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Re: selegiline patch

Posted by michael on May 14, 2001, at 18:07:43

In reply to Re: selegiline, dopamine, social anxiety: Adam, posted by Adam on July 19, 2000, at 9:08:56

Any word (ie: news) lately on selegiline patch fda approval?

> > Adam,
> >
> > Thanks for all the good info. Haven't heard from you for a while. You have been settled in with high dose selegiline for a while now since you were taken off the patch.
> No prob!
> >
> > Did you like the patch better?
> Yes. Especially at first. When I first took oral selegiline I wasn't on an efficacious dose. I then rapidly increased the dose and felt really wound-up and jittery for days, much more so than I ever did on the patch. I still deal with feelings of restlessness, especially around the time of dosing, and insomnia. These were also concerns with the patch, but not nearly as uneven and severe. As time has gone on, I've gotten used to selegiline in my system, and probably don't notice it as much, but I've never felt as good as I did on the patch. Also, in case you don't remember, I had great antidepressant response on the patch with no dietary restrictions. I've found dietary restrictions to be not a big problem, but still I do get these Pavlovian reactions to and cravings for certain foods that I just can't eat anymore, and it was nice not to have to worry about it.
> >Where do you think high dose selegiline's place is in the antidepressant spectrum. For who may it be particularly efficacious.
> I guess it would probably fit best next to Parnate in the spectrum, and maybe to some limited extent Welbutrin. Like all of the MAOIs, it has enough unique and relevant non-MAOI properties that it's sort of in a class by itself, but non-hydrazine MAOI would be the best description and classification, I think.
> It's hard to know who would it would be best for, since the MAOIs can be helpful for a variety of diagnoses. I'm not a physician so I can only speculate like any semi-educated person, and say that it might be best for atypical depressives and ideal for those with comorbid attention deficit issues. It might not be best for those who have anxiety disorders, but then again, there are paradoxical responses to certain drugs, and you do hear weird stories about people with social anxiety doing great on dextroamphetamine, etc., when you think they would respond best to a benzodiazapine.
> I guess there's always the "give it to people who it works for" response, like me. Thinking logically, I'm not sure I would have given myself oral selegiline, and my participation in the patch study was as much an experiment for me as it was for the investigators. The truth is I was running out of options, having tried just about every class of drug available with little or no success. An MAOI was the obvious choice at that point, and the patch study seemed like a relatively painless way to explore that class. I never expected to benefit so much from it. I imagine if I hadn't tried the patch, I might be on Parnate right now, and probably would be doing pretty well. But there's no way to know, unfortunately.
> >
> > AndrewB




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