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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by shelliR on May 14, 2001, at 10:02:11
Elizabeth, one of the reasons that Dr. Bodkin suggested selegiline to me was that he said, unlike nardil, you can go way up in dose with selegiline and not have side effects. I remember that selegiline was not successful for you, but I am wondering if you agree about not having any side effects. I have never taken an ad which has not given me rather severe side effects, so I am skeptical. Shelli
Posted by SalArmy4me on May 14, 2001, at 12:07:35
In reply to selegiline: Elizabeth, anyone, posted by shelliR on May 14, 2001, at 10:02:11
Sunderland, T. et al. High-Dose Selegiline in Treatment-Resistant Older Depressive Patients. Year Book of Psychiatry & Applied Mental Health. 1996(10):472-473, Annual 1996:
"Of interest is the robust clinical improvement in depression with a daily dose of 60 mg of selegiline in only a 3-week clinical trial. This is a good response in a relatively short period and suggests an unusually rapid onset of action..."
Posted by shelliR on May 14, 2001, at 17:39:56
In reply to selegiline: Elizabeth, anyone, posted by shelliR on May 14, 2001, at 10:02:11
Elizabeth, never mind. I just recalled that you said it gave you no side effects except making you jittery. To me being jittery would be a major thing! Shelli
Posted by AndrewB on May 15, 2001, at 10:15:53
In reply to Re: selegiline: Elizabeth, anyone » shelliR, posted by shelliR on May 14, 2001, at 17:39:56
Shelli,
Of course side effects will vary from person to person but you might want to look at the Psycho-Babble Tips Section to get an idea of the side effects of high dose selegiline.....agitation, sleep problems, dietary restrictions. You will also note from Adam's posts that a transdermal delivery system (i.e. topical gel?) will minimize or eliminate many potential side effects, lower the necessary effective dosage and, generally, have you feeling better on it. Regardless of the delivery system, many people may find high dose Selegiline to have a better side effect profile for them than other irreversible MAO-Is (Parnate, Nardil).
Note to all women, at least with low dose selegiline, use of birth controls pills will increase the bloodstream concentrations of selegiline approximately 20-fold! (This effect may apply to estrogen supplements also, I don't know.) Dosage must be lowered accordingly in such situations.
AndrewB
Posted by Elizabeth on May 15, 2001, at 14:30:22
In reply to selegiline: Elizabeth, anyone, posted by shelliR on May 14, 2001, at 10:02:11
> Elizabeth, one of the reasons that Dr. Bodkin suggested selegiline to me was that he said, unlike nardil, you can go way up in dose with selegiline and not have side effects. I remember that selegiline was not successful for you, but I am wondering if you agree about not having any side effects. I have never taken an ad which has not given me rather severe side effects, so I am skeptical. Shelli
I didn't like selegiline, no; and I'm not sure how high I increased the dose. I feel like I ought to give it a shot (maybe with a benzo and/or propranolol to start out, to counter the jitters). It definitely lacks Nardil's special anxiolytic properties, but I think most people can go up to quite high doses and tolerate it well. It also will *not* cause the weight gain seen with Nardil.
Out of curiosity, what recommendations have you been hearing, dosewise? The 60mg that Sal mentions sounds about right. I think I only went up to about 40 or so, which may be why it didn't work so great for me. As I mentioned, I didn't tolerated it too well, but I think this is unusual. (I also had other things going on -- this was when I was about 21 and I'd been having panic attacks that weren't diagnosed until quite a bit later.)
-elizabeth
Posted by shelliR on May 15, 2001, at 17:59:10
In reply to Re: selegiline » shelliR, posted by Elizabeth on May 15, 2001, at 14:30:22
> Out of curiosity, what recommendations have you been hearing, dosewise? The 60mg that Sal mentions sounds about right.Elizabeth, I didn't get a specific recommendation. It was a very quick conversation with Dr. Bodkin (who I've only met twice by phone), and he just suggested "going way up", no specific number. I am pretty shy to ask him a lot of questions since I just call him out of the blue and feel that any time he gives me is extremely generous.
I think for more information I would come to Boston and set up a consultation with him. Right now I am doing okay with nardil supplemented with hydrocodone (still never take higher than 7.5mg a day, and generally just half of that).
I am on very low estrogen birth control pills to try to alieviate some pretty bad premenstral symptoms, so Andrew B's post was important information for me. (Thanks, Andrew!)
This past month I had an ironic occurance. On my week off the pill, the lowering of estrogen in one day causes a two day migraine in me, something I never have--just minor migraines before my period. The fact that I'm on nardil precluded getting a shot for the migraine, and hydrocodone barely touched it. And sadly, I missed having mother's day out of town with my mom. This month I am switched to a bcp that gradually lowers the estrogen.
I think I am the most drug sensitive person in the world. The only good thing I can say is that I never have gained weight on nardil and the side effects are minor at the low dose I take (30mg). If I take any more I can't sleep at night; no matter what I take to help, I wake up every three hours which leaves me totally wiped out in the morning.
I wish Dr. Bodkin was in San Francisco because I'd like to go out there for a week or so this summer. I like Boston, but lived there for several months when I was in college, so it wouldn't be like a fun trip for me--just an expensive one! I'll just have to find a pdoc in a place that I'd like to take a vacation in (that way I could write it off as a medical expense). I got horrible jitters when I tried sam-e; it actually turned my regular depression into an agitated depression. It was expremely uncomfortable, but I went the distance (up to 1600mg) because I really wanted to give it a fair try.
Have you tried that? Dr. Richard Brown claims a 70% success rate and there is a sam-e board on the net with some amazing success stories. I think it was definitely worth a try.
Anyway, thank's for all your information. You've taken quite a beating on the board lately--and you graciously answer all posts. I had to chose to detach, otherwise I'm sure I would have been kicked off the board for nastiness and sarcasm.
Shelli
This is the end of the thread.
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