![[dr. bob]](/dr-bob-sm.gif)
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 BrightEyed+Blueberry on May 7, 2008, at 15:58:31
Will selegiline or EMSAM tend to work for those people suffering depression who respond to amphetamine with mood elevation?
I thought this excerpt interesting, specifically regarding 1) selegiline, 2) sample "subjects responded to amphetamine with mood elevation," and 3) atypical depression/soft signs of bipolarity:
"The combination of the selective MAO type B inhibitor L-deprenyl (selegiline) with LPA rapidly relieves depression in a significant number of patients,50 including 6 of 10 patients with drug-resistant major depressive disorder. Our sample was biased in that subjects had treatment-resistant depressions, responded to amphetaminewith mood elevation, and had reduced urinary FAA. Our subsequent clinical observations indicate that perhaps as many as one-fourth of depressed patients, particularly those with atypical depression or soft signs of bipolarity,
show substantial improvement with L-deprenyl (10 mg/ day), LFA (1-6 g), and pyridoxine (100 mg), the vitamin required as coenzyme for ecarboxylation. Currently, we
use this combination often as initial treatment because it can rapidly be tested for effectiveness and has a minimum of side effects."Phenylethylamine Modulation of Affect:
Therapeutic and Diagnostic Implications
Hector C. Sabelli, M.D., Ph.D., Javaid I. Javaid, Ph.
(The Journal of Neuropsychiatry and Clinical
Neurosciences 1995; 7:6-14)Anyone have any thoughts? I've been on EMSAM for 6 weeks and it started to work right away on my atypical depression (and yes done the SSRIs/Wellbutrin/Effexor rigamarole for 10 years),and I am someone who has responded with positive mood elevation in the past to insufflated street-procured methamphetamine (not everyone does--I never liked/felt "good" from cocaine, for instance).
It just seems to go with how eventually folks seem to self-medicate...well, when given the opportunity - they end up "addicted" to their particular "drug of preference" brand... people go towards what their brain needs...albeit, to extreme, debilitating excess leading to more mood/cognitive you-name-it impairment / negative life functioning.
Kinda like your body foraging for what it needs--you suddenly find yourself scarfing down broccoli, or gulping down ice-cold milk. Or Hershey's kisses :)
I'd like to be able to afford a few thousand dollars to see my brain--to have SPECT imaging done.
-Bright
Posted by undopaminergic on May 7, 2008, at 21:18:04
In reply to EMSAM works 4 those w/ amphetamine mood elevation?, posted by BrightEyed+Blueberry on May 7, 2008, at 15:58:31
> Will selegiline or EMSAM tend to work for those people suffering depression who respond to amphetamine with mood elevation?
>
> I thought this excerpt interesting, specifically regarding 1) selegiline, 2) sample "subjects responded to amphetamine with mood elevation," and 3) atypical depression/soft signs of bipolarity:
>
> "The combination of the selective MAO type B inhibitor L-deprenyl (selegiline) with LPA rapidly relieves depression in a significant number of patients,50 including 6 of 10 patients with drug-resistant major depressive disorder. Our sample was biased in that subjects had treatment-resistant depressions, responded to amphetaminewith mood elevation, and had reduced urinary FAA. Our subsequent clinical observations indicate that perhaps as many as one-fourth of depressed patients, particularly those with atypical depression or soft signs of bipolarity,
> show substantial improvement with L-deprenyl (10 mg/ day), LFA (1-6 g), and pyridoxine (100 mg), the vitamin required as coenzyme for ecarboxylation. Currently, we
> use this combination often as initial treatment because it can rapidly be tested for effectiveness and has a minimum of side effects."
>
> Phenylethylamine Modulation of Affect:
> Therapeutic and Diagnostic Implications
> Hector C. Sabelli, M.D., Ph.D., Javaid I. Javaid, Ph.
> (The Journal of Neuropsychiatry and Clinical
> Neurosciences 1995; 7:6-14)
>
> Anyone have any thoughts? I've been on EMSAM for 6 weeks and it started to work right away on my atypical depression (and yes done the SSRIs/Wellbutrin/Effexor rigamarole for 10 years),and I am someone who has responded with positive mood elevation in the past to insufflated street-procured methamphetamine (not everyone does--I never liked/felt "good" from cocaine, for instance).
>It seems very logical that those responding with mood elevation to amphetamine would respond favourably to selegiline, as selegiline inhibits the MAO-B enzyme that breaks down endogenous (or exogenous) phenylethylamine (PEA), which is similar to amphetamine in action (amphetamine is Alpha-MethylPHenylEThylAMINE). If selegiline on its own proves insufficient, it can be boosted with phenylalanine or PEA supplements.
Posted by BrightEyed+Blueberry on May 7, 2008, at 22:08:07
In reply to Re: EMSAM works 4 those w/ amphetamine mood elevation?, posted by undopaminergic on May 7, 2008, at 21:18:04
I don't understand how selegiline is metabolized into amphetamine and methamphetamine and that stuff is racing around in the bloodstream and NOT effecting you? I guess it's not making it up into the brain and saturating synapses, receptors, dopamine transporters, whatever?
EMSAM is not meant for ADD in any way, right? What about to promote executive functioning: memory, motivation...I've gathered some feel it can extend your life....
Just musings and wonderings....
BTW, thanks, I didn't know--geez, what's in a name?!--(amphetamine = Alpha-MethylPHenylEThylAMINE).
Learn something new everyday!
-Bright
***the metabolites> > Will selegiline or EMSAM tend to work for those people suffering depression who respond to amphetamine with mood elevation?
> >
> > I thought this excerpt interesting, specifically regarding 1) selegiline, 2) sample "subjects responded to amphetamine with mood elevation," and 3) atypical depression/soft signs of bipolarity:
> >
> > "The combination of the selective MAO type B inhibitor L-deprenyl (selegiline) with LPA rapidly relieves depression in a significant number of patients,50 including 6 of 10 patients with drug-resistant major depressive disorder. Our sample was biased in that subjects had treatment-resistant depressions, responded to amphetaminewith mood elevation, and had reduced urinary FAA. Our subsequent clinical observations indicate that perhaps as many as one-fourth of depressed patients, particularly those with atypical depression or soft signs of bipolarity,
> > show substantial improvement with L-deprenyl (10 mg/ day), LFA (1-6 g), and pyridoxine (100 mg), the vitamin required as coenzyme for ecarboxylation. Currently, we
> > use this combination often as initial treatment because it can rapidly be tested for effectiveness and has a minimum of side effects."
> >
> > Phenylethylamine Modulation of Affect:
> > Therapeutic and Diagnostic Implications
> > Hector C. Sabelli, M.D., Ph.D., Javaid I. Javaid, Ph.
> > (The Journal of Neuropsychiatry and Clinical
> > Neurosciences 1995; 7:6-14)
> >
> > Anyone have any thoughts? I've been on EMSAM for 6 weeks and it started to work right away on my atypical depression (and yes done the SSRIs/Wellbutrin/Effexor rigamarole for 10 years),and I am someone who has responded with positive mood elevation in the past to insufflated street-procured methamphetamine (not everyone does--I never liked/felt "good" from cocaine, for instance).
> >
>
> It seems very logical that those responding with mood elevation to amphetamine would respond favourably to selegiline, as selegiline inhibits the MAO-B enzyme that breaks down endogenous (or exogenous) phenylethylamine (PEA), which is similar to amphetamine in action (amphetamine is Alpha-MethylPHenylEThylAMINE). If selegiline on its own proves insufficient, it can be boosted with phenylalanine or PEA supplements.
Posted by michael on May 12, 2008, at 15:45:57
In reply to Re: EMSAM works 4 those w/ amphetamine mood elevation? » undopaminergic, posted by BrightEyed+Blueberry on May 7, 2008, at 22:08:07
> I don't understand how selegiline is metabolized into amphetamine and methamphetamine and that stuff is racing around in the bloodstream and NOT effecting you? I guess it's not making it up into the brain and saturating synapses, receptors, dopamine transporters, whatever?
>
It's very small amounts of amphetamines, so unlikely to even be noticed, if I'm not mistaken.Michael
Posted by BrightEyed+Blueberry on May 12, 2008, at 23:40:42
In reply to Re: EMSAM works 4 those w/ amphetamine mood elevation? » BrightEyed+Blueberry, posted by michael on May 12, 2008, at 15:45:57
Articles about phenylethylamine or PEA suggest perhaps some with depression have low levels of it and that's why regular exercise or taking an MAOi B + PEA help people feel better-elevate mood, less depressed-i think the studies they measured PEA levels befor and after either regimen and the levels are increased afterwards. And depressed people tended to have lower levels of PEA before either regimen.
The studies are from the 1990s , not sure if they've been 'disproven' or why it doesn't seem Much is written/said about it in the recent-post 2000 literature ? Is. There stigma regarding PEA?
That said, in reading about PEA I read of a practice called "stimulant challenge test" - dates seemed to be 1980s and a toxicity treatment text so not sure if that was done in clinical trials, or rehabilitation-related clinics, or something that quickly fell out of favor as anything related to dopamine as treatment for depression (reuptake inhibitors etc.) seems to hit the big "no-no" wall as worries about addiction and abuse overwhelm the issue ( treading on these controlled substances and on-label use issues--amphetamines are on-label for ADD not depression symptoms, right? Well, it *is* a scary place to be on the edge of).
Just thoughts. Any of this relate to new meds on horizon for united states approval / or what meds used succesfully in TX of depression in other countries but not here cuz of dopamine stigma?If it works, under doctors careful monitoring , don't we deserve to try every option?
> > I don't understand how selegiline is metabolized into amphetamine and methamphetamine and that stuff is racing around in the bloodstream and NOT effecting you? I guess it's not making it up into the brain and saturating synapses, receptors, dopamine transporters, whatever?
> >
> It's very small amounts of amphetamines, so unlikely to even be noticed, if I'm not mistaken.
>
> Michael
Posted by undopaminergic on May 15, 2008, at 22:13:19
In reply to Re: EMSAM works 4 those w/ amphetamine mood elevation?, posted by BrightEyed+Blueberry on May 12, 2008, at 23:40:42
>
> The studies are from the 1990s , not sure if they've been 'disproven' or why it doesn't seem Much is written/said about it in the recent-post 2000 literature ? Is. There stigma regarding PEA?
>Possibly a little, due to its similarity to amphetamine. One major reason why PEA hasn't received much attention is that it isn't commercially interesting - not patentable, etc.
> Just thoughts. Any of this relate to new meds on horizon for united states approval / or what meds used succesfully in TX of depression in other countries but not here cuz of dopamine stigma?
>Methylphenidate and amphetamines are relatively frequently used as adjuncts to other antidepressants in the treatment of refractory depression. Some doctors are more fond of such treatment than others - some of whom may be almost phobic about stimulants (although the dopamine stigma isn't as strong as the opioid stigma). It's also true that some cultures are more relaxed about potentially addictive drugs than Americans and North Europeans. For example, amineptine (a dopamine reuptake inhibitor antidepressant) was never available in the US, and remained available in Brazil for some time after it was discontinued in its country of origin, France.
> If it works, under doctors careful monitoring , don't we deserve to try every option?
>PEA is readily available over the Internet as a dietary supplement, etc. but I recommend trying phenylalanine (D,L-phenylalanine - DLPA - is probably better than L-phenylalanine) before PEA. If you do try PEA while on selegiline, you should be very careful, as it elevates blood pressure.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.