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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by TamaraJ on November 1, 2005, at 21:56:44
an SSRI? Or would even 10mg or less of Selegiline with an SSRI be risky?
Thanks.
Posted by zeugma on November 1, 2005, at 22:07:12
In reply to Can low dose Selegiline be combined with, posted by TamaraJ on November 1, 2005, at 21:56:44
> an SSRI? Or would even 10mg or less of Selegiline with an SSRI be risky?
>
> Thanks.
hello.there is a case somewhere in the archives of the NCBI about how a woman being treated for Parkinson's and depression with seligiline and nortriptyline developed serotonin syndrome.
doses of selegiline that are prescribed for Parkinson's are in the 10 mg range, as it is MAO-B inhibition that is desired.
Nortriptyline is a much weaker SRI than effexor or an SSRI. The woman in question was possibly more vulnerable because she was quite old, but i would still be careful.
-z
Posted by willyee on November 1, 2005, at 22:11:11
In reply to Can low dose Selegiline be combined with, posted by TamaraJ on November 1, 2005, at 21:56:44
Thats kinda high.The low dose theory is a long build of the med slowly,until one notices over all better effects from its dopamine increase,such as sexual side effects,more clarity,more motivation,less lethargy and blah feeling from ur ssri.
So for this id use a smaller dose,2-3 mg every two days.Remember added to an ssri ur not trying to power house it,instaed kinda sneak it in.
Posted by hawkeye on November 1, 2005, at 22:26:17
In reply to Can low dose Selegiline be combined with, posted by TamaraJ on November 1, 2005, at 21:56:44
I took 10 mgs/day of Selegiline with Serzone and Dexedrine for several years and the combination worked very well.
"Several adverse effects have been reported when fluoxetine and selegiline have been used together. A recent survey revealed that the incidence of a true serotonin syndrome is, however, very low with this combination. Concomitant use of selegiline and other selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs) like citalopram, which have generally less interactions than fluoxetine, seems to be well tolerated. Nevertheless, caution is advised when combining a SSRI or a tricyclic antidepressant and selegiline."
http://www.selegiline.com/safety.html
"Although the Food and Drug Administration and the manufacturer has warned against combining selegiline with selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, there was a recent article in Neurology suggesting that that this combination is common in the treatment of Parkinson's disease.1 A survey reported in this article suggests that a fulminant serotonin syndrome (i.e., cardiovascular, gastrointestinal, or autonomic instability) is rare in patients receiving a combination of selegiline and an SSRI. This finding is supported by other studies,2, 3 which raises the question of how often a partial or incomplete serotonin syndrome occurs as a result of this combination."
" The combination of selegiline at an oral dose of 10 mg per day or less and an SSRI generally is considered safe, although clinical monitoring is warranted."
"...a so-called “serotonin syndrome” has been reported to occur infrequently (0.25%) when selegiline is co-prescribed with an SSRI."
Posted by TamaraJ on November 2, 2005, at 18:53:01
In reply to Re: Can low dose Selegiline be combined with, posted by hawkeye on November 1, 2005, at 22:26:17
for all the good and useful information. It is much appreciated. I will be discussing this with my pdoc at my next appointment.
Posted by willyee on November 3, 2005, at 1:32:35
In reply to Thanks zeugma, willyee and hawkeye, posted by TamaraJ on November 2, 2005, at 18:53:01
It might be very likly your doc isnt aware of Liquid Deprenyls usage in this way.
The liquid form is not even available in the states,and the pill form is hardly used off label.Just dont be surprised if he gives u a blank stare
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