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Judy -- Selegiline, Pindolol, Melatonin & Estrogen

Posted by Zeke on December 25, 1999, at 23:53:27

In reply to Selegiline Expertise Needed Again, posted by Judy on December 18, 1999, at 14:19:35

I would think if you are in the Boston area that seeing a psychpharm there is a fantastic idea.

As for sleep, Xanax definetly interferes with REM sleep, and I believe Selegiline may also. What about trying a little Melatonin (0.3mg) at bedtime in place of the Xanax (so long as seasonal affective disorder isn't part of your depression). Melatonin should help with the sleep without blocking REM. (Not sure though of any interactions with Selegiline -- anyone have any ideas?)

Re Pindolol: it blocks serotonin autoreceptors and theoretically only AUGMENTS other meds that effect serotonin. Supposedly when SSRIs (for example) increase synaptic serotonin, the autoreceptors sense this and consequently cause a reduction in serotonin production (and probably other effects) and this comprimises the antidepressant effect. But the pindolol blocks this and the SSRI doesn't cause negative feedback. I keep saying 'theoretically' because this doesn't explain the delayed response to ADs or the effect ADs have on neurogenesis. So Pindolol (and the SSRIs etc) may likely not be completely described by these explanations. Its curious to me that Pindolol is being tried with Selegiline, as it does not directly effect serotonin but dopamine and phenethylamine which are 'downstream' from serotonin.

Lastly, you mentioned estrogen and that is worth considering. I recently was reading an Australian webpage where it referred to estrogen as an adjucnt in depression. I guess they consider estrogen like docs in the states consider lithium and pindolol etc. Also estrogen does have antidepressant effects in itself and this is receiving more and more documentation in the medical literature. (Interestingly, both Selegiline and estrogen have been shown beneficial in Alzheimer's and in terms of both memory and mood. And like Selegiline, estrogen has a neuroprotective effect, and receptors for estrogen definitely exist in the brain.) The only relative concern is edema which may occur from the estrogen. But then again, the edema produced in you from Nardil may not occur with estrogen (or occur to any significant degree). I think estrogen is certainly worth considering. (BTW do a medline search on estrogen and affective disorder if you want to know more. There is more.)




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