![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Axmann on May 14, 2016, at 21:21:09
I have been taking the 6mg/24h dose of the Emsam patch for a little over a month.
For some reason, my ADD seems like it is *much* worse than normal. I seem to have incredible difficulty initiating actions and switching my train of thought. My dexedrine doesn't even seem to help very much.
Is it possible that this MAO-B selective dose of selegiline is increasing dopamine too much as the expense of norepinephrine?
Would it be worth increasing the dose of Emsam to the 9 mg dose, or should I just scrap it altogether? My mood is doing fairly well actually, but I'm feeling very "dumb" and just not very sharp at all.
Posted by Larry Hoover on May 14, 2016, at 23:42:05
In reply to Selegiline making ADD worse? Increase dose?, posted by Axmann on May 14, 2016, at 21:21:09
> I have been taking the 6mg/24h dose of the Emsam patch for a little over a month.
>
> For some reason, my ADD seems like it is *much* worse than normal. I seem to have incredible difficulty initiating actions and switching my train of thought. My dexedrine doesn't even seem to help very much.
>
> Is it possible that this MAO-B selective dose of selegiline is increasing dopamine too much as the expense of norepinephrine?
>
> Would it be worth increasing the dose of Emsam to the 9 mg dose, or should I just scrap it altogether? My mood is doing fairly well actually, but I'm feeling very "dumb" and just not very sharp at all.Axmann, I would recommend, first and foremost, that you begin by validating your own personal experience.
No matter what treatment you try, no matter how much you trust the prescribing physician, nor the research and statistics you've interpreted, you must honour you own experience, first and foremost.
Let's look at one sentence you posted. You said: "For some reason, my ADD seems like it is *much* worse than normal."
I would ask you if your observation was simply that your ADD was worse with selegiline, and that you were having trouble accepting that? Your observations are far more important than you expectations.Rather than upping your selegiline, I would recommend that you go off it, and monitor whether your ADD symptoms return to a lower level. That is part of what is known as a challenge/dechallenge/rechallenge protocol. You would be doing the second stage of a possible three stage experiment, if you do as I suggest. https://en.wikipedia.org/wiki/Challenge%E2%80%93dechallenge%E2%80%93rechallenge
For the record, I am a practising scientist, and I am always testing methodology and assumptions in experiments. That includes my own attempts to manage my own symptoms.
Regards,
Lar
Posted by linkadge on May 15, 2016, at 6:55:52
In reply to Re: Selegiline making ADD worse? Increase dose? » Axmann, posted by Larry Hoover on May 14, 2016, at 23:42:05
Hi,
I would agree with what Larry said. One thing to note, however, is that if you discontinue, or reduce dose, it may take a few days to notice the adjustment. Because selegiline irreversibly binds to the MAO enzyme, your body can take a few days or weeks to have MAO levels return to normal.
Have you been taking Dexedrine in conjunction with the selegiline (or just recently added it back)?
Linkadge
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.