Posted by Astounder on November 15, 2007, at 18:22:18
In reply to Re: Diet restrictions on EMSAM 9 MGS?, posted by trx resistant on November 12, 2007, at 2:26:32
> Thanks everyone for your caring responses. The information is very helpful. Unfortunately after 5-7 days on the 9mg dose experienced extremely uncomfortable tightening in chest, like a broncho-spasm,had to double Xanax (anxiety level so high it was like brain freeze)and doubled Ambien Cr. Way too revved up, couldn't sleep. Tried to just live with it, but day 10 or 11 my throat felt like it was closing up. Just took the patch off before my dr. greturned my call. I kept it off completely for 3 days. Dr. decided I should go back down to 6mg and take off before bed. Couldn't face the 6mg. so I cut 9mg in half and have been removing before bed. I seem to be coming down a bit, hopefully. I'm worried this chest tightening could be an allergic reation that might prevent me from using even 6mg. Has anyone ever heard of a drug allergy to this?
Major metabolites of Selegiline (L-deprenyl) are L-methamphetamine (Vicks Inhaler), and L-amphetamine (1/4 of Adderall). These metabolites do not penetrate well through the blood brain barrier, and so mostly cause peripheral sympathetic stimulation. What may have happened is you've saturated MAO-B and now have a large amount of fee L-deprenyl, so more of the metabolites are being formed (L-deprenyl's affinity for MAO-A is over tenfold less than for MAO-B).
Your doctor should be able to do a prick test for an allergic reaction. If it's not an allergic reaction, excessive sympathetic discharge (causing spastic bronchodilation, tightening of smooth muscle around the esophagous, or vasospastic angina) might be responsible. You could test this yourself buy buying a Vick's Inhaler over the counter and seeing if symptoms worsen. If this is the reason, your anxiety over this is certainly worsening the symptoms: You may be able to allay your fears by getting a stress test or try a beta blocker.
I actually had left chest pain on EmSam, Remeron, and Desipramine. After the stress test turned up negative, I realized the psych was right in that I was exacerbating it by running from a transient somatic symptom, and it went away a week after I tried focusing on the sensation.
poster:Astounder
thread:662533
URL: http://www.dr-bob.org/babble/20071115/msgs/795320.html