your opinion on the Parnate! I do appreciate it. (Ironic that you mentioned David Burns' "Handbook" as I just got that out of the library.) I want to try it or Nardil but I just can't get beyond my fear. I'm less worried about the dietary issues I can control. I'm more worried about the ones that I don't know about - like eating meat at a restaurant that may be old or eating dishes that have things in them I don't know about. I read posts where a woman had a couple of dishes at a restaurant (one had a fish paste in it and the other had smoked oysters) that she didn't know about and so she had a crisis each time. That kind of thing scares me combined with the fact that I don't have health insurance should something go very wrong. I'm almost 50 and the chances of something going very wrong in a crisis are more likely. I don't know. Maybe someday I will try them out of desperation. (I really wish I weren't so neurotic.)
>
> By the by, I tried Beyond A Century’s cheap Rhodiola Rosea a few days ago. (It has been sitting on my medicine shelf since last summer.) And I was astonished to find that it did give me a lift in both energy and mood. I remember that you tried the most highly recommended version from a company in Sweden, and you did not notice any good effect. It might be worth trying the cheap stuff, just to see how you do. Who knows, maybe there is some chemical in the plant that enhances the active compounds for some of us that gets filtered out in the expensive version. I thought I would mention it because most OTC’s have no effect on me at all. But just in the last few weeks I have tried two OTC’s, Taurine and Rhodiola, that both produced good effects for me.I tried another brand of Rhodiola and got the same results. Maybe it wasn't cheap enough though. :-)
For now I've decided to go back on 75 mg. Effexor and probably a small amount of maprotiline for sleep and anxiety control. If it still works for me, it will get me to a level of functioning so that I can hopefully get and hold down a job. With that should come health insurance and more options. Maybe at that point I'd feel comfortable enough to start on an MAOI. Or maybe by then the selegiline patch will be out. Maybe that will also lead to patches for Nardil and Parnate as well so that all people suffering from depression have safer, more effective options.
>
> Best of luck to you,
> Ktemene
>
Thanks again for all of your insight and advice.Kara
Posted by gromit on January 20, 2005, at 4:08:31
In reply to Re: Selegiline+DLPA (Kara and Elroy) » Ktemene, posted by KaraS on January 16, 2005, at 15:35:40
For those of you who have tried both the pills and the liquid can you compare the two? What dose of the liquid is equivalent to a 5 mg tablet?
Thanks
Rick
Posted by Elroy on February 11, 2005, at 21:39:50
In reply to Selegiline working well, posted by pseudonym on December 16, 2004, at 11:50:19
Not sure that you'll even get this, but this is exactly the kind of post that I like to read about! You know, that kind that says; "hey, this works, no need to keep beating the bushes, so I'm out of here"!
Hope this continues to work wel for you. Am currently trying to get my psych doc to prescribe the selegiline (low dose) for me to try with the DLPA and Vit B6 combo. I will start with very low SLPA as I also have some milder anxiety problems in the background (being dealt with separately). If this works out, hope to wean of my anti-anxiety med for something more natural.
Also have been getting some decent results (slow, but sure) with Rhodiola Roscea as a general, all-around adaptogen with some anti anxiety and AD properties.
Elroy
> Hello,
>
> I am pleased to report that selegiline (5mg bid) is working well. I take it in combination with 800mg of phenylalanine in the morning, and by itself in the midafternoon. I have been given SSRI's, but they just didn't do the trick for my diagnosis (generalized + social anixety). I can tell you this though, I've been doing so well, that I don't bother reading Psycho-Babble. So, in my case, there is truth to the notion that if you're feeling well, there not much motivation to read or post.
This is the end of the thread.
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