![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by n_shrimpie on April 3, 2012, at 18:08:35
I don't have insurance and can't afford emsam, and though Nardil was effective, the insomnia and weight gain were intolerable, untreatable side effects, so i'm hoping to avoid them with the selegeline, but one doctor i spoke to said it's not very effective.
Posted by Tomatheus on April 3, 2012, at 21:53:03
In reply to any experience with selegeline in pill form?, posted by n_shrimpie on April 3, 2012, at 18:08:35
n_shrimpie,
I tried oral selegiline back in 2006 for what at the time was a severe vegetative depression, and I found that it produced a fairly strong antidepressant effect that faded after about three days on the medication. Once the antidepressant benefits of the selegiline faded, I started to feel more agitated and cognitively impaired than usual. I had basically the same response to Marplan (isocarboxazid) and the version of Parnate (tranylcypromine) manufactured by Goldshield for the U.K., although I didn't experience any significant agitation or cognitive impairment on those medications after they stopped producing antidepressant benefits.
I think I remember taking 5 or 10 mg of oral selegiline when I tried it.
Tomatheus
Posted by n_shrimpie on April 3, 2012, at 22:24:28
In reply to Re: any experience with selegeline in pill form?, posted by Tomatheus on April 3, 2012, at 21:53:03
did you ever try nardil?
Posted by Avenarius on April 3, 2012, at 23:02:32
In reply to any experience with selegeline in pill form?, posted by n_shrimpie on April 3, 2012, at 18:08:35
I took oral selegiline and it worked well. I believe 30mg was the effective dose. Most people (especially on the Emsam patch) don't take an effective dose.
I think it took about 4 weeks to kick in. It caused severe insomnia but I lost weight.
It was also very expensive.
Posted by Phillipa on April 3, 2012, at 23:36:29
In reply to Re: any experience with selegeline in pill form?, posted by Avenarius on April 3, 2012, at 23:02:32
I thought inexpensive I'm guessing compared to Emsam. Phillipa
Posted by 757tech on April 3, 2012, at 23:58:21
In reply to any experience with selegeline in pill form?, posted by n_shrimpie on April 3, 2012, at 18:08:35
From my experiance and reading on other uses,the pills dont do much however the liuid,which is expensive is pretty potent go figure
Posted by Tomatheus on April 4, 2012, at 6:25:31
In reply to Re: any experience with selegeline in pill form?, posted by n_shrimpie on April 3, 2012, at 22:24:28
n_shrimpie,
I have taken Nardil. It's actually the only medication that's significantly reduced the severity of my vegetative depression (which in 2006 was the only psychiatric condition that I suffered from) for more than a few days at a time. In short, my depressive symptoms completely remitted for about a month when I took a certain version of the Australian Nardil, and my symptoms were significantly relieved but not in remission for about two months when I took a certain version of the American (post-2003) Nardil. I suspect that a bad batch may have led to my demise on the American Nardil because I noticed both a sudden loss of efficacy and an emergence of new side effects after I started taking my last batch of Nardil tablets. That was in 2006. I haven't taken Nardil since then.
Tomatheus
Posted by Phillipa on April 4, 2012, at 18:37:20
In reply to Re: any experience with selegeline in pill form? » n_shrimpie, posted by Tomatheus on April 4, 2012, at 6:25:31
So you think your diagnosis changed from the change in the nardil? Phillipa
Posted by Tomatheus on April 4, 2012, at 19:26:32
In reply to Re: any experience with selegeline in pill form? » Tomatheus, posted by Phillipa on April 4, 2012, at 18:37:20
> So you think your diagnosis changed from the change in the nardil? Phillipa
No. What I was trying to convey was that the condition that I had when I took Nardil was a vegetative depression (diagnosed as recurrent major depressive disorder). My diagnosis changed (first to schizophrenia, then to schizoaffective disorder) after my psychotic symptoms emerged in February 2007, but that wasn't related to any change in Nardil. The emergence of my psychotic symptoms occurred more than eight months after I discontinued Nardil.
Tomatheus
Posted by Phillipa on April 4, 2012, at 19:58:13
In reply to Re: any experience with selegeline in pill form? » Phillipa, posted by Tomatheus on April 4, 2012, at 19:26:32
Is your new diagnosis related in any way to depression? It was never thought bipolar? As I really don't understand schizoaffective as isn't that considered personality disorder? Phillipa
Posted by Tomatheus on April 4, 2012, at 20:15:33
In reply to Re: any experience with selegeline in pill form? » Tomatheus, posted by Phillipa on April 4, 2012, at 19:58:13
The diagnoses that I have received are as follows and are ordered from oldest to most recent:
1st: dysthymic disorder
2nd: bipolar disorder
3rd: recurrent major depressive disorder (that was my diagnosis when I was taking Nardil)
4th: paranoid schizophrenia
5th (and current): schizoaffective disorder, depressive typeSchizoaffective disorder is considered to be a psychotic disorder that is characterized by the symptoms of both schizophrenia and either bipolar disorder or major depressive disorder. The psychiatrist who originally diagnosed me with schizoaffective disorder told me that she thought that I was of the depressive type rather than the bipolar type. Schizoaffective disorder isn't a personality disorder. Perhaps you're thinking of schizotypal personality disorder or schizoid personality disorder?
Tomatheus
Posted by Novelagent on April 5, 2012, at 15:41:48
In reply to any experience with selegeline in pill form?, posted by n_shrimpie on April 3, 2012, at 18:08:35
> I don't have insurance and can't afford emsam, and though Nardil was effective, the insomnia and weight gain were intolerable, untreatable side effects, so i'm hoping to avoid them with the selegeline, but one doctor i spoke to said it's not very effective.
He doesn't know what he's talking about. Oral selegiline saved my life. I was so depressed for a year and a half I nearly slept through life. Do a search for "DLPA selegiline" on this board.
I took it in 2005. The first day I started, two different professors in different classes made a point to point out I was smiling at what happened to be times where the topic was... Well the point is they pointed out I was smiling at inopportune moments that I happened to space out at (not to the knowledge of my professors) while super smiley. It was a big deal then.
I didn't think much of it at the time, but 2 weeks later, I realized I hadn't craved napping in bed for the prior 2 weeks.
I took 5mg. We're not suppose to tell you to get it or where to find it on this board. But do not take more than 5mg/day-- you'll get a hypertensive crisis otherwise.
And combine it with DLPA. I used LifeExtension brand. Dosing should be mentioned in the search I told you to do. Good luck :)
Posted by Novelagent on April 5, 2012, at 15:44:54
In reply to Re: any experience with selegeline in pill form?, posted by Avenarius on April 3, 2012, at 23:02:32
Irresponsible poster-- he knows better than to risk a hypertensive crisis. You got lucky if you took 30mg. I took 10mg and I got lucky too, but I'm not risking someone else's life on it. I was foolish at the time.
> I took oral selegiline and it worked well. I believe 30mg was the effective dose. Most people (especially on the Emsam patch) don't take an effective dose.
>
> I think it took about 4 weeks to kick in. It caused severe insomnia but I lost weight.
>
> It was also very expensive.
Posted by Novelagent on April 5, 2012, at 15:48:30
In reply to Re: any experience with selegeline in pill form?, posted by 757tech on April 3, 2012, at 23:58:21
> From my experiance and reading on other uses,the pills dont do much however the liuid,which is expensive is pretty potent go figure
You don't need the liquid. Stick with the oral tablets. They're fine and cheap (how are they expensive? I forget but I don't even think my 3 month supply cost $100! Or $200, i don't remember. Either way, it's not a thousand
a month like emsam probably is.Also, if you're poor, you may be eligible for patient assistance from the maker-- you'd have to ask the company. Or medicaid if you're poor.
Posted by n_shrimpie on April 5, 2012, at 17:42:34
In reply to Re: any experience with selegeline in pill form?, posted by Novelagent on April 5, 2012, at 15:48:30
> > From my experiance and reading on other uses,the pills dont do much however the liuid,which is expensive is pretty potent go figure
>
> You don't need the liquid. Stick with the oral tablets. They're fine and cheap (how are they expensive? I forget but I don't even think my 3 month supply cost $100! Or $200, i don't remember. Either way, it's not a thousand
> a month like emsam probably is.
>
> Also, if you're poor, you may be eligible for patient assistance from the maker-- you'd have to ask the company. Or medicaid if you're poor.Thanks for the feedback. i've read that higher doses are often necessary and the hypertensive crisis can be easily avoided with the MAO diet which i've been on before and is no big deal.
Posted by Phillipa on April 5, 2012, at 21:51:05
In reply to Re: any experience with selegeline in pill form? » Phillipa, posted by Tomatheus on April 4, 2012, at 20:15:33
Just home sorry for late reply I must do some googling to understand this correctly. For some reason my brain can't seem to wrap around this to me complicated diagnosis and Axis I vs Axis II. My fault as you explained it quite clearly. Guess full day on road I'm a bit tired. Phillipa
Posted by softheprairie on April 6, 2012, at 2:52:00
In reply to any experience with selegeline in pill form?, posted by n_shrimpie on April 3, 2012, at 18:08:35
I was really uncomfortable with the patch delivery system of Emsam, but my understanding was that the traditional pills were very poorly absorbed. I did Emsam for maybe two months, got up to the highest dose. Then I asked to be switched to the orally disintegrating tablet form, which is not FDA approved for depression, but for Parkinson's disease. The name brand was Zelapar. I gradually got the dose up high. I forget the total. I think the pill was 1.25 mg each (not sure on that), and I think I got up to maybe ten or twelve of those tablets a day. The price was exorbitant, at such a high dose. I had a name-brand copay, but, luckily, my insurance covered the rest. If I recall correctly from around four years ago, I think the Emsam was around $500 a month, and my high dose of Zelapar more like $1,000 a month (! yes, crazy high). I felt like I was getting a little bit of antidepressant effect from it, but then decided it wasn't enough, and that I wanted to taper off and try some other main antidepressant. A part of my decision may have included feeling bad that I was costing my insurance so much, and yet I wasn't getting something awesome from that big money spent. Note -- I did keep to the MAOI diet while on it.
Posted by Avenarius on April 6, 2012, at 13:49:29
In reply to Don't take more than 5mg!!, posted by Novelagent on April 5, 2012, at 15:44:54
Novelagent, you really don't know what you're talking about so I suggest you simply stop posting. I'm sure this suggestion has upset you, but I don't care to argue with you. Why don't you just read this thread (link below) and take it up with the doctors who've prescribed selegiline in the 40 to 60 mg per day range.
http://www.dr-bob.org/tips/split/Selegiline-for-depression.html
If you want to educate yourself beyond your own anecdotal evidence try reading this:
http://www.psychotropical.com/maois_full.shtml
or just read this section...
MAOIs and blood pressure
I am sure a survey of psychiatrists would reveal that most think that MAOIs raise the blood pressure. MAOIs are effective hypo-tensive agents. A substantial proportion of hyper-tensive patients who take MAOIs for their depression are able to cease some, or even all, of blood pressure treatments they were previously taking. How and why the oft quoted admonition not to use MAOIs in patients with hypertension arose is utterly opaque to me. The usual pattern of BP change with MAOIs (see figure below) is for a postural drop to occur when the dose is raised to a therapeutic level. Partial or complete acclimatisation to this drop develops over one to three weeks. Regular monitoring of the sitting and standing BP (this is best done immediately on standing, and again after one minute) allows the dose to be adjusted without problematic hypo-tension developing. A significant but not incapacitating degree of hypo-tension indicates that the minimum therapeutic dose has been achieved.
AND read this regarding MAOI dietary restrictions:
http://www.psychotropical.com/maois_diet_full.shtml
Posted by n_shrimpie on April 6, 2012, at 16:10:41
In reply to Re: Don't take more than 5mg!!, posted by Avenarius on April 6, 2012, at 13:49:29
Agreed, I'll push the selegiline dosage as high as i need to. forgoing wine and cheese is a SMALL price to pay for relief from my depression. Not sure why more people don't see it that way...
Posted by sigismund on April 7, 2012, at 2:57:45
In reply to Re: any experience with selegeline in pill form?, posted by softheprairie on April 6, 2012, at 2:52:00
The selegeline tablets can be crunched and stuck under the tongue.
I always did that.
Posted by softheprairie on April 7, 2012, at 3:45:19
In reply to Re: any experience with selegeline in pill form? » softheprairie, posted by sigismund on April 7, 2012, at 2:57:45
Ahhh. Was this with a doctor's permission?
Posted by Novelagent on April 8, 2012, at 13:41:30
In reply to Re: any experience with selegeline in pill form?, posted by n_shrimpie on April 5, 2012, at 17:42:34
I would try the lowest effective dose.... Also, there's a drug for counteracting a hypertensive crisis-- you should get it and keep it in a keychain pill holder on you at all times.
> > > From my experiance and reading on other uses,the pills dont do much however the liuid,which is expensive is pretty potent go figure
> >
> > You don't need the liquid. Stick with the oral tablets. They're fine and cheap (how are they expensive? I forget but I don't even think my 3 month supply cost $100! Or $200, i don't remember. Either way, it's not a thousand
> > a month like emsam probably is.
> >
> > Also, if you're poor, you may be eligible for patient assistance from the maker-- you'd have to ask the company. Or medicaid if you're poor.
>
> Thanks for the feedback. i've read that higher doses are often necessary and the hypertensive crisis can be easily avoided with the MAO diet which i've been on before and is no big deal.
>
Posted by sigismund on April 9, 2012, at 23:48:59
In reply to Re: any experience with selegeline in pill form? » sigismund, posted by softheprairie on April 7, 2012, at 3:45:19
>Ahhh. Was this with a doctor's permission?
Not at all.
No doctor was involved with either the prescription or administration of this substance.
Posted by laurie laurie on April 12, 2012, at 15:01:18
In reply to Re: any experience with selegeline in pill form? » softheprairie, posted by sigismund on April 9, 2012, at 23:48:59
I had a fairly good run with selegeline pills a few years ago- got up to 15mgs. But after about 10mos. had to stop because of anxiety spells. I've been on 5-10 mgs. of selegeline for approx. 7mos. this time and am not having the same success. What if I added a very TINY bit of Prozac? I am having major issues with irritability and social withdrawing. I had increased irritability last time with 10 mgs., but not 15.Tried Prozac years ago and it didn't help much. No energy improvement and craved carbs. Most of the SSRIs I've tried didn't quite get it. Atypical depression, but more and more problems with irritability.I can hardly stand myself,sometimes! Anyway,thought a tiny bit of serotonin might help? (Prozac)
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.