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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 linkadge on December 7, 2019, at 9:17:09
Although MAO-B inhibitors are not effective in their own right (in many cases) as antidepressants, MAO-B appears to be elevated in major depression. Hence (perhaps) some degree of MAO-B inhibition would still prove therapeutic in patients with depression.
Linkadge
Posted by undopaminergic on December 8, 2019, at 9:03:11
In reply to MAO-B elevated in Depression, posted by linkadge on December 7, 2019, at 9:17:09
>
> Although MAO-B inhibitors are not effective in their own right (in many cases) as antidepressants, MAO-B appears to be elevated in major depression. Hence (perhaps) some degree of MAO-B inhibition would still prove therapeutic in patients with depression.
>
> LinkadgeThat is an interesting finding. Normalising the MAO-B levels is probably a good idea. Reducing it to abnormal levels, I don't know for sure.
While taking 10 mg/day (or even more) of selegiline resulted in more of an improvement than a worsening, I don't know whether there is something subtly negative about it. It changes the way certain substances are metabolised. For example, it likely changes the role phenylethylamine (PEA) normally plays in neuromodulation (especially dopaminergic).
Also, with selegiline (l-deprenyl) there is the question of the l-amphetamine metabolites. They play a significant role in the pharmacology of the drug. The amphetamine levels produced are far too low to be neurotoxic, but they are the likely reason for the initial stimulation (including a mood lift) you experience upon initiating selegiline. I know this, because I did not experience any stimulant effect when I started rasagiline (a similar MAO-B inhibitor), which does not metabolise into amphetamines.
-undopaminergic
Posted by linkadge on December 8, 2019, at 12:57:13
In reply to Re: MAO-B elevated in Depression » linkadge, posted by undopaminergic on December 8, 2019, at 9:03:11
There is some connection between inflammation and MAO-B levels. The increased MAO-B may contribute to cognitive dysfunction and/or anhedonia (associated with reduced PEA levels).
To be honest, you may normalize MAO-B levels with much lower doses of selegiline (<5mg). Not sure though, I'd have to see if there are some human dose / MAO-B inhibition studies.
Linkadge
Posted by SLS on December 8, 2019, at 13:23:43
In reply to Re: MAO-B elevated in Depression » undopaminergic, posted by linkadge on December 8, 2019, at 12:57:13
Emsam (transdermal seligiline) is selective for MAO-B at low dosages. However, it usually will not produce an antidepressant effect until the dosage is high enough to inhibit MAO-A along with MAO-B. The package label is clear about this.
" Selegiline has a greater affinity for MAO-B, compared to MAO-A. However, at antidepressant doses, selegiline inhibits both isoenzymes "
Yet, the label also says that it is not necessary to follow a low-tyramine diet at the lowest dosage patch - EMSAM 6 mg/24 hours.
"You do not have to make any diet changes with the EMSAM 6 mg/24 hours patch."
I don't understand it.
- Scott
Posted by rjlockhart37 on December 8, 2019, at 15:08:42
In reply to Re: MAO-B elevated in Depression, posted by SLS on December 8, 2019, at 13:23:43
i've been on prozac for years, my doctor was saying they had a patient that took selegine and stimulant, vycase i don't know
i posted to a poster they take desoxyn and parnate which would be the ultimate depression fighter, they told me desoxyn is not like the others, like dexedrine, it has it's own properties. Dexedrine has a worse crash, desoxyn does not
i've been on prozac for years and im familyar iwth it's effects, max dose, and if i don't take it, serious depression will happen. But i don't maybe one day would try parnate, its better than selegine, stronger. Give it a try
Posted by linkadge on December 9, 2019, at 16:21:32
In reply to Re: MAO-B elevated in Depression, posted by SLS on December 8, 2019, at 13:23:43
Good point.
However, perhaps normalizing MAO-B might improve some aspects of the disease even before producing an antidepressant effect.
Linkadge
Posted by SLS on December 24, 2019, at 13:31:21
In reply to Re: MAO-B elevated in Depression » SLS, posted by linkadge on December 9, 2019, at 16:21:32
> Good point.
>
> However, perhaps normalizing MAO-B might improve some aspects of the disease even before producing an antidepressant effect.
>
> LinkadgeMy doctor observed more of an anxiolytic effect at the beginning of treatment.
- Scott
This is the end of the thread.
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