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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 26 to 50 of 96. Go back in thread:
Posted by Elizabeth on July 23, 1999, at 0:05:11
In reply to Question for Elizabeth, posted by Brandon on July 22, 1999, at 18:34:27
> I just wanted to know how you knew wether you were taking the actual med or a placebo in the selegiline patch study. Is it still ongoing and if so is it still possible to register,
Ahh, point of confusion: I was never in the selegiline study, Annie was. (I tried selegiline a year or so before the grant proposal for said study in my locale had been submitted - by the guy who had recommended selegiline to me, in fact.)
So anyway, I was pretty sure I was on "the real thing" because what kind of sicko pharmacist would sell somebody placebo pills? :->
Posted by Adam on July 29, 1999, at 17:27:33
In reply to Re: Question for Elizabeth - wrong person!, posted by Elizabeth on July 23, 1999, at 0:05:11
I just started the selegiline study today at McLean
hospital (actually, I was screened earlier and just
got my first selegiline patch today). It's tough
to say much about this since it's so new. I have
no clue if I'm on the actual drug or a placebo. I
thought I felt a little funny this morning a couple
hours after I put the patch on, but you know how
these things are. The mind can play little tricks
on you, so it's best not to speculate. For those
curious about the study at McLean (in Belmont, MA,
not far from Boston), there is an 8-week period
where you have a 33.3% chance of getting either of
two doses of selegiline or a placebo. Then after
this period, everybody gets a selegiline patch for
six months. One really beautiful thing about this
study is that I can continue with the CBT that I've
been doing, and that I feel is an essential part of
my getting better. Many studies do not allow one
to continue psychotherapy while in a drug trial.I'm hoping this helps me. Selegiline seems to have
some interesting properties that could be really
nice. Then again it might not work at all. We'll
see.
Posted by Annie on July 29, 1999, at 21:22:36
In reply to Study, posted by Adam on July 29, 1999, at 17:27:33
Adam,
What doses are the patches in the study?
Thanks, Annie
> I just started the selegiline study today at McLean
> hospital (actually, I was screened earlier and just
> got my first selegiline patch today). It's tough
> to say much about this since it's so new. I have
> no clue if I'm on the actual drug or a placebo. I
> thought I felt a little funny this morning a couple
> hours after I put the patch on, but you know how
> these things are. The mind can play little tricks
> on you, so it's best not to speculate. For those
> curious about the study at McLean (in Belmont, MA,
> not far from Boston), there is an 8-week period
> where you have a 33.3% chance of getting either of
> two doses of selegiline or a placebo. Then after
> this period, everybody gets a selegiline patch for
> six months. One really beautiful thing about this
> study is that I can continue with the CBT that I've
> been doing, and that I feel is an essential part of
> my getting better. Many studies do not allow one
> to continue psychotherapy while in a drug trial.
>
> I'm hoping this helps me. Selegiline seems to have
> some interesting properties that could be really
> nice. Then again it might not work at all. We'll
> see.
Posted by Elizabeth on July 29, 1999, at 22:31:44
In reply to Study, posted by Adam on July 29, 1999, at 17:27:33
Hey Adam, you're in Boston? Me too. (Actually right now I'm in North Carolina, but I live in Boston.)
Posted by Adam on July 30, 1999, at 15:27:48
In reply to Re: Study, posted by Annie on July 29, 1999, at 21:22:36
I believe the doses are 10mg and 20mg/patch, or, of
course, no selegiline in the placebo group.I'm still trying to figure out if I'm getting the
active drug. I feel, a couple hours after I put
patch on, a little funny, but nothing really
remarkable.10 and 20 mg. are a bit low for selegiline as an
antidepressant if it were being delivered orally,
but for the transdermal delivery system, a lower
dose is a bit more potent.> Adam,
> What doses are the patches in the study?
> Thanks, Annie
Posted by Adam on July 30, 1999, at 15:29:16
In reply to Re: Study, posted by Elizabeth on July 29, 1999, at 22:31:44
Hey, Elizabeth,
Yep, I'm in the Boston area. How are things going
with you in the study?> Hey Adam, you're in Boston? Me too. (Actually right now I'm in North Carolina, but I live in Boston.)
Posted by Elizabeth on July 30, 1999, at 19:14:56
In reply to Re: Study, posted by Adam on July 30, 1999, at 15:29:16
> Hey, Elizabeth,
>
> Yep, I'm in the Boston area. How are things going
> with you in the study?I'm not in the study, but I know Dr. Bodkin (actually I talked to him about it when he was working on the grant proposal - he seemed excited about it) so I'm interested to know how it goes.
I tried oral selegiline (40mg, if I remember correctly) and it caused me nothing but grief (reminded me of Wellbutrin). Oh well. For a lot of people it doesn't have any side effects to speak of. (I sort of feel like I shouldn't tell you what they were for me, so as not to bias you. :->)
Email me if you want (it's shapere@aol.com). I'd be interested to meet "in real life," if you would.
Posted by Robin on July 31, 1999, at 9:16:33
In reply to Selegiline for depression?, posted by Brandon on May 10, 1999, at 23:07:11
> Has anyone heard of selegiline for depression. I have heard that it can be helpful.
Brandon, How is the selegiline working for you? Have you tried Marplan , Nardil or Parnate before? How does the Selegiline compare?
Robin
Posted by Robin on July 31, 1999, at 9:22:40
In reply to Re: Study, posted by Elizabeth on July 30, 1999, at 19:14:56
> > Hey, Elizabeth,
> >
> > Yep, I'm in the Boston area. How are things going
> > with you in the study?
>
> I'm not in the study, but I know Dr. Bodkin (actually I talked to him about it when he was working on the grant proposal - he seemed excited about it) so I'm interested to know how it goes.
>
> I tried oral selegiline (40mg, if I remember correctly) and it caused me nothing but grief (reminded me of Wellbutrin). Oh well. For a lot of people it doesn't have any side effects to speak of. (I sort of feel like I shouldn't tell you what they were for me, so as not to bias you. :->)
>
> Email me if you want (it's shapere@aol.com). I'd be interested to meet "in real life," if you would.Adam, What was the comparison of Wellbutrin and Selegiline? I hated Wellbutrin it made me more depressed. I haven't tried Selegiline, but was considering it.
Robin
Posted by Brandon on August 1, 1999, at 10:28:15
In reply to Re: Selegiline for depression?, posted by Robin on July 31, 1999, at 9:16:33
> Brandon, How is the selegiline working for you? Have you tried Marplan , Nardil or Parnate before? How does the Selegiline compare?
>
> RobinHi Robin, the selegiline so far has been a true life saver. I have tried prozac, serzone and effexor, all of them really gave me no relief and a lot of nasty side effects. I cant't give you a comparison between selegiline and the other MAOI's but the difference is dramatic against the SSRI's. My concentration, motivation and mood are great, I'm actually sleeping better and my sex has been better than ever. I hope this helps.
Posted by Robin on August 1, 1999, at 11:06:22
In reply to Re: Selegiline for depression?, posted by Brandon on August 1, 1999, at 10:28:15
> > Brandon, How is the selegiline working for you? Have you tried Marplan , Nardil or Parnate before? How does the Selegiline compare?
> >
> > Robin
>
> Hi Robin, the selegiline so far has been a true life saver. I have tried prozac, serzone and effexor, all of them really gave me no relief and a lot of nasty side effects. I cant't give you a comparison between selegiline and the other MAOI's but the difference is dramatic against the SSRI's. My concentration, motivation and mood are great, I'm actually sleeping better and my sex has been better than ever. I hope this helps.Brandon, Thank You so much for the info on Selegiline. Could you tell me the dosage you are on and how long it took for you to notice the drug was helping. I would be taking Selegiline for Atypical Depression and Social Phobia. I hope I can get my doc to prescribe it for me. Any problems with weight gain .
Thanks again for the info.
Robin
Posted by Brandon on August 2, 1999, at 18:59:58
In reply to Re: Selegiline for depression?, posted by Robin on August 1, 1999, at 11:06:22
I started taking selegiline in two doses of 5mg a piece. The pills are only offered in that dosage so it makes it a little difficult during the day. I am currently taking 30mg. I take 4 at 5am when I wake up and 2 around noon. I noticed an improvement in mood after only one week. After about a month I really felt it kick in. I have also been diagnosed with atypical depression and it really helped me cope with stress. I hope this helps and good luck!
P.S. One MAJOR drawback with selegiline is the price. I pay about $80 a month for it and thats with insurance.
Posted by Adam on August 2, 1999, at 19:18:56
In reply to Re: Study and Adam, posted by Robin on July 31, 1999, at 9:22:40
Wellbutrin is a bit mysterious in that it's mechanism of action
isn't well understood. It is thought to be an inhibitor of
dopamine reuptake, but its active metabolites also inhibit the
reuptake of serotonin and norepinepherine, albeit weakly. It
tends to be fairly activating, from what I hear. I tried it, and
found that it did essentially nothing at all to me one way or
the other.Selegiline is a very different beast. It is a potent and
irreversible inhibitor of monoamine oxidase B when taken at doses
around 5mg/day. At higher doses, it also is able to inhibit
monoamine oxidase A. MAO-B is primarily responsible for the
breakdown of dopamine in the brain, where MAO-A is primarily
responsible for the breakdown of serotonin and norepinepherine.
Selegiline also mildly inhibits the reuptake of dopamine, and
some of its metabolites are amphetamines, again affecting the
dopamine system.MAO-A is also involved in the breakdown of tyramine in the gut.
At low doses of oral selegiline, there's no need to follow
dietary restrictions, but at higher doses, one needs to avoid
foods rich in tyramine to prevent the "cheese effect", just like
with other irreversible inhibitors of MAO-A. The study I am
involved with now is using a transdermal delivery system (a patch,
like the nicotine patch) to get around the hazards of MAOI use
and hypertensive crises caused by the tyramine pressor effect.
Bypassing the gut allows one to take high doses of selegiline
without having to watch what you eat. At least, that's how it
looks. I've read in one paper that transdermal delivery of
selegiline changes its metabolite profile somewhat, with less
l-amphetamine being produced.The doctors I spoke with at McLean hope the patch delivery system
will be available on the market in a couple of years, or maybe
even less. I don't know if selegiline will work for me yet, but
if it does work for some people, it seems like it would be a
wonderful thing to reap the benefits of a MAOI without having to
deal with some of the hazards.
> > > Hey, Elizabeth,
> > >
> > > Yep, I'm in the Boston area. How are things going
> > > with you in the study?
> >
> > I'm not in the study, but I know Dr. Bodkin (actually I talked to him about it when he was working on the grant proposal - he seemed excited about it) so I'm interested to know how it goes.
> >
> > I tried oral selegiline (40mg, if I remember correctly) and it caused me nothing but grief (reminded me of Wellbutrin). Oh well. For a lot of people it doesn't have any side effects to speak of. (I sort of feel like I shouldn't tell you what they were for me, so as not to bias you. :->)
> >
> > Email me if you want (it's shapere@aol.com). I'd be interested to meet "in real life," if you would.
>
> Adam, What was the comparison of Wellbutrin and Selegiline? I hated Wellbutrin it made me more depressed. I haven't tried Selegiline, but was considering it.
> Robin
Posted by Robin on August 4, 1999, at 9:33:46
In reply to Re: Selegiline for depression?, posted by Brandon on August 2, 1999, at 18:59:58
> I started taking selegiline in two doses of 5mg a piece. The pills are only offered in that dosage so it makes it a little difficult during the day. I am currently taking 30mg. I take 4 at 5am when I wake up and 2 around noon. I noticed an improvement in mood after only one week. After about a month I really felt it kick in. I have also been diagnosed with atypical depression and it really helped me cope with stress. I hope this helps and good luck!
>
> P.S. One MAJOR drawback with selegiline is the price. I pay about $80 a month for it and thats with insurance.
>What brand are you taking? Deprenyl or Eldepryl? How long did it take you to go from 10 mgs to 30 mgs? Thanks for the info
Robin
Posted by MA on August 4, 1999, at 12:12:56
In reply to Re: Selegiline for depression?(Brandon), posted by Robin on August 4, 1999, at 9:33:46
Our dog was on Seliegiline for Cushings disease.
He took one pill a day at the cost of about $3.50, so it is a very expensive drug.Out of curiosity I asked the vet about this because my father had been on it for Parkinson's disease. She said it was the same drug. I was trying to find out if I could substitute the human drug for the animal one to see if I could reduce the cost of treating the dog.
The problem was that I would have had to give the dog many human pills to make up for the one animal pill.Unfortunately our dog passed away about a month ago, so I did not have to pursue the cost issue.
I'm just so amazed that a pill my dog took for one disease was prescribed for my father for another and now I see it is being used for depression, which I have. Maybe, I'll end up taking it myself.
Life is so strange...
Posted by Rick on August 5, 1999, at 3:33:26
In reply to Selegiline is great!, posted by Brandon on July 19, 1999, at 20:55:14
First off, a disclaimer: I've only done a cursory
browsing of the Selegeline posts.As I mentioned in another thread, my pdoc
(surprisingly) gave me Selegeline for Social
Anxiety, after Nardil quickly pooped out but
created troublesome, long-lasting side effects.
The Selegeline was a total bust after four weeks
(at 15mg). No reduction whatsoever in my Social
Phobia (BTW, I am not clinically depressed).There WERE some pleasant (!) side effects, such as
increased libido and intensified sexual sensations
(nice!), as well as some needed (mild) lowering of
my blood pressure. No bad side effects.But since there was zilch improvement in the
Social Anxiety, I went off the Selegeline (Cold
Turkey's O.K. at 15 mg), and insisted he let me
try Klonopin (currently 2mg/day). Fairly
promising results after about a week. But then I
suggested (to my rather perplexed pdoc) that I add
back some low-dose Selegeline for mildly
hypotensive effects and possible sexual/cognitive
effects...and WOW! I don't know if this will
last, but the Social Phobia is virtually gone; my
confidence and concentration are currently through
the roof (despite minimal sleep of late, owing to
ultra-busy-ness, NOT insomnia or mania), libido
sky-high, and BP down (though not quite
enough...may move from 5mg. to 10mg. of
Selegeline...still low enough to avoid the MAOI
food restrictions...OR add pindolol...but I'm
afraid to mess with such success!) Of course,
Selegeline's fabled life-extension and
brain-protection qualities don't hurt either. I
probably shouldn't have written this; I'm rarely
superstitious, but for some reason I'm afraid I'll
jinx the wonderfully effective combination I
concocted!Maybe Selegeline works best for augmenting other
meds in mental problems, just as it serves as a
levodopa (sp?) potentiator for Parkinson's. Just
a thought. (As always, YMMV) Of course, your
doctor would have to carefully assess any possible
adverse reactions/dangerous combinations.In any event, I'm excited about the
Klonopin/Selegeline combo. Has anyone else used
this for Social Anxiety, or have I discovered a
"magic combo"?
Posted by Brandon on August 5, 1999, at 11:21:26
In reply to Re: Selegiline for depression?(Brandon), posted by Robin on August 4, 1999, at 9:33:46
I only take the generic form. There is some debate whether selegiline itself is as bioavailable as eldepryl. I personally have noticed that eldepryl did cause a slight bit more anxiety than the generic form. Otherwise unless you noticed no effect from the generic I would stick with it. The brand name is very expensive. I just ordered the discoverey liquid form from an overseas source in England. It is supposedly far superior in it's efficacy and side effect profile. We'll see! It took about 3wks. to work up to my current dose. I should warn you that selegiline is quite activating and may cause uncomfortable anxiety. Good luck with convincing your doc to prescribe it, most in my area have not heard of its use in psychiatric health. It took a couple of sessions for me to talk him into it. Hope this helps!Brandon
Posted by Rick on August 6, 1999, at 3:03:20
In reply to Re: Selegiline for depression?(Robin), posted by Brandon on August 5, 1999, at 11:21:26
I had just the opposite situation. When my Nardil
quicky pooped out for Social Phobia, the pdoc said
"I'm really not supposed to do this (!), but I'm
going to add some Eldepryl (actually Selegeline)
to smooth out the effects of the Nardil." I said
"huh?"I had never even heard of Eldepryl. He claims
it's widely used for Depression and Social Phobia
in Europe. Hell, if even non-selective
Moclobemide (sp?) is getting less than rave
reviews, how could Selegeline do the trick? Thank
God I'm now off of Nardil and onto Klonopin (plus
a small dose of Selegeline -- my own idea, as per
my previous post).Rick
>
> I only take the generic form. There is
some debate whether selegiline itself is as
bioavailable as eldepryl. I personally have
noticed that eldepryl did cause a slight bit more
anxiety than the generic form. Otherwise unless
you noticed no effect from the generic I would
stick with it. The brand name is very expensive.
I just ordered the discoverey liquid form from an
overseas source in England. It is supposedly far
superior in it's efficacy and side effect profile.
We'll see! It took about 3wks. to work up to my
current dose. I should warn you that selegiline
is quite activating and may cause uncomfortable
anxiety. Good luck with convincing your doc to
prescribe it, most in my area have not heard of
its use in psychiatric health. It took a couple
of sessions for me to talk him into it. Hope this
helps!
>
> Brandon
>
Posted by Adrian on August 8, 1999, at 5:18:43
In reply to Re: What about Moclobemide - an MAOI Type A?, posted by Jaime on May 12, 1999, at 8:06:38
Moclobemide has been available in Australia for some time. I have had much success in treating mild depression. The side effects are minimal at a dose of 300-450mg. Zoloft (or other SSRIs) such as Prozac had much greater side effects in comparison. It works for me.
> > Has anyone taken Moclobemide (Manerix or Aurorix) with any success? I've read that the Type A's tend to deal more with mood elevation and (do I dare even suggest) "happiness."
> >
> > Does anyone else out there blow out their birthday candles or see the first star in the evening sky and wish for "happy" like I do?
> >
> > I was excited when I read about Moclobemide but had my bubble burst when my doctor wouldn't allow it because it's not approved in the US by the FDA.
Posted by Tom on August 8, 1999, at 19:26:34
In reply to Re: What about Moclobemide - an MAOI Type A?, posted by Adrian on August 8, 1999, at 5:18:43
>Is it possible to get some in the US??
Moclobemide has been available in Australia for some time. I have had much success in treating mild depression. The side effects are minimal at a dose of 300-450mg. Zoloft (or other SSRIs) such as Prozac had much greater side effects in comparison. It works for me.
>
>
> > > Has anyone taken Moclobemide (Manerix or Aurorix) with any success? I've read that the Type A's tend to deal more with mood elevation and (do I dare even suggest) "happiness."
> > >
> > > Does anyone else out there blow out their birthday candles or see the first star in the evening sky and wish for "happy" like I do?
> > >
> > > I was excited when I read about Moclobemide but had my bubble burst when my doctor wouldn't allow it because it's not approved in the US by the FDA.
Posted by robin on August 9, 1999, at 8:46:35
In reply to Re: What about Moclobemide - an MAOI Type A?, posted by Tom on August 8, 1999, at 19:26:34
> >Is it possible to get some in the US??
>
>
> Moclobemide has been available in Australia for some time. I have had much success in treating mild depression. The side effects are minimal at a dose of 300-450mg. Zoloft (or other SSRIs) such as Prozac had much greater side effects in comparison. It works for me.
> >
> >
> > > > Has anyone taken Moclobemide (Manerix or Aurorix) with any success? I've read that the Type A's tend to deal more with mood elevation and (do I dare even suggest) "happiness."
> > > >
> > > > Does anyone else out there blow out their birthday candles or see the first star in the evening sky and wish for "happy" like I do?
> > > >
> > > > I was excited when I read about Moclobemide but had my bubble burst when my doctor wouldn't allow it because it's not approved in the US by the FDA.What is the difference between a type A or B Maoi? If type A helps with your mood what does type B help with?
Thanks,
Robin
Posted by Adam on August 9, 1999, at 16:58:39
In reply to Re:MAOI Type A or B?, posted by robin on August 9, 1999, at 8:46:35
> What is the difference between a type A or B Maoi? If type A helps with your mood what does type B help with?
>
> Thanks,
> RobinMAO-A is found throughout the body, including the gut, and largely deaminates
serotonin and norepinepherine (as well as tyramine in the gut), though it does
have some low and non-specific activity on dopamine. MAO-B is found in the brain
and primarily deamniates dopamine.I have read that inhibition of MAO-B alone is not sufficient for the treatment of
depression, and in the case of selegiline, low doses (5mg/day, when there is only
inhibition of MAO-B) are not sufficient for that indication. However, selegiline
has been shown to be efficacious at higher doses, where MAO-A is also inhibited.
There may be a benefit in the dopaminergic effects of selegiline in addition to
its serotonergic and norepinepherinergic effects. For example, as some have posted
above, it may improve some cognitive functioning and sex drive.This is all anecdotal, of course. I have seen nothing in the literature that clearly
demonstrates that a robust dopaminergic effect is of any real benefit in treating
depression.
Posted by Adam on August 9, 1999, at 19:23:10
In reply to Re:MAOI Type A or B?, posted by Adam on August 9, 1999, at 16:58:39
In my last post, what I meant to say was "I have seen nothing in the literature that clearly demonstrates
that THE robust dopaminergic effect is of any real benefit in treating depression", meaning the MAO-B
inhibatory effects of selegiline. Many drugs that are "dopaminergics" like ritalin and amineptine have
been shown to be effective in treating depression, sometimes alone, or sometimes in combination with
other drugs. I apologise for my poor choice of wording.>
> > What is the difference between a type A or B Maoi? If type A helps with your mood what does type B help with?
> >
> > Thanks,
> > Robin
>
> MAO-A is found throughout the body, including the gut, and largely deaminates
> serotonin and norepinepherine (as well as tyramine in the gut), though it does
> have some low and non-specific activity on dopamine. MAO-B is found in the brain
> and primarily deamniates dopamine.
>
> I have read that inhibition of MAO-B alone is not sufficient for the treatment of
> depression, and in the case of selegiline, low doses (5mg/day, when there is only
> inhibition of MAO-B) are not sufficient for that indication. However, selegiline
> has been shown to be efficacious at higher doses, where MAO-A is also inhibited.
> There may be a benefit in the dopaminergic effects of selegiline in addition to
> its serotonergic and norepinepherinergic effects. For example, as some have posted
> above, it may improve some cognitive functioning and sex drive.
>
> This is all anecdotal, of course. I have seen nothing in the literature that clearly
> demonstrates that a robust dopaminergic effect is of any real benefit in treating
> depression.
Posted by D.C on August 11, 1999, at 8:17:36
In reply to Re:MAOI Type A or B?, posted by Adam on August 9, 1999, at 19:23:10
>
It doesn't do squat compared to the other MAOI's. Yeah I've heard about all the supposed health benefits, intelligence boosting etc. It strikes me as rather odd. Ritalin is more likely to get your mind pumping from what I hear. I don't know though maybe it's just my own biochemistry. It would be nice though to get a drug that could boost your brain power. Anyone know of any?
In my last post, what I meant to say was "I have seen nothing in the literature that clearly demonstrates
> that THE robust dopaminergic effect is of any real benefit in treating depression", meaning the MAO-B
> inhibatory effects of selegiline. Many drugs that are "dopaminergics" like ritalin and amineptine have
> been shown to be effective in treating depression, sometimes alone, or sometimes in combination with
> other drugs. I apologise for my poor choice of wording.
>
> >
> > > What is the difference between a type A or B Maoi? If type A helps with your mood what does type B help with?
> > >
> > > Thanks,
> > > Robin
> >
> > MAO-A is found throughout the body, including the gut, and largely deaminates
> > serotonin and norepinepherine (as well as tyramine in the gut), though it does
> > have some low and non-specific activity on dopamine. MAO-B is found in the brain
> > and primarily deamniates dopamine.
> >
> > I have read that inhibition of MAO-B alone is not sufficient for the treatment of
> > depression, and in the case of selegiline, low doses (5mg/day, when there is only
> > inhibition of MAO-B) are not sufficient for that indication. However, selegiline
> > has been shown to be efficacious at higher doses, where MAO-A is also inhibited.
> > There may be a benefit in the dopaminergic effects of selegiline in addition to
> > its serotonergic and norepinepherinergic effects. For example, as some have posted
> > above, it may improve some cognitive functioning and sex drive.
> >
> > This is all anecdotal, of course. I have seen nothing in the literature that clearly
> > demonstrates that a robust dopaminergic effect is of any real benefit in treating
> > depression.
Posted by Elizabeth on August 11, 1999, at 13:33:13
In reply to Re:MAOI Type A or B?, posted by Adam on August 9, 1999, at 16:58:39
> This is all anecdotal, of course. I have seen nothing in the literature that clearly
> demonstrates that a robust dopaminergic effect is of any real benefit in treating
> depression.One word: nomifensine!
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