Posted by Robin on September 30, 1999, at 22:46:35
In reply to Re: Selegiline :Deprenyl or Generic??, posted by Jen on September 30, 1999, at 11:28:04
> I've tried Deprenyl, but not the generic. Have also stayed on Parnate for extended periods of time.
>
> My experience and understanding:
> 1) Parnate caused excessive dry mouth, sweating, and some degree of cognitive dysfunction (for example, the pace of my speech significantly slowed). I also did not find that it significantly reduce my social phobia, so I augmented with Klonopin (Clonazepam) which is very effective.
> 2) Deprenyl (at less than 15 mg/day) affects only MAO-B
> 3) Let me back up: discussion of MAO Inhibitors (confirm with your psychdoc - I'm not an MD)
> a. Reversible and Non-reversible
> - Non-reversible are the older type, which can cause a hypertensive crisis
> if you consume foods rich in tyramine. The worst are dates, figs, aged cheeses
> and red wines. I've never had a problem, and I eat pizza like crazy and enjoy
> beer and white wines. Moclobemide falls into the reversible category. Deprenyl,
> Phenelzine, Tranylcypromine (Parnate), and Isocarboxazid (Marplan) are non-reversible.
> b. Inhibitors of MAO-A or MAO-B or both
> - Deprenyl is selective for MAO-B at less than 15 mg/day. This means you can avoid the
> "cheese effect" or the tyramine induced hypertensive crisis.
> - Deprenyl above 15 mg/day loses its selectivity and acts on MAO-A and MAO-B
> - Inhibitors of MAO-A, such as the reversible MAOI Moclobemide have been found to
> lack efficacy in treating social phobia
> c. Hydrazine and Non-Hydrazine MAOI's
> -Phenelzine (Nardil) and Isocarboxazid (Marplan) are hydrazine MAOI's, non-reversible, and
> non-selective. That is, they affect both MAO-A and MAO-B.
> -Hydrazine MAOI's are thought to achieve their efficacy by their added effect on GABA,
> the primary inhibitory neurotransmitter in the brain.
> -Non-Hydrazine MAOI's, such as Parnate and Deprenyl to not affect GABA levels
>
> To summarize:
> (a) Deprenyl at less than 15 mg/day will primarily affect dopamine, which, by itself, does
> not appear to exhibit efficacy in treating social phobia.
> (b) Deprenyl above 15 mg/day should be closer to Parnate, but without the dry mouth and
> and slowed speech, excessive sweating, etc. I've found that up to 60 mg/day of
> Deprenyl did not appear to help my social anxiety.
> (c) You may want to consider Nardil (Phenelzine). You need at least a two week washout
> of Parnate, of course, before you could start this. You could also supplement with
> Klonopin in the interim, to get you through. Phenelzine does have some side effects,
> but you might want to see how it affects you, individually, before you make up your
> mind.
> (d) Marplan (Isocarboxazid) is another alternative to Phenelzine. It's recently been
> reintroduced to the market. As a Hydrazine, non-rerversible and non-selective MAO
> inhibitor, it should exert both anti-panic and anti-anxiety effects. I'm not aware
> of its side effect profile, but you might want to switch to this if your experience
> with Phenelzine (Nardil) is not positive.
>
> Good Luck!
>
> JenJen,
Thank You so much for taking the time to explain the MAOI drugs for me. It was very helpful.Robin
poster:Robin
thread:11826
URL: http://www.dr-bob.org/babble/19990914/msgs/12381.html