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Re: Selegiline Info??

Posted by Adam on October 24, 1999, at 20:07:42

In reply to Selegiline Info??, posted by Lynne on October 24, 1999, at 10:15:38

Hey, Lynn,

The truth is, there isn't that much out there about the use of selegiline in depression. It's kind of an
odd choice for that indication, actually, since it was developed as an adjunct therapy for Parkinsons. Medline
seaches won't turn up very muc: there are only three papers that I have been able to find that even deal with
the idea of using selegiline in humans for depression. There was one using the forced-swim model in rats where
selegiline, both orally and transdermally, has an antidepressant-like effect. A search on the writings of Dr.
Ivan at Depression Central (Dr. Bob has links to this page, I think in the Tips section of his page) comes up
with only one reference to selegiline, with the remarkable statement that it isn't a very good antidepressant.

That fact is, I may be involved in what is the only large study of selegiline in depression that has been done
(ongoing at McLean Hospital and other places). Just about everything out there on selegiline in the literature
and on the web refers to its use in Parkinson's, though some stuff also deals with its possible uses in delaying
the onset of Alzheimer's Disease. There are other rather flakey references to selegiline's life-extending
properties and its use as a "smart" drug. All of this is relevant, probably, only if you are taking selegiline
in low doses (5-10mg/day) where its effects on monoamine oxidase A are negligible. If you look in the PDR or
similar drug-info databases, what you'll find is explicit instructions NOT to use selegiline above 10mg/day
because of the potential for dietary issues. That's excactly what you'll have to do if you use it as a treatment
for depression. You might even have to take it in doses five to ten times as large as the "normal" dose to treat
depression, and there's virtually nothing out there describing such a scenerio.

What there is to know is this:

It has a much higher specificity for MAO-B than MAO-A, but at doses in the 50-60 mg/day range, it starts to have
significant effects on MAO-A, irreversibly inhibiting it.

In addition to blocking the breakdown of dopamine, it also can inhibit the reuptake of dopamine, boosting it
independantly of its effects on MAO.

Among its major metabolites are L-amphetamine and L-methamphetamine. These L enantiomers are not nearly as potent
as the D forms, though they do have some effects, perhaps even some differential effects on the noradrenergic system
(though I have only seen one paper from way long ago that referred to such differences btw. amphetamine isomers).

At the doses needed to treat depression, you have to worry about the food and drug interactions you would with
any MAOI.

It appears that those who have responded well in the past to selegiline as an AD had fewer issues with anxiety
than those who had anxiety problems. One reference, using a limited sample size, but something to think about.

That's all I can think of that might be relevant. I'm sorry I don't have the specific references in front of me.
It's all in Medline, though it took me a while to dig up some of these things, and I had to use some creative
keyword combinations. I hope more info. becomes available in the future. As my doctor said, it's considered
by many to be a "whacky" treatment for depression.

It has worked for me, and, it would appear, a bunch of other people too, typically with few side-effects, and
I guess that's what's most important. Try it, and see what happens. Unfortunately, the literature doesn't
seem to be much of a guide.

> I would like to find more information about Selegiline use for depression and ADD. I have read everything on these boards. Does anyone know where I could find more info?




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