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Re: Selegeline ? for Annie

Posted by Annie on July 20, 1999, at 22:31:40

In reply to Re: Selegeline ? for Annie, posted by Judy on July 19, 1999, at 20:08:38

> Annie,
>
> Just a quick question that's been bothering me. When you complete the patch study, why aren't you considering taking Selegeline orally? I KNOW there must be a good reason - just curious as to what it is.
>
> Judy

Judy,
Actually, I considered it, but my Pdoc seems to think that I would respond better to Parnate or Marplan at the dose I would need. The 30mg Selegiline patch has really helped many of the symptoms of my depression and the lack of side effects has been great. The best improvements have been a total absence of suicidal thoughts, a much higher tolerance for stress and the fact that I am losing weight without even trying! I haven't felt this good in years. The increase in energy and motivation leveled out after a slight initial improvement. I still have to force myself to do anything or to leave the house. Social activities still feel like a penance. If there were a patch at a higher dose it would be a no-brainer for me, even though the diet would then be required. Remember that with transdermal delivery, lower doses are needed to reach a therapeutic level because it bypasses the liver. Taken orally it is unlikely 30mg would have any effect for me. I usually need to meet or exceed maximum dose to get any benefit(eg 400mg desipramine for several months before my desipramine reached the supposed therapeutic level of 180. Still didn't help though, and side effects were horrendous. My doc says that my liver must be very,very good indeed at metabolizing.) I don't know what the oral equivalent of 30mg transdermally would be,[does anyone know?] but I would probably have to go much higher. There isn't much information about effects of very high doses of Selegiline, so I guess it's safer to try Parnate or Marplan for now. I am a little leery of Parnate because I experienced spontaneous hypertension in my first trial of it. I'm not ruling it out though, if I can start low and build slowly to an effective dose. I'd rather stay on the patch longer but it isn't possible. I'm really frightened that all the relief I've gotten is going to disappear. I don't think I could stand it.

Hope the Marplan is going well for you.

Annie

PS If anyone is aware of any studies using selegiline at higher doses, I'd appreciate if you would post the information.



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poster:Annie thread:5905
URL: http://www.dr-bob.org/babble/19991001/msgs/9007.html