Posted by SLS on November 14, 2015, at 6:27:50
In reply to Re: My new cocktail » Horse, posted by former poster on November 14, 2015, at 0:29:07
Did you read the link I posted? It also contains the following:
"Pharmacodynamics
MAO exists as two isoenzymes, referred to as MAO-A and MAO-B. Selegiline has a greater affinity for MAO-B, compared to MAO-A. However, at antidepressant doses, selegiline inhibits both isoenzymes. In an in vivo animal model used to test for antidepressant activity (Forced Swim Test), selegiline administered by transdermal system exhibited antidepressant properties only at doses that inhibited both MAO-A and MAO-B activity in the brain. In the CNS, MAO-A and MAO-B play important roles in the catabolism of neurotransmitter amines such as norepinephrine, dopamine, and serotonin, as well as neuromodulators such as phenylethylamine."
Central serotonin syndrome is not the same as the peripheral tyramine reaction, and I am dubious that they are mutually inclusive. Ask this same pharmacist if the safety of Emsam extends to higher dosages. If it were me, I would want a detailed explanation as to why the combination of Emsam with a serotonin reuptake inhibitor is safe when the drug company clearly states otherwise.
MAO-inhibitors do not work for depression unless MAO-A is inhibited in the brain. Even pargyline is ineffective until dosages that inhibit MAO-A are reached. The irreversible inhibitor specific for MAO-A, clorgyline, does not inhibit MAO-B at all at any dosage. It is perhaps the most clinically effective antidepressant in the world. This was the position of the NIH in 1993. Since it became unavailable shortly thereafter, further study in humans became impossible. There was some concern regarding cardiac side effects. Valvulopathy, maybe? They didn't tell me.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1083990
URL: http://www.dr-bob.org/babble/20150929/msgs/1083999.html