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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Joe Schmoe on November 17, 2005, at 12:31:57
Can anyone clear up for me what the interaction is with GABA / dopamine, and how Nardil affects it vs. Selegiline (I am interested in MAOI drugs now because of Emsam).
I have read low dopamine levels are implicated in social phobia, as are low GABA levels and serotonin as well, and that is why Nardil works - it raises all three. Also I know benzos like Klonopin are used to treat low GABA levels and are used for social phobia.
But I have also read that GABA inhibits dopamine activity. I don't understand the theory behind raising both of them, or why raising just GABA (via Klonopin) would help if doing so lowers dopamine activity.
I am also curious if Selegiline / Emsam will affect GABA at all, or whether it will require Klonopin as well in order to combat social phobia. Nardil seems to work by itself. Does Selegiline require a benzo supplement to effectively treat social phobia? If so, what advantage would Selegiline and a benzo have over an SSRI and a benzo?
Thanks.
Posted by blueberry on November 17, 2005, at 17:23:12
In reply to GABA , dopamine , Nardil vs. Selegiline / Emsam, posted by Joe Schmoe on November 17, 2005, at 12:31:57
I can't speak for nardil. Never tried it and haven't read up on it much.
We all respond differently, so you can take this with a grain of salt. I tried deprenyl a few years ago, starting at 2mg a day and working up to 10mg. At first, I liked it. Energizing, good mood, I think it was the amphetamine metabolite from it. Then tolerance set in. Upon raising the dose, I got jitteriness, inner tension, restlessness, and then almost a full blown paranoia psychotic thing. Too much dopamine I guess, even at 10mg. For social phobia, it was for me a bad thing. Not socially comfortable at all, actually quite scared.
Posted by Joe Schmoe on November 17, 2005, at 17:31:58
In reply to Re: GABA , dopamine , Nardil vs. Selegiline / Emsam, posted by blueberry on November 17, 2005, at 17:23:12
I take Lexapro and Klonopin now, used to take Wellbutrin too for a dopamine component but it made me too anxious so I had to stop. I admit I am puzzled by the idea of MAOIs being good for social phobia because they raise dopamine - if Wellbutrin made me too anxious I suspect a MAOI would too.
You'd think the Klonopin would make the Wellbutrin tolerable, but it didn't. The anxiety was bad enough but the chest tightness/pain was bizarre and forced me to stop taking it even though I liked how it elevated my mood.
Posted by RobertDavid on November 17, 2005, at 19:35:29
In reply to Re: GABA , dopamine , Nardil vs. Selegiline / Emsam, posted by Joe Schmoe on November 17, 2005, at 17:31:58
Klonopin is the only med that has worked for me regarding social anxiety. I'm going to try EMSAM if and when it becomes available (I understand we'll get an answer from the FDA soon).
Klonopin alone has not been the answer and I've always held out on trying an MAOI, Nardil in particular. I need help with some depression that I think Klonopin may agrivate a bit. I'd like a little additional help with the social anxiety without going higher on klonopin.
So If EMAM is approved I'm going on it. It's my understanding that the side affects will be much less than oral MAOI's not to mention the food issue. Plus I like the fact that it's a 24 hour patch and the medicine trickles in steady over that period as opposed to mutilple daily dosing.
My doc thinks that EMSAM may be able to completely replace klonopin, but if not, I'm fine with blending the two. If EMSAM isn't approved I think I'm just going to give in and try Nardil.
Posted by Joe Schmoe on November 17, 2005, at 20:22:42
In reply to Re: GABA , dopamine , Nardil vs. Selegiline / Emsam, posted by RobertDavid on November 17, 2005, at 19:35:29
Well, Emsam is apparently just a patch version of selegiline, so while it may avoid the dietary problems of oral selegiline, I would think it would not have any more efficacy than oral selegiline - and from the reading I've done on this board tonight (from searching for keywords selegiline and social) it seems selegilene is not great for social anxiety - I assumed it would be, since like Nardil it is an MAOI, but apparently they are quite different somehow. Maybe Nardil exhances GABA and selegiline does not.
So far I have not read anything really encouraging that would make me want to go from lexapro to selegiline/Emsam for my depression. It appears selegiline causes anxiety in people with social anxiety, like Wellbutrin does.
Posted by willyee on November 18, 2005, at 19:52:54
In reply to Re: GABA , dopamine , Nardil vs. Selegiline / Emsam, posted by Joe Schmoe on November 17, 2005, at 20:22:42
Besides diet restrictions the patch will offer a medication to come in through the blood,this HOPEFULLY can avoid some popp-out problems if the cause is the body/live has made anti-enzymres for a drug from having it go pass so much.
Also if a drug has poor bio-availability this new route would be a plus.
Lastly not too many people have gone high with the potent liquid Deprenyl,as i know cause its extremly expensive.
So now it will be common to hit ranges of 40-60 mg of deprenyl where it should not be selective to dopamine but more rounded instead.
Personaly in the same way many people not a termondous difference between deprenyl TABS and LIQUID deprenyl,the patch as well i believe and hope will be much different in effect
Posted by bigcat on November 21, 2005, at 21:59:03
In reply to Re: GABA , dopamine , Nardil vs. Selegiline / Emsam, posted by willyee on November 18, 2005, at 19:52:54
if the deprenyl patch might help prevent poopout (which is apparently caused by liver enzymes metabolizing the active chemicals), could there potentially be a Nardil patch that might lower or eliminate the poop-out rate?
Posted by gibber on November 21, 2005, at 23:40:07
In reply to Re: GABA , dopamine , Nardil vs. Selegiline / Emsam » willyee, posted by bigcat on November 21, 2005, at 21:59:03
It would seem much more likely that the brain actually adapts to these meds and tries to go back to its genetically programed depressed state. Not unlike what happens with stimulants or coffee etc. I have never had a med poop-out, simply because none have ever worked for me. I think poopout is not unlike tolerance.
gibber
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