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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 Ame-Sans-Vie on August 11, 2006, at 6:38:45
Well today marks two weeks on Emsam 20mg for me. For the first time in years I'm waking up and practically jumping out of bed, ready to go for a jog around the neighborhood and face the day to come. Have cut out caffeine entirely -- I just don't need my morning coffee anymore.
Could I really be seeing such a profound improvement in such a short period of time, at this low a dose? I mean, obviously I'm seeing a great improvement, but at this point is it more likely that the drug is doing its intended job, or that the L-amphetamine and L-methamphetamine metabolites are giving me a little "kick"? I know the metabolites are formed in much smaller amounts when selegiline is administered transdermally as opposed to orally, and while I had a response to a combination of oral selegiline 10mg and DL-phenylalanine a while back, it wasn't anywhere near this good.
Thoughts, anyone?
Cheers,
Michael
Posted by Paulbwell on August 11, 2006, at 8:08:31
In reply to Emsam Day 14 - Too soon to tell if it's working?, posted by Ame-Sans-Vie on August 11, 2006, at 6:38:45
> Well today marks two weeks on Emsam 20mg for me. For the first time in years I'm waking up and practically jumping out of bed, ready to go for a jog around the neighborhood and face the day to come. Have cut out caffeine entirely -- I just don't need my morning coffee anymore.
>
> Could I really be seeing such a profound improvement in such a short period of time, at this low a dose? I mean, obviously I'm seeing a great improvement, but at this point is it more likely that the drug is doing its intended job, or that the L-amphetamine and L-methamphetamine metabolites are giving me a little "kick"? I know the metabolites are formed in much smaller amounts when selegiline is administered transdermally as opposed to orally, and while I had a response to a combination of oral selegiline 10mg and DL-phenylalanine a while back, it wasn't anywhere near this good.
>
> Thoughts, anyone?
>
> Cheers,
> MichaelHi Ya Mike!
"Great to hear of your success-hoping it lasts:)the drug is doing its intended job, or that the L-amphetamine and L-methamphetamine metabolites are giving me a little "kick"
Excuse my ignorance, but wouldn't Dextroamphetamine, or Dextromethamphetamine tabs give a 'little kick' to your day?
You were on 4, 15mg Dex Spans+40mgs Desoxyn? daily a few months ago?
Let us know ok:)-good health
Cheers
Posted by Ame-Sans-Vie on August 11, 2006, at 8:18:07
In reply to Re: Emsam Day 14 - Too soon to tell if it's working? » Ame-Sans-Vie, posted by Paulbwell on August 11, 2006, at 8:08:31
> Excuse my ignorance, but wouldn't Dextroamphetamine, or Dextromethamphetamine tabs give a 'little kick' to your day?lol, they certainly would, but I can't take them anymore (the story behind that is in my response to your post in the thread above about treatment-resistant depression). Besides, they take about an hour to kick in fully, and I prefer actually waking up already feeling good!! lol
I'm just wondering if the very small amounts of L-amphetamine and L-methamphetamine that selegiline metabolizes to could be the cause of my current "get-up-and-go" attitude.Cheers,
Mike
Posted by Paulbwell on August 11, 2006, at 8:41:18
In reply to Re: Emsam Day 14 - Too soon to tell if it's working? » Ame-Sans-Vie, posted by Paulbwell on August 11, 2006, at 8:08:31
I have followed your progress, over the recent years and wished you well.
You have certainly come along way from:
Desoxyn -40mgs
Dexedrine 60mgs
Xanax - 16mg! thats like illegal
Klonopoin 8mgs?
Tuinal 2-4
Seconal 2-4
Xyrem
Alurate - barbiturateGood for you, MAN 16mgs Xanax LEGALLY scripted, the max here is 4# few people would be on that.
Cheers michael:)
Posted by Crazy Horse on August 11, 2006, at 8:46:53
In reply to Emsam Day 14 - Too soon to tell if it's working?, posted by Ame-Sans-Vie on August 11, 2006, at 6:38:45
> Well today marks two weeks on Emsam 20mg for me. For the first time in years I'm waking up and practically jumping out of bed, ready to go for a jog around the neighborhood and face the day to come. Have cut out caffeine entirely -- I just don't need my morning coffee anymore.
>
> Could I really be seeing such a profound improvement in such a short period of time, at this low a dose? I mean, obviously I'm seeing a great improvement, but at this point is it more likely that the drug is doing its intended job, or that the L-amphetamine and L-methamphetamine metabolites are giving me a little "kick"? I know the metabolites are formed in much smaller amounts when selegiline is administered transdermally as opposed to orally, and while I had a response to a combination of oral selegiline 10mg and DL-phenylalanine a while back, it wasn't anywhere near this good.
>
> Thoughts, anyone?
>
> Cheers,
> Michael
I'll keep this short and to the point...YES, it's working michael!!:) Monte
Posted by SLS on August 11, 2006, at 9:53:44
In reply to Emsam Day 14 - Too soon to tell if it's working?, posted by Ame-Sans-Vie on August 11, 2006, at 6:38:45
As an observer, and reading the reports of others, it seems that an energizing effect is seen within the first few days. However, this is not the true antidepressant effect. That comes later and follows a pattern similar to that seen with other antidepressants. So, one might not see significant improvements for two weeks in symptoms such as depressed mood, sadness, negative thoughts, anhedonia, loss of interest, drive, libido, and cognitive impairments.
There will be exceptions to the classic pattern, though, as we have seen examples of here on Psycho-Babble. A minority of people do begin to respond robustly within the first week. Perhaps you are one of them.
- Scott
Posted by SLS on August 11, 2006, at 10:19:35
In reply to Emsam Day 14 - Too soon to tell if it's working?, posted by Ame-Sans-Vie on August 11, 2006, at 6:38:45
> I know the metabolites are formed in much smaller amounts when selegiline is administered transdermally as opposed to orally, and while I had a response to a combination of oral selegiline 10mg and DL-phenylalanine a while back, it wasn't anywhere near this good.
There is no consensus on the board, but it may be that the blood level produced by the 6mg/24hr-20mg Emsam patch is equivalent to that achieved with an oral dose of 40mg.
It would be interesting to know whether or not selegiline itself possesses any psychostimulant properties such as DA or NE release or uptake inhibition.
- Scott
Posted by SLS on August 11, 2006, at 11:05:40
In reply to Re: Emsam Day 14 - Too soon to tell if it's workin, posted by SLS on August 11, 2006, at 10:19:35
> > I know the metabolites are formed in much smaller amounts when selegiline is administered transdermally as opposed to orally, and while I had a response to a combination of oral selegiline 10mg and DL-phenylalanine a while back, it wasn't anywhere near this good.
>
> There is no consensus on the board, but it may be that the blood level produced by the 6mg/24hr-20mg Emsam patch is equivalent to that achieved with an oral dose of 40mg.
>
> It would be interesting to know whether or not selegiline itself possesses any psychostimulant properties such as DA or NE release or uptake inhibition.
Aparently, it does (if I am interpreting this abstract properly). This would help explain the acute energizing effect that appears within the first few days of initiating Emsam treatment. This may indicate that the parent drug, selegiline, is actually more potent as a releaser of DA and NE than are its metabolites and explains why the transdermal delivery system produces a greater energizing effect that does the oral preparation.I subsequently found another abstract that demonstrated an inhibitory effect for tyramine-induced release of NE, but not for DA by Emsam, perhaps an index of reuptake inhibition. This might indicate a greater energizing effect than reward/hedonic effect by Emsam during the first few weeks of treatment.
- Scott-------------------------------------------
Neurobiology (Bp). 2000;8(2):179-99. Related Articles, Links(-)Deprenyl (Selegiline): past, present and future.
Knoll J.
Department of Pharmacology, Semmelweis University of Medicine, Budapest, Hungary.
(-)Deprenyl (Selegiline), the N-propargyl analogue of (-)methamphetamine, is the only drug in clinical case which, by enhancing the impulse propagation mediated release of noradrenaline and dopamine in the brain (catecholaminergic activity enhancer, CAE, effect), keeps in small doses without side-effects the catecholaminergic brain system on a higher activity level. (-)Deprenyl stimulates the catecholaminergic neurons selectively in the brain because, in contrast to PEA and the amphetamines which induce the continuous release of noradrenaline and dopamine from their intraneuronal stores, (-)deprenyl is devoid of this property. It is due to the CAE effect that a) the maintenance of rats on (-)deprenyl during the postdevelopmental phase of their life slows the age-related decline of sexual and learning performances and prolongs life significantly; b) patients with early, untreated Parkinson's disease maintained on (-)deprenyl need levodopa significantly later than their placebo-treated peers, and when on levodopa plus (-)deprenyl, they live significantly longer than patients on levodopa alone; and c) in patients with moderately severe impairment from Alzheimer's disease, treatment with (-)deprenyl slows the progression of the disease. It is reasonable to expect that a prophylactic low dose administration of a safe catecholaminergic activity enhancer substance during the postdevelopmental phase of life will slow the age-related decline of behavioral performances, delay natural death and decrease susceptibility to Parkinson's disease and Alzheimer's disease.
--------------------------------------------
Pharmacol Res. 2004 Mar;49(3):253-8. Related Articles, Links
Click here to read
(-)-Deprenyl inhibits tyramine-induced noradrenaline release, but not tyramine-induced dopamine release or potassium-induced noradrenaline release, from rat brain synaptosomes.Takahata K, Shimazu S, Yoneda F.
Research Institute, Fujimoto Pharmaceutical Corporation, 1-3-40 Nishiotsuka, Matsubara, Osaka 580-0011, Japan.
The effect of (-)-deprenyl (selegiline), a therapeutic agent for Parkinson's disease, on the tyramine-induced release of catecholamine from rat brain synaptosomes was studied using a superfusion system. Tyramine (10(-7) to 10(-5)M) enhanced the release of [3H]noradrenaline (NA) and [3H]dopamine (DA) from forebrain and striatal synaptosomes in a dose-dependent manner. (-)-Deprenyl (5x10(-5)M) had no effect on spontaneous catecholamine release, suggesting that it has no tyramine-like catecholamine releasing effect. Pretreatment with (-)- or (+)-deprenyl (5x10(-5)M) significantly prevented the tyramine (10(-6)M)-induced NA release, but not DA release. The inhibitory action of (-)-deprenyl was not observed on potassium (15mM)-induced NA release. (-)-Desmethyldeprenyl (5x10(-5)M), a metabolite of (-)-deprenyl, and a monoamine oxidase-A (MAO-A) inhibitor, clorgyline (5x10(-5)M), failed to block the tyramine-induced NA and DA release. Although (+)-deprenyl, a potent DA uptake inhibitor, did not inhibit tyramine-induced DA release, a catecholamine uptake inhibitor nomifensine (5x10(-5)M) did. In summary, (-)-deprenyl at a dose inhibiting tyramine-induced NA release did not have any effect on tyramine-induced DA release or potassium-induced NA release.
PMID: 14726221 [PubMed - indexed for MEDLINE]
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Posted by Phillipa on August 11, 2006, at 22:21:46
In reply to Re: Emsam Day 14 - Too soon to tell if it's workin, posted by SLS on August 11, 2006, at 11:05:40
I heard it was an antiaging drug. Scott are you now considering it? love Phillipa
Posted by SLS on August 11, 2006, at 22:52:29
In reply to Re: Emsam Day 14 - Too soon to tell if it's workin » SLS, posted by Phillipa on August 11, 2006, at 22:21:46
> I heard it was an antiaging drug. Scott are you now considering it? love Phillipa
After reading a few abstracts on Medline about Emsam, and watching how some of the people here are responding favorably to it, I find myself placing Emsam higher on my list.
- Scott
Posted by Phillipa on August 11, 2006, at 23:13:07
In reply to Re: Emsam Day 14 - Too soon to tell if it's workin, posted by SLS on August 11, 2006, at 22:52:29
Scott we can go on it together. At the same time. As you would also need to wean off meds right? Love Jan
Posted by SLS on August 11, 2006, at 23:39:28
In reply to Re: Emsam Day 14 - Too soon to tell if it's workin » SLS, posted by Phillipa on August 11, 2006, at 23:13:07
> Scott we can go on it together. At the same time. As you would also need to wean off meds right? Love Jan
I'm going to give sibutramine some more time to work. I hope the dysphoria it has produced over the last two days isn't foreboding.
- Scott
Posted by Jost on August 12, 2006, at 11:59:07
In reply to Re: Emsam Day 14 - Too soon to tell if it's workin, posted by SLS on August 11, 2006, at 23:39:28
I hope not. Is the foreboding a learned response, or an actual response, to each different AD, do you think?
Wonder why you would get so much down-regulation. Have you researched how or what might cause re-upregulation, or might conteract down-regulation?
Jost
Posted by SLS on August 12, 2006, at 12:20:43
In reply to Re: Emsam Day 14 - Too soon to tell if it's workin » SLS, posted by Jost on August 12, 2006, at 11:59:07
> I hope not. Is the foreboding a learned response, or an actual response, to each different AD, do you think?
A few antidepressants - not all - produce a worsening of my depression. However, they don't all produce the same kind of worsening. Many antidepressants produce an improvement. Unfortunately, they rarely last more than three days.
> Wonder why you would get so much down-regulation. Have you researched how or what might cause re-upregulation, or might conteract down-regulation?
I think it might be something that happens postsynaptically along the second messenger / gene expression cascade. It must have a memory of some sort. This might be where the mechanisms lie that set up the phenomenon whereby subsequent exposure to a previously effect drug yields non-response.
Just musing. I really have very little idea what's going on.
- Scott
Posted by Check on August 15, 2006, at 15:51:34
In reply to Emsam Day 14 - Too soon to tell if it's working?, posted by Ame-Sans-Vie on August 11, 2006, at 6:38:45
> Well today marks two weeks on Emsam 20mg for me. For the first time in years I'm waking up and practically jumping out of bed, ready to go for a jog around the neighborhood and face the day to come. Have cut out caffeine entirely -- I just don't need my morning coffee anymore.
>
> Could I really be seeing such a profound improvement in such a short period of time, at this low a dose? I mean, obviously I'm seeing a great improvement, but at this point is it more likely that the drug is doing its intended job, or that the L-amphetamine and L-methamphetamine metabolites are giving me a little "kick"? I know the metabolites are formed in much smaller amounts when selegiline is administered transdermally as opposed to orally, and while I had a response to a combination of oral selegiline 10mg and DL-phenylalanine a while back, it wasn't anywhere near this good.
>
> Thoughts, anyone?
>
> Cheers,
> MichaelFor what it's worth, my understanding is that the levorotary forms of methamphetamine and amphetamine are either not pharmacologically active or exert effects that pale in comparison to the dextro forms. I agree with other who think that the initial boost is the result of the drug catching your brain off guard. The energizing effect may wear off and be replaced by a true antidepressant effect later as metabolic and receptor changes kick in.
Check
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