![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 36. Go back in thread:
Posted by RobertDavid on February 7, 2006, at 23:15:49
In reply to Selegiline/Deprenyl effective anti-depressant?, posted by LizinManhattan on February 7, 2006, at 21:35:15
If I was going to try selegiline, I'd wait for the patch EMSAM. The FDA will most likely approve it by Feb 26th, then it will take a few months before it's available.
My doctor who is envolved with writing the perscribing info for the drug co. tells me that it will definately be a good option for both anxiety and depression. I'm not really clear why, but he indicates that it will be far superior to the oral in terms of effectiveness, not to mention fewer side effects including weight gain, decreased libido as well as less food restrictions at the 20mg dose.
I'm going to give it a try for SP with mild depression. My doc tells me that EMSAM may replace the klonopin I take now for SP or perhaps be a good blend with it. Should be interesting.....
Posted by River1924 on February 8, 2006, at 1:14:52
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by RobertDavid on February 7, 2006, at 23:15:49
Don't get too excited. I have an liquid oral form and if I take more than a couple milligrams a week, I am wired and irritable. I suppose it is the fact that I have tried so many drugs but I don't believe in miracles anymore. Good luck though... everyone reacts to meds differently. Gotta keep trying and maybe, just maybe it will help you.
Posted by willyee on February 8, 2006, at 8:04:42
In reply to Re: Selegiline/Deprenyl effective anti-depressant? » RobertDavid, posted by River1924 on February 8, 2006, at 1:14:52
> Don't get too excited. I have an liquid oral form and if I take more than a couple milligrams a week, I am wired and irritable. I suppose it is the fact that I have tried so many drugs but I don't believe in miracles anymore. Good luck though... everyone reacts to meds differently. Gotta keep trying and maybe, just maybe it will help you.
Actualy one should be excitied,taking it in very small doses as u mentioned makes it very selective as a dopamine drug,when the patch comes out and you starting using it daily in dose ranges of 40,60 mg it will begin to have a more Maoi overall effect and im almost certain it will not be as stimulative and speed like as the lower dose.For example smart drug users,people who look for mind stimulants to wake it up,consider deprenyl as one of their favorites,but only in low doses of 1-10 mg,anything higher and were gonna be looking at the drug having standerd parnate/marplan/nardil effects,the method if introduction to the blood is just that more exciting.
Liquid deprenyl is very expensive,and i doubt many users used it in hihh doses long term as it os an overseas medication and i dont think it can be covered,ill put my mark for the group that this patch is gonna be a big change,you guys hold me to this,and lets all hope im right !!!!
Posted by willyee on February 8, 2006, at 9:04:53
In reply to Selegiline/Deprenyl effective anti-depressant?, posted by LizinManhattan on February 7, 2006, at 21:35:15
> Hi,
> Does anyone have experience with Selegiline as an anti-depressant? I am currently on Parnate which is effectively controlling my depression. However, I have had a couple of BP scares and so am going off it. willyee on this board just let me know that the Selegiline patch (by the name of Emsam)is due out at the end of the month. I mentioned it to my psychiatrist and he said he doesn't consider Selegiline an effective anti-depressant. So now I was wondering if anyone has heard/experienced differently?
> Thanks a lot!
> Liz
OMG i just wrote a long response to this and lost it,and it was good,uggh.Well hopefully it will reappear,but what i said in a nit shell was i dont see how ur doc was able to tell u deprenyl is not a good anti depressant.
To date its only use here is for parkinson,it is extremly rare to see it used in the psych field as a off label anti depressant.
Moais period are rare to find being used,so to say deprnyl,a maoi,one in which has almost zero documented history for depression in tab form used by a p-doc,over parnate/nardil,when its rare a maoi would even have been considered in the first place,its like four leaf clover.
Your doc went one step further and said most people dont have luck with it for depression,so with the statement above id love to know where hes getting this theory from.For him to say that would mean not only has he encountered deprenyl for the use of depression a EXTREMLY EXTREMLY rare thing once,but rather munerous times,enough to come to a conclusion that it isnt helpful.
Think about that,and as for the patch,lots of money,lots of time and work are being invested in this drug,people are putting up lots on it.More importantly lol it isnt OUT yet,so he could not have been referring to that because the drug is still unavailable.
Personly,and dr bob just my own opinion lol,is when a doc is approached about something from a patient that they are not too familiar on,they seem to like to blow it off change the direction very very fast.
I again in my own opinion have to say ur doc was blowing u off on the deprenyl cause he might not have been informed,so rather have u know something he doesent,he quickly moved away,.....i cant logicaly in anyway see how ur doc could be in a postion to have made a statement about deprenyl when it isnt even out yet,we are all waiting,the only info about deprenyl and depression mainly are from deep rooted net news groups,boards,foroums,and these are with deprenyl in no set dose etc,maois are not a popular choice in the psych world,and deprenyl a maoi would have to date been usd off label which is like finding a four leaf clover on the floor after tripping over a found wallet with tons of money,prior to this patch deprenyl info,history on depression is rare to none,ur doc seemed to make a very bold statement,i would personaly not credit it,instead id personaly look into emsam urself on the net and see how it works,look at some trial data,and see if u believe it might help.I luckly found a doc finaly who doesent care if i might know more than her on a certain drug,and she said this patch is unknown with many p-docs,it hasent hit there seminars yet,but she took the name from me and said thanks,and said she was gonna look it up at home that night,and let me know the second she has it come up in her little pysch world.
P.s i miss manhattern,shopping on 34th lol,are u from there?
Posted by Larry Hoover on February 8, 2006, at 10:15:42
In reply to Selegiline/Deprenyl effective anti-depressant?, posted by LizinManhattan on February 7, 2006, at 21:35:15
> Hi,
> Does anyone have experience with Selegiline as an anti-depressant? I am currently on Parnate which is effectively controlling my depression. However, I have had a couple of BP scares and so am going off it. willyee on this board just let me know that the Selegiline patch (by the name of Emsam)is due out at the end of the month. I mentioned it to my psychiatrist and he said he doesn't consider Selegiline an effective anti-depressant. So now I was wondering if anyone has heard/experienced differently?
> Thanks a lot!
> LizYour psychiatrist is basing his opinion on oral selegiline, which really could be thought of as being a different drug. Selegiline is readily changed by digestive enzymes in the intestinal wall and the liver. This protective net of enzymes is called the first pass metabolism; all oral drugs pass through this gauntlet.
If I recall correctly, as much as 60% of oral selegiline can be metabolized before it even gets into general blood circulation. And, the metabolites have activities that are different than the parent drug.
In contrast, the patch delivery system allows selegiline to trickle through directly into general circulation, avoiding that significant destruction via first pass enzymes. You get different drug effects, because the selegiline pretty much makes it into the brain unchanged.
It remains to be seen that Emsam is similar in effect to other MAOIs. And, individual differences in sensitivity to tyramine makes it hard to predict if food restrictions will apply or not. Some people may still have to watch their diet closely, to avoid BP effects.
Lar
Posted by willyee on February 8, 2006, at 11:48:26
In reply to Re: Selegiline/Deprenyl effective anti-depressant? » LizinManhattan, posted by Larry Hoover on February 8, 2006, at 10:15:42
Mr.hoover aside from the groups and the whole deprenyl/phenylane movement,
wouldent u say it odd your everyday p-doc have any exper with deprenyl and depression prior to emsam.
Posted by willyee on February 8, 2006, at 11:58:52
In reply to Re: Selegiline/Deprenyl effective anti-depressant? » LizinManhattan, posted by Larry Hoover on February 8, 2006, at 10:15:42
Sorry i forgot to ask something i very much wanted to,would you say the delivery of a drug directly via bloodstream would avoid the problem of poop out.
My understanding from reading is poop out is when ur body having had just about enough of a foreign substance begins to fight back by building specific anti-enzmyes to keep this substance out and away,hence the longer of introduction of a drug,the more chance your body will start getting wise to it and fighting it.
Would the patch benifit here.
P.S As a note i have seen your postings since i began posting period on the internet approx 5 years ago,guess im giving respect due i dunno,but glad certain people are around,lol you part of the kind that makes me look smart as i read your info and turn around and pass it along,shhhhh thats a secret.
Posted by gibber on February 8, 2006, at 13:38:05
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by RobertDavid on February 7, 2006, at 23:15:49
just wanted to mention that oral selegiline is know to substantially increase libido and sexual functioning and I don't believe weight gain is a problem. I hypothesize the patch will be none different in that regard. Is it accurate to say the drug will hit the market 2-3 months after the 26th of this month???? I don't understand all these bureaucratic steps!!
Posted by RobertDavid on February 8, 2006, at 13:48:41
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by gibber on February 8, 2006, at 13:38:05
It's my understanding that it will get approval finally, by the end of the month. My doctor is working with the drug co's regarding perscribing language (source of my info). I understand once approved it will take a few months to finish do the packaging/marketing and manufacturing of EMSAM. It will certainly be interesting to see how well this works for all that have been waiting to try it.
Posted by linkadge on February 8, 2006, at 15:45:02
In reply to Re: Selegiline/Deprenyl effective anti-depressant? » gibber, posted by RobertDavid on February 8, 2006, at 13:48:41
I think the results of ensam as an antidepressant are very mixed. Most doctors believe that it is the MAO-A inhibition that carries the most theraputic benefit in depression.
I think that a lot of patients who try it as an antidepressant find that it has a psychic energizing effect, but does not posess much of a mood brightening effect.
It is also not too wise to use in cases of psychotic depression. It increases the activity of phenlythylamine which is a very strong endogenious amphetamine. Boosting phenyethylamine can produce stereotypical behavior associated with other stimulants.
Linkadge
Posted by willyee on February 8, 2006, at 15:55:23
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by linkadge on February 8, 2006, at 15:45:02
> I think the results of ensam as an antidepressant are very mixed. Most doctors believe that it is the MAO-A inhibition that carries the most theraputic benefit in depression.
>
> I think that a lot of patients who try it as an antidepressant find that it has a psychic energizing effect, but does not posess much of a mood brightening effect.
>
> It is also not too wise to use in cases of psychotic depression. It increases the activity of phenlythylamine which is a very strong endogenious amphetamine. Boosting phenyethylamine can produce stereotypical behavior associated with other stimulants.
>
>
>
> Linkadge
>
>But lets be fair and say your basising this from the people used in the study,not your average joe.
How many studies have outcomes totaly different?
As for either the tab or oral solution,i think we discussed to death how that cant be compared to the patch,dosage,introdcution to the body etc
Posted by LizinManhattan on February 8, 2006, at 18:31:46
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by RobertDavid on February 7, 2006, at 23:15:49
Oh yes, I would definitely wait for the patch! I just wanted to check and see if people had had any luck with taking selegiline orally since my doc didn't seem to think it's an effective a.d.
It would be so great to be able to take and MAOI (both Nardil and Parnate were great for my depression) but not have to deal with BP issues. Although from what I understand the FDA is arguing with Emsam's people about tyramine labeling right now...
Liz
> If I was going to try selegiline, I'd wait for the patch EMSAM. The FDA will most likely approve it by Feb 26th, then it will take a few months before it's available.
>
> My doctor who is envolved with writing the perscribing info for the drug co. tells me that it will definately be a good option for both anxiety and depression. I'm not really clear why, but he indicates that it will be far superior to the oral in terms of effectiveness, not to mention fewer side effects including weight gain, decreased libido as well as less food restrictions at the 20mg dose.
>
> I'm going to give it a try for SP with mild depression. My doc tells me that EMSAM may replace the klonopin I take now for SP or perhaps be a good blend with it. Should be interesting.....
Posted by LizinManhattan on February 8, 2006, at 18:33:40
In reply to Re: Selegiline/Deprenyl effective anti-depressant? » RobertDavid, posted by River1924 on February 8, 2006, at 1:14:52
I'm sorry you haven't found relief. It took me 10 years to find something that worked. I wish you luck.
Liz> Don't get too excited. I have an liquid oral form and if I take more than a couple milligrams a week, I am wired and irritable. I suppose it is the fact that I have tried so many drugs but I don't believe in miracles anymore. Good luck though... everyone reacts to meds differently. Gotta keep trying and maybe, just maybe it will help you.
Posted by LizinManhattan on February 8, 2006, at 18:48:34
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by willyee on February 8, 2006, at 9:04:53
I used to think that my doctor wasn't like most psychiatrists. In other words, he would listen to me and wouldn't be afraid if I knew something he didn't. For example, when I told him about the reformulated Nardil and about Emsam he was very interested and said he hadn't heard about that yet. Most psychiatrists I have been in contact with (my brother's been through 22!) need to have their egos stroked and be worshipped as all-knowing, but mine hasn't shown any signs of that. I wonder... It would make me very sad if he did indeed blow me off about Selegiline. Maybe that's just what he was taught in med school? You're right though; how could he possibly have used it enough to know that it's not effective?
I'm not nuts about leaving the MAOI world and going on Remeron which supposedly causes weight gain in 25% of users so maybe I'll try the patch when it finally comes out. I'm pretty sure my doc would prescribe it if I made my case.
As for the Manhattan part of my name, I signed up with that name out of pure habit as that is what I always sign up as on message boards. I live in Manhattan, right next to the off-ramp for the 59th Street bridge until a few months ago. Now I'm 25 miles north of Manhattan. 34th Street does have some good shopping, although it's a tad too crowded for me!
Liz
> OMG i just wrote a long response to this and lost it,and it was good,uggh.
>
> Well hopefully it will reappear,but what i said in a nit shell was i dont see how ur doc was able to tell u deprenyl is not a good anti depressant.
>
> To date its only use here is for parkinson,it is extremly rare to see it used in the psych field as a off label anti depressant.
>
> Moais period are rare to find being used,so to say deprnyl,a maoi,one in which has almost zero documented history for depression in tab form used by a p-doc,over parnate/nardil,when its rare a maoi would even have been considered in the first place,its like four leaf clover.
>
> Your doc went one step further and said most people dont have luck with it for depression,so with the statement above id love to know where hes getting this theory from.For him to say that would mean not only has he encountered deprenyl for the use of depression a EXTREMLY EXTREMLY rare thing once,but rather munerous times,enough to come to a conclusion that it isnt helpful.
>
> Think about that,and as for the patch,lots of money,lots of time and work are being invested in this drug,people are putting up lots on it.More importantly lol it isnt OUT yet,so he could not have been referring to that because the drug is still unavailable.
>
> Personly,and dr bob just my own opinion lol,is when a doc is approached about something from a patient that they are not too familiar on,they seem to like to blow it off change the direction very very fast.
>
>
> I again in my own opinion have to say ur doc was blowing u off on the deprenyl cause he might not have been informed,so rather have u know something he doesent,he quickly moved away,.....i cant logicaly in anyway see how ur doc could be in a postion to have made a statement about deprenyl when it isnt even out yet,we are all waiting,the only info about deprenyl and depression mainly are from deep rooted net news groups,boards,foroums,and these are with deprenyl in no set dose etc,maois are not a popular choice in the psych world,and deprenyl a maoi would have to date been usd off label which is like finding a four leaf clover on the floor after tripping over a found wallet with tons of money,prior to this patch deprenyl info,history on depression is rare to none,ur doc seemed to make a very bold statement,i would personaly not credit it,instead id personaly look into emsam urself on the net and see how it works,look at some trial data,and see if u believe it might help.
>
> I luckly found a doc finaly who doesent care if i might know more than her on a certain drug,and she said this patch is unknown with many p-docs,it hasent hit there seminars yet,but she took the name from me and said thanks,and said she was gonna look it up at home that night,and let me know the second she has it come up in her little pysch world.
>
> P.s i miss manhattern,shopping on 34th lol,are u from there?
>
>
Posted by LizinManhattan on February 8, 2006, at 18:52:33
In reply to Re: Selegiline/Deprenyl effective anti-depressant? » LizinManhattan, posted by Larry Hoover on February 8, 2006, at 10:15:42
Hi Lar,
Thanks so much for the information. What you say makes a lot of sense. A bit disappointing to hear that there might still be blood pressure issues though. AS long as it doesn't spontaneously cause hypertensive crisis (as Parnate did for me) I suppose I could deal with it!
Liz> Your psychiatrist is basing his opinion on oral selegiline, which really could be thought of as being a different drug. Selegiline is readily changed by digestive enzymes in the intestinal wall and the liver. This protective net of enzymes is called the first pass metabolism; all oral drugs pass through this gauntlet.
>
> If I recall correctly, as much as 60% of oral selegiline can be metabolized before it even gets into general blood circulation. And, the metabolites have activities that are different than the parent drug.
>
> In contrast, the patch delivery system allows selegiline to trickle through directly into general circulation, avoiding that significant destruction via first pass enzymes. You get different drug effects, because the selegiline pretty much makes it into the brain unchanged.
>
> It remains to be seen that Emsam is similar in effect to other MAOIs. And, individual differences in sensitivity to tyramine makes it hard to predict if food restrictions will apply or not. Some people may still have to watch their diet closely, to avoid BP effects.
>
> Lar
>
Posted by willyee on February 8, 2006, at 19:35:19
In reply to Re: Selegiline/Deprenyl effective anti-depressant? » willyee, posted by LizinManhattan on February 8, 2006, at 18:48:34
Cool,im orginaly from redhook.....the old old REDHOOK where you knew your boundaries at night.
LOL i remeber i literaly was the only white face in the entire redhook,but i wouldent have changed it for the world,bad place,but grew up with great great people.
I hear redhook is changing into a very hih class place now anyway im not sure if u said ur going on remeron,all these postins criss crossins i might be confused,BUT just my opintion and i hate to scare you,disapoint you are anything,im just honestly sorry to hear ur choosing remeron,regardless i wish u luck and hope.
Posted by Phillipa on February 8, 2006, at 20:55:32
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by willyee on February 8, 2006, at 19:35:19
This us offtopic but not altogether so. They use the same delivery system for menopausal symtoms either a cream absorbed into the skin or a patch. Supposed to eliminate a lot of the side effects. The cream did that for me. Just a note that delivery systems do work differnely. Fondly, Phillipa
Posted by gibber on February 8, 2006, at 23:13:36
In reply to Selegiline/Deprenyl effective anti-depressant?, posted by LizinManhattan on February 7, 2006, at 21:35:15
one of the only emsam studies I know of. I had an appointment with Dr. Bodkin the study doctor a few months ago and he did recommend the patch to me. He was an amazing person to talk to and no ego. Unfortunately the doctor I have now is the complete opposite but he may give me the emsam when it comes out. Below is the study, the full article is free too:
Transdermal selegiline in major depression: a double-blind, placebo-controlled, parallel-group study in outpatients.
Bodkin JA, Amsterdam JD.
McLean Hospital, 115 Mill St. Belmont, MA 02478, USA. abodkin@mclean.harvard,edu
OBJECTIVE: The authors investigated the efficacy and safety of transdermal selegiline in adult outpatients with major depressive disorder. METHOD: Following a 1-week placebo lead-in, 177 adult outpatients with major depressive disorder were randomly assigned to receive transdermal selegiline (20 mg applied once daily by means of a 20-cm(2) patch) (N=89) or placebo (N=88) for 6 weeks. The patients followed a tyramine-restricted diet during the medication trial and for 2 weeks after completion of treatment. Response to medication or placebo was measured by using the 17-item and 28-item versions of the Hamilton Depression Rating Scale, the Montgomery-Asberg Depression Rating Scale, and the Clinical Global Impression (CGI) severity and improvement measures. RESULTS: Greater improvement was observed after 6 weeks in patients treated with transdermal selegiline than in those given placebo according to all measures. A statistically significant difference between drug and placebo was seen in Hamilton depression scale and Montgomery-Asberg Depression Rating Scale scores as early as week 1 of treatment. There were no differences in the adverse event profile of the patients given selegiline and those given placebo with the exception of application-site reactions, which were more common with the selegiline transdermal system. No orthostatic hypotensive or hypertensive reactions were observed. CONCLUSIONS: Transdermal selegiline (20 mg applied once daily by means of a 20-cm(2) patch) administered for 6 weeks was an effective and well-tolerated treatment for adult outpatients with major depression. The typical side effects commonly seen with traditional monoamine oxidase inhibitor antidepressants were not observed.
Posted by linkadge on February 9, 2006, at 9:18:16
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by willyee on February 8, 2006, at 15:55:23
You're right, I really don't know untill/if the drug comes out.
Linkadge
Posted by LizinManhattan on February 9, 2006, at 14:35:23
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by willyee on February 8, 2006, at 19:35:19
Yea, artists have moved into Red Hook so the prices are going up... Where do you live now?
I take it Remeron didn't help you? Do you suffer from atypical depression? That's my problem.
Liz> Cool,im orginaly from redhook.....the old old REDHOOK where you knew your boundaries at night.
>
> LOL i remeber i literaly was the only white face in the entire redhook,but i wouldent have changed it for the world,bad place,but grew up with great great people.
>
> I hear redhook is changing into a very hih class place now anyway im not sure if u said ur going on remeron,all these postins criss crossins i might be confused,BUT just my opintion and i hate to scare you,disapoint you are anything,im just honestly sorry to hear ur choosing remeron,regardless i wish u luck and hope.
Posted by LizinManhattan on February 9, 2006, at 14:38:47
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by gibber on February 8, 2006, at 23:13:36
Hi,
Do you know which journal the study's in? I'd love to read the whole article, and have it for my doctor if necessary.
Thanks!
Liz> one of the only emsam studies I know of. I had an appointment with Dr. Bodkin the study doctor a few months ago and he did recommend the patch to me. He was an amazing person to talk to and no ego. Unfortunately the doctor I have now is the complete opposite but he may give me the emsam when it comes out. Below is the study, the full article is free too:
>
> Transdermal selegiline in major depression: a double-blind, placebo-controlled, parallel-group study in outpatients.
>
> Bodkin JA, Amsterdam JD.
>
> McLean Hospital, 115 Mill St. Belmont, MA 02478, USA. abodkin@mclean.harvard,edu
>
> OBJECTIVE: The authors investigated the efficacy and safety of transdermal selegiline in adult outpatients with major depressive disorder. METHOD: Following a 1-week placebo lead-in, 177 adult outpatients with major depressive disorder were randomly assigned to receive transdermal selegiline (20 mg applied once daily by means of a 20-cm(2) patch) (N=89) or placebo (N=88) for 6 weeks. The patients followed a tyramine-restricted diet during the medication trial and for 2 weeks after completion of treatment. Response to medication or placebo was measured by using the 17-item and 28-item versions of the Hamilton Depression Rating Scale, the Montgomery-Asberg Depression Rating Scale, and the Clinical Global Impression (CGI) severity and improvement measures. RESULTS: Greater improvement was observed after 6 weeks in patients treated with transdermal selegiline than in those given placebo according to all measures. A statistically significant difference between drug and placebo was seen in Hamilton depression scale and Montgomery-Asberg Depression Rating Scale scores as early as week 1 of treatment. There were no differences in the adverse event profile of the patients given selegiline and those given placebo with the exception of application-site reactions, which were more common with the selegiline transdermal system. No orthostatic hypotensive or hypertensive reactions were observed. CONCLUSIONS: Transdermal selegiline (20 mg applied once daily by means of a 20-cm(2) patch) administered for 6 weeks was an effective and well-tolerated treatment for adult outpatients with major depression. The typical side effects commonly seen with traditional monoamine oxidase inhibitor antidepressants were not observed.
>
Posted by gibber on February 9, 2006, at 19:34:26
In reply to Re: Selegiline/Deprenyl effective anti-depressant? » gibber, posted by LizinManhattan on February 9, 2006, at 14:38:47
Here's the link to the full-text article. This is the first study done on the patch. 4 other studies were done later where 2 showed significant difference bwtn patch and placebo and 2 that did not. This single study is very encouraging, however when the studies are combine the authors use the term "modest difference" bwtn patch and placebo.
I think this is another case of what works for some does not work for others. I'm encouraged by the results.http://ajp.psychiatryonline.org/cgi/content/full/159/11/1869
You can find a few more studies at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed
Posted by LizinManhattan on February 9, 2006, at 22:05:56
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by gibber on February 9, 2006, at 19:34:26
Thanks so much for the links. I have bookmarked them and will look at them tomorrow.
Thanks!
Liz> Here's the link to the full-text article. This is the first study done on the patch. 4 other studies were done later where 2 showed significant difference bwtn patch and placebo and 2 that did not. This single study is very encouraging, however when the studies are combine the authors use the term "modest difference" bwtn patch and placebo.
> I think this is another case of what works for some does not work for others. I'm encouraged by the results.
>
> http://ajp.psychiatryonline.org/cgi/content/full/159/11/1869
>
> You can find a few more studies at:
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed
Posted by Larry Hoover on February 10, 2006, at 9:52:40
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by willyee on February 8, 2006, at 11:48:26
> Mr.hoover aside from the groups and the whole deprenyl/phenylane movement,
>
> wouldent u say it odd your everyday p-doc have any exper with deprenyl and depression prior to emsam.I do agree with that. L-deprenyl was unknown in North America before it became one of the first effective treatments for Parkinson's disease. Dr. Morton Shulman formed a company for the sole purpose of importing this drug under license, so that he could have access to it to treat his own Parkinson's symptoms.
Lar
Posted by Larry Hoover on February 10, 2006, at 10:00:47
In reply to Re: Selegiline/Deprenyl effective anti-depressant?, posted by willyee on February 8, 2006, at 11:58:52
> Sorry i forgot to ask something i very much wanted to,would you say the delivery of a drug directly via bloodstream would avoid the problem of poop out.
>
> My understanding from reading is poop out is when ur body having had just about enough of a foreign substance begins to fight back by building specific anti-enzmyes to keep this substance out and away,hence the longer of introduction of a drug,the more chance your body will start getting wise to it and fighting it.It is possible that the induction of enzymes is at the heart of poop-out, but I wouldn't put that theory at the top of my "probable causes" list. Enzyme induction tends to be rather rapid, if it's going to occur at all. It's part of our defense against toxic substances, and a tardy response to toxicity could well end in death (hypothetical evolutionary perspective). I'm most inclined towards a tolerance-based mechanism for poop-out.
> Would the patch benifit here.
The patch works well in two situations. The first is maintaining stable blood concentration. Oral dosing is characterized by substantial changes in blood concentration, rising rapidly after a dose, and tapering off to a much lower level just prior to the next dose. The second situation is to provide an alternate route of entry into the body, where normal digestive processes would tend to destroy the drug before it could do any good.
> P.S As a note i have seen your postings since i began posting period on the internet approx 5 years ago,guess im giving respect due i dunno,but glad certain people are around,lol you part of the kind that makes me look smart as i read your info and turn around and pass it along,shhhhh thats a secret.Thanks, willyee.
Lar
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