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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by JohnB11 on July 22, 2005, at 10:28:43
Was wondering if anyone had any recent experience with high dose deprenyl (selegiline) for SP.
I'm currently taking Nardil and Klonopin. Effective combo, but my mental clarity is off and I have almost complete sexual dysfunctin. Have previously tried Parnate and almost all of the SSRI's, but with out much benefit.
Reason for high-dose deprenyl is that it loses its MAO-B selectivity above 20 mg/day. Therefore, I'm hoping that a higher dose, say 60 mg/day could provide benefit similar to Nardil, but without the sexual dysfunction, loss of mental clarity, etc.
Thanks, in advance, for sharing your experiences.
John
Posted by Tom Twilight on July 22, 2005, at 15:11:00
In reply to High-Dose Deprenyl for Social pHobia, posted by JohnB11 on July 22, 2005, at 10:28:43
I'm hoping that a higher dose, say 60 mg/day could provide benefit similar to Nardil, but without the sexual dysfunction, loss of mental clarity, etc.
>
> Thanks, in advance, for sharing your experiences.I'm sorry to be negative, but I doubt that Deprenyl would work as well as Nardil for SP.
Nardil prevents the breakdown of GABA, other MAOIs like Nardil and Parnate don't have this effect.
Most people seem to find Deprenyl worsens their SP.If your having trouble with mental clarity you could always take a "smart drug" like Aricept.
>
> John
Posted by Declan on July 22, 2005, at 15:50:31
In reply to High-Dose Deprenyl for Social pHobia, posted by JohnB11 on July 22, 2005, at 10:28:43
I think in this world we have to settle for *any* benefit, and if we get it we're lucky. Which is why I take 10mg/d (only) Parnate. Someone here did this thing: deprenyl>parnate>nardil, in terms of stimulation. You've taken deprenyl? (I've taken it low dose for years)I'm curious about how you would sleep. I had trouble sleeping on any amount of deprenyl. I couldn't even get up to 2mg/d without sleep interference. I suspect that Nardil's the only one that makes you sociable, but then as you say it ruins your sex life.
If you want to tell me about your Parnate experiences, how much you took, the difference in effects between different doses, how you managed to sleep etc, I'm all ears.
Declan
Posted by johnb11 on July 22, 2005, at 17:27:40
In reply to Re: High-Dose Deprenyl for Social pHobia, posted by Declan on July 22, 2005, at 15:50:31
I initially started treatment with Nardil and Klonopin. While I've stayed on Klonopin, I've had numerous changes in the drung Klonopin is supposed to be augmenting. Initial Nardil of 60 mg/day was great at first, until I realized that I had gained 10 lbs and had lost sexual function and libido. Switched to Parnate which, I believe, was 40 mg/day. Had to be careful titrating up to the final dose, as Parnate is quite activating. Parnate provided some relief - maybe 30 to 40% of what I got from Nardil. It also made me lose weight, which was a nice side effect. Undesirable side effects were dry mouth and a slowed pattern of speech. My rapid fire method of talking dropped several notches. Dropped my sexual desire/function about 20%, which was a great improvement versus Nardil.
Ultimately, I found Parnate to be of just slight help, and was unwilling to face the dry mouth, slowed speech pattern, and slight degradation in my sexual enjoyment. Tried numerous other meds, including Citalopram, Venlafaxine, Prozac, etc. I think I tried just about every one. None seem to provide noticeable relief from SP.
I did have a 2 week trial of 60 mg/day Deprenyl, with the thought that, at the higher dose, Deprenyl loses its MAO-B selectivity, and then takes on a profile more similar to Nardil and Parnate. Should have waited for about 6 weeks to give it a fair trial. Mental clarity was greatly enhanced, and I had no trouble sleeping. One side effect was that I was constantly thinking of and wanting sex. Sort of like the porn channel being on 24 hours per day.
John
Posted by willyee on July 22, 2005, at 19:32:19
In reply to Re: High-Dose Deprenyl for Social pHobia, posted by Declan on July 22, 2005, at 15:50:31
If your lucky enough to achieve benifit from 10 mg of parnate then stick to it.I remember my first few months on it i was able to keep the dose at a single 20 mg morning dose and that was it.
For whatever reason that is certainly not the case now.
One thing about parnate is its being said now to be possably a REVERSABLE maoi as opposed to ireversable.I can believe this to be true.
As dangerous as it can be,parnate also seems to work well with quite a few other meds,herbs.I cant imagine taking it alone now as it just wont work for me.
Deprenyl alone did the same thing,interupted sleep,and made me a big hornball.HOWEVER if done carefully,and im not recomending this,i have used both liquid deprenyl and parnate in conjunction,just spaced out the dosing carefully and made sure i felt ok before i dosed anything.
Parnate at higher doses looses a lot of stimulant properties and can be somewhat sedating,the addition of deprenyl provdided me with a short but roboust remission at one time,and its something i might try again.
Feel free to ask any questions as im pretty much a guru on this drug,its the only one i will touch as a primary drug unless something else pops up as promising,which it hasent yet.Cheers
Posted by Declan on July 22, 2005, at 21:54:18
In reply to Re: High-Dose Deprenyl for Social pHobia, posted by johnb11 on July 22, 2005, at 17:27:40
Posted by smith562 on July 24, 2005, at 15:45:27
In reply to High-Dose Deprenyl for Social pHobia, posted by JohnB11 on July 22, 2005, at 10:28:43
Dear John,
I stopped Nardil after 4 years due to 25 lbs weight gain, sexual dysfunction, insomnia and memory loss. So far this combo is about 75% of nardil ....
selegiline 10
klonopin 1
lithium 450
zoloft 75
coffee
exerciseSmith
Depression
Panic Disorder
(family h/o of depression, panic and bipolar II)
Posted by Declan on July 24, 2005, at 17:48:29
In reply to Re: As close to Nardil as I can get » JohnB11, posted by smith562 on July 24, 2005, at 15:45:27
Hi Smith
I'm impressed that you can get 75% of Nardil. That sounds like quite an achievement.
I know what the selegeline does. What does the Zoloft add to your combo?
Declan
Posted by Declan on July 24, 2005, at 17:50:06
In reply to Re: As close to Nardil as I can get » JohnB11, posted by smith562 on July 24, 2005, at 15:45:27
O yes, and how do you sleep on 10mg/d selegeline? Does the Klonopin cover that?
Declan
Posted by johnb11 on July 24, 2005, at 22:11:05
In reply to Re: As close to Nardil as I can get » JohnB11, posted by smith562 on July 24, 2005, at 15:45:27
Thanks, very much for sharing your med experience. It is hard to think about not having all of Nardil's benefit. My pdoc has continued to recommend my obtaining Moclobemide (MAO-A inhibitor) and combining with Deprenyl. Apparently, Leibowitz (New York University) found that clorgyline (MAO-A inhibitor) combined with Deprenyl was as effective as Nardil. But, clorgyline isn't available, except to researchers. I hope his work suggests that a different MAO-A inhibitor, such as Moclobemide, would be as effective when combined with Deprenyl.
Posted by smith562 on July 24, 2005, at 22:23:29
In reply to Re: As close to Nardil as I can get, posted by Declan on July 24, 2005, at 17:48:29
Hey Delcan,
To be very reductionistic ... I have though of nardil as affecting serotonin, dopamine, GABA, PEA and norepinephrine (I know there is alot more that we don't know, and using this logic is too simplistic). So to cover all my bases in recreating nardil I am using ....
Selegiline for dopamine and PEA
Klonopin for GABA
zoloft and lithium for serotonin
coffee for norepinephrineI do notice some sleeping difficulties with 10mgs of selegiline. I am testing out some theories ... no one will tell me, "Hey Smith, your acting anxious/hypomanic/depressed today". I don't really feel my own thoughs about my moods are total accurate. So I am trying to discover objective markers of "normal mood". I think sleep is a good marker ... if I take to much selegiline and can't sleep I am probably in a mild mixed/anxious/hypomanic state. If I am sleeping too much, I am probably depressed.
This sounds crazy but ... I think music is a good indicator of mood. I listen to heavy metal when hypomanic and dysphoric (need to up the klonopin or lithium). I listen to nothing when I am depressed. I listen to contempory soft rock when euthymic.
Too much information .. sorry!
Smith
Posted by smith562 on July 24, 2005, at 22:30:29
In reply to == Smith, posted by johnb11 on July 24, 2005, at 22:11:05
Hey John,
Good luck ... as you know Liebowitz is the best pdoc in terms of anxiety! I was thinking of emailing him and see if he had experience using selegiline + SSRI + klonopin to replace nardil. I will never forget what one of the Godfathers of nardil told me, Dr. Fredick Quitken .... "Nardil works for 90% of patients, but only 25% of patients can stay on it and tolerate the side effects. I just give prozac now." Nardil is so tough to tolerate.
Smith
Posted by SLS on July 25, 2005, at 1:44:12
In reply to Re: == Smith » johnb11, posted by smith562 on July 24, 2005, at 22:30:29
> Hey John,
>
> Good luck ... as you know Liebowitz is the best pdoc in terms of anxiety! I was thinking of emailing him and see if he had experience using selegiline + SSRI + klonopin to replace nardil. I will never forget what one of the Godfathers of nardil told me, Dr. Fredick Quitken .... "Nardil works for 90% of patients, but only 25% of patients can stay on it and tolerate the side effects. I just give prozac now." Nardil is so tough to tolerate.
>
> Smith
Were you ever treated at Columbia Presbyterian?If you ever get an answer from Liebowitz regarding your Nardil substitute approach, I would be very interested in knowing what he has to say.
Good luck.
- Scott
Posted by smith562 on July 25, 2005, at 5:31:47
In reply to Re: == Smith » smith562, posted by SLS on July 25, 2005, at 1:44:12
I had to a consult at Columbia with Dr Glassman .... a psychopharmacologist. I also had a consultation with Dr Quitken, but that was at his office in downtown NYC. My regular pdoc is downtown.
Smith
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