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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by verne on January 27, 2005, at 9:37:11
I've googled this and get nowhere. Does anybody know if this is close to approval? And can it be prescribed for depression?
Cymbalta isn't really working out for me. In addition to the sexual side effects, I've experienced sharp pains in the chest (heart?), and low back pain. (when I stopped cymbalta for a few days the back pain disappeared)
Previous doctors wanted me to try an MAO Inhibitor but I resisted due to the diet restrictions and risk. My blood pressure runs on the high side so I don't want to risk a hypertensive crisis. I had heard that the newer MAO's don't have the diet restrictions and was hoping that segeline was among them.
verne
Posted by Optimist on January 27, 2005, at 10:31:17
In reply to Segeline Patch, posted by verne on January 27, 2005, at 9:37:11
> I've googled this and get nowhere. Does anybody know if this is close to approval? And can it be prescribed for depression?
>
> Cymbalta isn't really working out for me. In addition to the sexual side effects, I've experienced sharp pains in the chest (heart?), and low back pain. (when I stopped cymbalta for a few days the back pain disappeared)
>
> Previous doctors wanted me to try an MAO Inhibitor but I resisted due to the diet restrictions and risk. My blood pressure runs on the high side so I don't want to risk a hypertensive crisis. I had heard that the newer MAO's don't have the diet restrictions and was hoping that segeline was among them.
>
> verne
The reason you found nothing is probably because the spelling is wrong. Try "Selegiline patch" or "EMSAM", you may have better luck.It is close to approval and can be prescribed for depression although I don't know the exact date. I'm sure others here can tell you some more exact figures. The good thing about this MAOi is that there are no diet restrictions, and it's prosexual!!!
Typically when one goes on an MAOi their blood pressure drops significantly so it may be a plus for you in that regard. You still have to worry about drug interactions on selegiline though, (correct me if I'm wrong anyone else) so it's not completely a benign a drug.
Brian
Posted by jeopardy on January 27, 2005, at 10:31:52
In reply to Segeline Patch, posted by verne on January 27, 2005, at 9:37:11
> I've googled this and get nowhere. Does anybody know if this is close to approval? And can it be prescribed for depression?
>
> Cymbalta isn't really working out for me. In addition to the sexual side effects, I've experienced sharp pains in the chest (heart?), and low back pain. (when I stopped cymbalta for a few days the back pain disappeared)
>
> Previous doctors wanted me to try an MAO Inhibitor but I resisted due to the diet restrictions and risk. My blood pressure runs on the high side so I don't want to risk a hypertensive crisis. I had heard that the newer MAO's don't have the diet restrictions and was hoping that segeline was among them.
>
> verneTry spelling it "selegiline" Go to this web-site...tons of info. http://www.selegiline.com/
Posted by bipolarspectrum on January 27, 2005, at 10:59:29
In reply to Segeline Patch, posted by verne on January 27, 2005, at 9:37:11
Hi,
THe selegiline patch was approved by the FDA last year... but the company that produces it is small, based in florida, and unable to distribute it on its own.. but it recently signed a contract with a bigger company to help produce and distribute it... I would think it would be out by this summer at the latest..
bps
ps. u can find out about this contract between the two companies somewhere on the web, i believe at somersetpharm.com or somethign like that
Posted by Kenny Koala on January 27, 2005, at 11:19:15
In reply to Re: Segeline Patch - it is approved!!, posted by bipolarspectrum on January 27, 2005, at 10:59:29
Hi Verne, I wouldn't get too excited about the Selegiline patch, not having to follow a strict diet is probably going to be the only good thing about them. You will still have to pay special attention to what other drugs you are taking plus patches have their own problems like rashes, falling off on hot sweaty days & difficulties in appying the right amount of patches that equates to the doseage you want. If you have a doc that want to give you an MAOI, I would cut to the chase & try one of them.
Posted by KaraS on January 27, 2005, at 11:51:38
In reply to Segeline Patch, posted by verne on January 27, 2005, at 9:37:11
> I've googled this and get nowhere. Does anybody know if this is close to approval? And can it be prescribed for depression?
>
> Cymbalta isn't really working out for me. In addition to the sexual side effects, I've experienced sharp pains in the chest (heart?), and low back pain. (when I stopped cymbalta for a few days the back pain disappeared)
>
> Previous doctors wanted me to try an MAO Inhibitor but I resisted due to the diet restrictions and risk. My blood pressure runs on the high side so I don't want to risk a hypertensive crisis. I had heard that the newer MAO's don't have the diet restrictions and was hoping that segeline was among them.
>
> verneHi Verne,
Oral selegiline should not cause hypertensive crises on dosages of 10 mg. a day and under (though people should probably be careful in case they are slow metabolizers). Some people have had great success using that dosage along with some l-phenylalanine or DLPA. (If you do a search here you'll find some very informative and inspiring posts on this esp. by Ktemene, Pseudonym and Adam.)The other selective MAOIs that you are referring to aren't available in this country yet. Others on this board have tried them without much success though. If you search here for Moclobemide I doubt that you'll find many good posts.
As for the patch, Adam was using that as part of a drug trial and it changed his life. He had incredible results. Today (unless something has changed from his last post) he takes selegiline orally and is waiting for the patch to come out so he can switch over.
Take care,
Kara
Posted by sfy on January 27, 2005, at 12:17:24
In reply to Re: Segeline Patch - it is approved!!, posted by bipolarspectrum on January 27, 2005, at 10:59:29
> Hi,
> THe selegiline patch was approved by the FDA last year... but the company that produces it is small, based in florida, and unable to distribute it on its own.. but it recently signed a contract with a bigger company to help produce and distribute it... I would think it would be out by this summer at the latest..
> bps
> ps. u can find out about this contract between the two companies somewhere on the web, i believe at somersetpharm.com or somethign like thatNot exactly - the EMSAM patch received an "approvable letter" from the FDA which, I believe, is the last step right before final approval. The remaining issue seems to be on the dietary restrictions. The manufacturer wants to market without the usual MAOI dietary restrictions (otherwise there is no benefit to the patch over other MAOI's). The FDA was hedging on this and wanted more data in support of this position. Most of the studies were conducted (for treating major depression, by the way) without any dietary restrictions with no ill effects. So, right now, it's just a waiting game for the FDA to finish its review.
The EMSAM patch is produced by Somerset Pharmaceuticals, a joint venture of Mylan Laboratories and Watson Pharmaceuticals - two large generic drug manufacturers perfectly capable of distributing the patch on their own. Somerset recently signed a deal with Bristol-Myers Squibb to market the patch thus giving them additional assistance in publicizing the patch.
Posted by verne on January 27, 2005, at 12:19:49
In reply to Re: Segeline Patch » verne, posted by KaraS on January 27, 2005, at 11:51:38
Thanks for all the help everybody. I may ask for the oral variety while I wait for the patch.
Do you know whether oral selegiline is prescribed for depression? I heard it was for Parkinsons Disease and some patients encounter difficulty getting an Rx for depression. My insurance can be difficult at times. They gave me a hard time over a wellbutrin prescription. Thought I was trying to quit smoking, restore hair, or use it for something other than depression.
I'll have to sell the selegiline idea to a regular MD. Even with insurance a psychdoc is too expensive.
verne
Posted by bipolarspectrum on January 27, 2005, at 13:21:17
In reply to Re: Segeline Patch - it is approved!!, posted by sfy on January 27, 2005, at 12:17:24
Hi,
You maybe right about the approvable letter.. I remember hearing that there were potential dietary restrictions.. but i also remember reading that it was fully approved.. anywayz, we can only hope for the best
bps
Posted by 3 Beer Effect on January 27, 2005, at 20:33:48
In reply to Thanks All, posted by verne on January 27, 2005, at 12:19:49
They have done trials for selegeline for depression & at 10 mg per day or less it is supposed to be ineffective for depression. I used to take oral selegeline that I ordered from Europe, & I didn't like it. I didn't find it to have much of an antidepressant effect, although it does seem to help with ADD symptoms. It also helps you do more work in the early morning hours & is somewhat activating.
However, I found the dry mouth & dry eyes to be absolutely intolerable so I had to go down to 5 mg (although I was taking it with Prozac 20 mg). It also caused a lot of social anxiety/shakiness & worst of all it makes you sweat excessively. 10 mg also made me somewhat irritable. It kind of felt like when you drink too much caffeine but without the great pleasure of the d-amphetamines. But I took the entire 10 mg dose in the morning while you are really supposed to split it into a breakfast & lunch dose (& always take it on a full stomach= much greater bioavailability). When the Prozac started working about 5 weeks later (my 2nd month on Selegeline) I actually felt good, but that could be just the Prozac working. You might have success by combining an SSRI with Selegeline since that is sort of like taking Parnate (although contrary to popular belief, Parnate is supposed to have little effects on dopamine receptors). If you have alcohol or drug problems the best thing about selegeline is that it reduces the pleasure of alcohol probably by inhibiting alcohol induced dopamine release & seems to reduce cravings.
My blood pressure seemed to go up on Selegeline, probably because it does metabolize to l-amphetamine & l-meth both of which release norepinephrine & raise your blood pressure.
Parnate & Nardil especially will actually lower your blood pressure over time as long as you don't eat anything with tyramine. (Sometimes the blood pressure drop is significant enough that you have to change positions or stand up slowly to avoid fainting.)
Cheers,
3 Beer Effect
Posted by KaraS on January 27, 2005, at 22:58:33
In reply to Thanks All, posted by verne on January 27, 2005, at 12:19:49
Verne,
Here's a link to a recent post by Ktemene (it's actually higher up on the board.) In includes links to other posts about selegiline. Ktemene is currently taking low dose selegiline with DLPA and has had great success with it. (Once I'm in a better position and have less anxiety, I will try it myself.)
http://www.dr-bob.org/babble/20050124/msgs/448885.html
Take care,
K
Posted by KaraS on January 27, 2005, at 23:46:06
In reply to Selegeline 10 mg is ineffective for depression » verne, posted by 3 Beer Effect on January 27, 2005, at 20:33:48
> They have done trials for selegeline for depression & at 10 mg per day or less it is supposed to be ineffective for depression. I used to take oral selegeline that I ordered from Europe, & I didn't like it. I didn't find it to have much of an antidepressant effect, although it does seem to help with ADD symptoms. It also helps you do more work in the early morning hours & is somewhat activating.
>
> However, I found the dry mouth & dry eyes to be absolutely intolerable so I had to go down to 5 mg (although I was taking it with Prozac 20 mg). It also caused a lot of social anxiety/shakiness & worst of all it makes you sweat excessively. 10 mg also made me somewhat irritable. It kind of felt like when you drink too much caffeine but without the great pleasure of the d-amphetamines. But I took the entire 10 mg dose in the morning while you are really supposed to split it into a breakfast & lunch dose (& always take it on a full stomach= much greater bioavailability). When the Prozac started working about 5 weeks later (my 2nd month on Selegeline) I actually felt good, but that could be just the Prozac working. You might have success by combining an SSRI with Selegeline since that is sort of like taking Parnate (although contrary to popular belief, Parnate is supposed to have little effects on dopamine receptors). If you have alcohol or drug problems the best thing about selegeline is that it reduces the pleasure of alcohol probably by inhibiting alcohol induced dopamine release & seems to reduce cravings.
>
> My blood pressure seemed to go up on Selegeline, probably because it does metabolize to l-amphetamine & l-meth both of which release norepinephrine & raise your blood pressure.
>
> Parnate & Nardil especially will actually lower your blood pressure over time as long as you don't eat anything with tyramine. (Sometimes the blood pressure drop is significant enough that you have to change positions or stand up slowly to avoid fainting.)
>
> Cheers,
> 3 Beer Effect
Selegiline alone at 5-10 mg. isn't supposed to do much for depression. At that dosage you need to add the phenylalanine or DLPA. Then the antidepressant response is from the PEA.k
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