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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Minsc22 on August 11, 2010, at 4:10:34
Hello, i took selegiline for 10 days to increase my motivation but i have the opposite effect : lethargy, apathy,sleepy.
Each day is really boring.
I tried 2.5mg/ day, 5 mg/day and 10 mg/day.
Do you think i should stop or the stimulant effect can appear?
Usually, the activating effect is fast with selegiline.
Thanks
Posted by linkadge on August 11, 2010, at 9:59:54
In reply to apathy with selegiline, posted by Minsc22 on August 11, 2010, at 4:10:34
Contrary to popular believe, dopaminergics can sometimes worsen apathy.
Side effects of stimulants is sometimes apathy / depression.
Linkadge
Posted by Minsc22 on August 11, 2010, at 19:23:10
In reply to Re: apathy with selegiline, posted by linkadge on August 11, 2010, at 9:59:54
> Contrary to popular believe, dopaminergics can sometimes worsen apathy.
>
> Side effects of stimulants is sometimes apathy / depression.
>
> Linkadge
>
>Thanks, is it possible that apathy disappear and stimulant effect appear with time or it's not probable?
Posted by linkadge on August 11, 2010, at 20:38:37
In reply to apathy with selegiline, posted by Minsc22 on August 11, 2010, at 4:10:34
IMHO, its not probable, esp if you are not suffering from depression.
If you are suffering from depression, then there is a chance that further treatment may result in clinical improvement. There is a chance that the dose is too low for an AD effect.
I know people who have had the same reaction (i.e. increased apathy lethargy etc) for whom it persisted, but nobody can say for sure.
Posted by Minsc22 on August 11, 2010, at 23:11:39
In reply to Re: apathy with selegiline, posted by linkadge on August 11, 2010, at 20:38:37
> IMHO, its not probable, esp if you are not suffering from depression.
>
> If you are suffering from depression, then there is a chance that further treatment may result in clinical improvement. There is a chance that the dose is too low for an AD effect.
>
> I know people who have had the same reaction (i.e. increased apathy lethargy etc) for whom it persisted, but nobody can say for sure.
>
>Thanks, i take selegiline with 300 mg of bupropion
but all the benefits of bupropion are cancelled.Do you think dopamine agonists at low dose like mirapex are dangerous in my case?
Can they worsen the situation in the long term?
Posted by linkadge on August 13, 2010, at 7:51:20
In reply to Re: apathy with selegiline, posted by Minsc22 on August 11, 2010, at 23:11:39
Hmm, you're taking wellbutrin and selegeline.
Theoretically, you are blocking two pathways for dopamine metabolism DAT and MAO-B.
The problem could be because of an imbalence between dopamine and serotonin. Some animal reseach sugests that brain reward proceses requires both serotonergic and dopaminergic signalling. Pushing dopamine too high, can actually reduce serotonergic and or opioid signalling.
I remember when I was taking ritalin (a DAT inhibitor) with the herb fo-it (a realtively potent MAO-B inhibitor). My moods felt fairly dark, like my mind was being controlled. It definately made me more irritable almost mildy psychotic.
Have you ever taken anything serotonergic with the wellbutrin, or the selegiline for that matter?
Low dose SSRI + selegiline combinations are generally safe. You might even try some 5-htp cautiously.
Linkadge
Posted by Minsc22 on August 13, 2010, at 23:11:29
In reply to Re: apathy with selegiline, posted by linkadge on August 13, 2010, at 7:51:20
I took prozac 20 mg with wellbutrin but that didn't work.
I took cymbalta, milnacipran with a good balance between serotonin and noradrenaline but again, didn't work.
I'm going to try tianeptine but i think i will have the usual response : numbness...Thanks for your advises.
This is the end of the thread.
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