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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 Jimmyboy on July 20, 2006, at 9:32:10
Just took Seroquel 100 mg for the first time last night and I feel like a walking zombie today.
Only two medicines have been somewhat helpful to me over the years, Serzone and a low dose of Selegiline ( 5 mg)
Does anyone know if you could take these two at the same time?? I know MAO inhibitors like selegiline will cause dangerous interactions while taking a medicine like Serzone, but I have heard that if you are taking a small dose ( like 5 mg) it acts on different enzymes ( MAO A only), does this matter, or would it still be dangerous? Just want to get some info before I talk to the doc next time..
Posted by Jimmyboy on July 20, 2006, at 11:33:41
In reply to Low dose Selegiline- can I take with other meds??, posted by Jimmyboy on July 20, 2006, at 9:32:10
My mistake, I think lose dose selegiline inhibits MAO B not MAO A
Posted by silvercoin on July 20, 2006, at 13:07:37
In reply to Low dose Selegiline- can I take with other meds??, posted by Jimmyboy on July 20, 2006, at 9:32:10
> Just took Seroquel 100 mg for the first time last night and I feel like a walking zombie today.
>
> Only two medicines have been somewhat helpful to me over the years, Serzone and a low dose of Selegiline ( 5 mg)
>
> Does anyone know if you could take these two at the same time?? I know MAO inhibitors like selegiline will cause dangerous interactions while taking a medicine like Serzone, but I have heard that if you are taking a small dose ( like 5 mg) it acts on different enzymes ( MAO A only), does this matter, or would it still be dangerous? Just want to get some info before I talk to the doc next time..
>
>Serzone is contraindicated with selegiline, but the rather similar trazodone has been used for years for MAOI induced insomnia. My own opinion is that Serzone could perhaps be used very cautiously with selegiline, but sometimes things are more complicated in reality than they appear on paper. However, at the low dose you suggest, there is even less concern with selegiline because relatively little MAO-A is being inhibited, which is the enzyme primarily responsible for metabolizing serotonin. The combination is one that I would not be inclined to label as imprudent and reckless, but your doctor may have a different opinion. I know my own doctor would veto it, as he is notoriously conservative when it comes to combining MAOIs with other antidepressants.
Todd
Posted by Jimmyboy on July 20, 2006, at 16:26:38
In reply to Re: Low dose Selegiline- can I take with other meds??, posted by silvercoin on July 20, 2006, at 13:07:37
Thanks for the response silvercoin,
Do you think if I lowered the dose of selegiline to 2.5 mg that would make it even safer? Do you know what the dangers are associated with blocking MAO B enzyme and taking a medicine like Serzone?Like I said , I have tried about everything and these two meds have worked to some degree in the past.. but in different ways. The selegiline was more activating , in a good way , but did little for anxiety while the serzone seemed to stabilize me and help w/ anxiety but was somewhat sedating , so if possible it would be nice to be able to combine them, but we will see what my doctor says..
Posted by silvercoin on July 20, 2006, at 16:42:16
In reply to Re: Low dose Selegiline- can I take with other meds?? » silvercoin, posted by Jimmyboy on July 20, 2006, at 16:26:38
> Thanks for the response silvercoin,
>
>
> Do you think if I lowered the dose of selegiline to 2.5 mg that would make it even safer? Do you know what the dangers are associated with blocking MAO B enzyme and taking a medicine like Serzone?
>
> Like I said , I have tried about everything and these two meds have worked to some degree in the past.. but in different ways. The selegiline was more activating , in a good way , but did little for anxiety while the serzone seemed to stabilize me and help w/ anxiety but was somewhat sedating , so if possible it would be nice to be able to combine them, but we will see what my doctor says..
>
>MAO-B is mainly responsible for metabolizing dopamine and phenylethyl amine, and there is not going to be any interaction with Serzone in this regard. MAO-A is the important enzyme from an antidepressant and drug interaction standpoint, as this is the one that really affects serotonin and norepinephrine levels. There is some MAO-A inhibition even with 5 mg/day selegiline, and obviously, there will be less with 2.5 mg/day, so 2.5 mg/day is an inherently safer dosage. I question if 5 mg/day is actually all that dangerous in this situation, however, and would probably be willing to take the risk myself if I thought there was a potential therapeutic benefit. However, one would still need to convince one's doctor of its legitimacy and safety. In any event, it would be highly prudent to start at 2.5 mg/day to both observe for any serious adverse effects (serotonin syndrome symptoms) and minimize their severity.
Todd
Posted by Jimmyboy on July 20, 2006, at 16:53:45
In reply to Re: Low dose Selegiline- can I take with other meds??, posted by silvercoin on July 20, 2006, at 16:42:16
Thanks again for the info,
I think I will talk to the doc about the 2.5 mg dose of Selegiline. In my experience he generally has an open mind to my suggestions , so I think he might go for it.
Posted by Declan on July 21, 2006, at 0:19:57
In reply to Re: Low dose Selegiline- can I take with other meds??, posted by silvercoin on July 20, 2006, at 13:07:37
I took low dose selegeline/deprenyl with lots of things including methadone which is contraindicated without ill effect.
Not ADs though, except the herb rhodiola.
Posted by Jimmyboy on July 23, 2006, at 18:38:09
In reply to Re: Low dose Selegiline- can I take with other med, posted by Declan on July 21, 2006, at 0:19:57
Well, I started that combo a few days ago, and very surprising to me I already feel much better, I know it takes a few weeks for Serzone to get in your system , so it could be placebo.. but I definitely have felt a lot less anxiety, I have not even had to take any Klonopin at all .
I am getting the typical side effects that have always happened at first with Serzone. Feel kind of spacy , a little tired, and some VERY vivid dreaming ( woke up laughing out loud this morning - * actually* kind of enjoyable : ) But those side effects typically have gone away in a couple of weeks in the past , so I expect they will again.
This is the end of the thread.
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