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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by jealibeanz on August 30, 2006, at 18:57:12
MAOI's were the first antidepressants available for use. The biggest drawback to their use was that they had many interactions with drugs and foods, because they were MAOI-A drugs. Once we had the availability of newer agents, like Prozac,we didn't use these agents any longer(except in rare instances) due to these disadvantages.
Selegilene is an MAOI-B agent, which has been used in Parkinson's disease. It is unlikely to cause weight gain, as previously stated, as it usually causes weight loss as a side effect.
It has a stimulating effect,as in it keeps people awake at night, etc. It is not a "stimulant" such as Strattera. However, it is possible that you could experience some benefit from this medication with your ADHD, since this medication acts on Norepinephrine, Dopamine and Serotonin. This medication has not been studied in the treatment of ADHD.
It is true that at the higher doses it is possible for Emsam to work at MAOI-A. It is more selective for MAOI-B, but this is lost at higher doses. When used at the 2 higher doses, one must use the dietary restrictions that the older antidepressants had. Even at the lower doses, there would be an
effect on serotonin.
Posted by Jimmyboy on August 30, 2006, at 20:29:29
In reply to EMSAM response from a Pharmacist, posted by jealibeanz on August 30, 2006, at 18:57:12
Did he tell you how long it takes this *@#&^! patch to start working ? : )
JB
Posted by jealibeanz on August 30, 2006, at 20:38:28
In reply to Re: EMSAM response from a Pharmacist, posted by Jimmyboy on August 30, 2006, at 20:29:29
I didn't ask. I was surprised about the bit about serotonin, even at the lower levels. I'm not sure my body would be pleased.
I emailed the ECKERD pharamcist helpline. A lot of drugstores have them. They're quick, friendly, and usually fairly knowledgeable.
Posted by Phillipa on August 30, 2006, at 20:44:49
In reply to Re: EMSAM response from a Pharmacist, posted by jealibeanz on August 30, 2006, at 20:38:28
If I take the EMSAM because my anxiety is so bad my pdoc said 1/4 patch. Will this be too stimulating for me too? Love Phillipa
Posted by jealibeanz on August 30, 2006, at 20:58:56
In reply to Re: EMSAM response from a Pharmacist » jealibeanz, posted by Phillipa on August 30, 2006, at 20:44:49
I'm not sure, only you can answer that question. If it's too stimulating you must adjust. How are you doing with EMSAM right now.
Posted by linkadge on August 30, 2006, at 21:17:36
In reply to Re: EMSAM response from a Pharmacist, posted by jealibeanz on August 30, 2006, at 20:58:56
In some ways though, it is speculative as to just how much this drug will effect serotonin at lower doses.
For instance, have there been any studies showing the extent of MAO-A inhibition at clinical doses?
While some people do respond to it, it seems that a number of people don't. For some people its more energizing than mood brighening.
Linkadge
Posted by jealibeanz on August 30, 2006, at 22:16:48
In reply to Re: EMSAM response from a Pharmacist, posted by linkadge on August 30, 2006, at 21:17:36
I would think that individual's metabolism could have a major role in the MAOI-A system. Some people may process the drug at different rates,influencing its actions?
Posted by linkadge on August 31, 2006, at 16:18:09
In reply to Re: EMSAM response from a Pharmacist, posted by jealibeanz on August 30, 2006, at 22:16:48
Yeah, the level of MAO inhibition will depend on the concentration, which is affected by dose and metabolism, but I'd think that the ratio of MAO-A inhibition to MAO-B inhibition would still be constant.
I don't know I was under the impression that selegeline was selective to MAO-B over MAO-A by something like 3:1 or more?
Linkadge
Posted by jealibeanz on August 31, 2006, at 16:53:10
In reply to Re: EMSAM response from a Pharmacist, posted by linkadge on August 31, 2006, at 16:18:09
Yuck! I'm getting visions of Wellbutrin here (didn't enjoy!)... I wonder how similar they really are in terms of side effects and efficacy.
Posted by Phillipa on August 31, 2006, at 18:12:47
In reply to Re: EMSAM response from a Pharmacist, posted by linkadge on August 30, 2006, at 21:17:36
Link what do you know about EMSAM you've yet to comment with an opinion. I value your opinions. Love Phillipa
Posted by Phillipa on August 31, 2006, at 18:15:18
In reply to Re: EMSAM response from a Pharmacist, posted by jealibeanz on August 31, 2006, at 16:53:10
Jelly if it's like wellbutrin I can't take it as it made me appear manic to my pdoc a couple of years ago so he hospitalized me. Love Phillipa
Posted by linkadge on August 31, 2006, at 18:28:32
In reply to Re: EMSAM response from a Pharmacist » jealibeanz, posted by Phillipa on August 31, 2006, at 18:15:18
I can't comment on a drugs performance unless I have taken it. Though I venture to guess from what I have seen, that is can be a very stimulating drug.
*See the below link*. (see the box in the center) It lists the comparitive affinities of a few different MAO inhibitors for MAO-A and MAO-B. (Note the lower numbers mean higher affinities)
Both nardil and parante (phenelzine, tranylcypromine) have approximately equal affinities for MAO-A, and MAO-B. Emsam (Deprenly) however shows *significant* selectivity for MAO-B.
http://www.bdbiosciences.com/discovery_labware/gentest/products/pdf/Fluor_A&B-ISSX02.pdf
Linkadge
Posted by Phillipa on August 31, 2006, at 19:26:57
In reply to Re: EMSAM response from a Pharmacist, posted by linkadge on August 31, 2006, at 18:28:32
Link thanks guess it's not a good one for me. Any suggestions? Love Phillipa
Posted by linkadge on August 31, 2006, at 19:30:45
In reply to Re: EMSAM response from a Pharmacist » linkadge, posted by Phillipa on August 31, 2006, at 19:26:57
What all have you tried?
Linkadge
Posted by Phillipa on August 31, 2006, at 19:59:18
In reply to Re: EMSAM response from a Pharmacist » Phillipa, posted by linkadge on August 31, 2006, at 19:30:45
Link I've been slightly depressed since a child. It went away til my first panic attack age 24. Valium and mepbromated allowed me to live normally, raise three kids, go to nursing school, run a dance business, go through a divorse. Years later when my thryroid went all the SSRI"S and cymbalta a good long time twice. And luvox is the only one I feel safe on with the valium. No alchohol in l0years but that worked the best 5-6 beers nightly. And I was given TCA's with such horrendous side effects never again. Maybe excercise and benzos are the only ones for me. Oh and lamictal up to 50mg salivating so horrible spitting out of the car. And trileptal l50mg no side effects. Love Jan ps you have my e-mail.
Posted by jealibeanz on September 1, 2006, at 15:38:37
In reply to Re: EMSAM response from a Pharmacist, posted by linkadge on August 31, 2006, at 18:28:32
Link...
What an interesting site. It's a little over my head, although I've got a decent chem/bio background, so most of the terms make sense. It's just difficult to see the big picture.
Maybe it's this stems from my lack of pharmacologic knowledge, but that data table (3)is a bit confusing! They've listed inherent neurotransmitters (substrates) in the brain alongside biproducts(inhibitors) of medications (I think!?). The other tables are a little too much for organic-chem hating brain!
I feel like I'd benefit from something that is mainly dopaminergenic, but none of these seem to be so.
Posted by linkadge on September 1, 2006, at 16:32:04
In reply to Re: EMSAM response from a Pharmacist, posted by jealibeanz on September 1, 2006, at 15:38:37
The lower the number under in the column, the higher the affinity the drug has for that enzyme:
Linkadge
Posted by linkadge on September 1, 2006, at 21:58:33
In reply to Re: EMSAM response from a Pharmacist » linkadge, posted by Phillipa on August 31, 2006, at 19:59:18
Have you tried provigil? Some people say it helps augment antidepressants.
Linkadge
Posted by Phillipa on September 1, 2006, at 22:55:07
In reply to Re: EMSAM response from a Pharmacist » Phillipa, posted by linkadge on September 1, 2006, at 21:58:33
Link I think for now I'm going to wean off the luvox , continue the benzos which work, get a baseline and continue from there. Love Phillipa
This is the end of the thread.
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