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To Judy and Zeke re: Selegiline and Pindolol

Posted by Rick on December 26, 1999, at 18:31:55

In reply to Re: Judy -- Selegiline, Pindolol, Melatonin & Estrogen, posted by Judy on December 26, 1999, at 10:59:00

While Selegiline was designed as a dopamine-enhancing agent, the attached monograph section suggests that Selegiline's long-lasting metabolites *may* help discourage serotonin re-uptake. Thus, it is not necessarily illogical to think that the serotonergic beta blocker Pindolol could potentiate Selegiline, as it purportedly does for SSRI's and other AD's.

While I also feel that Selegiline is neutral-to-negative for anxiety (that's why I keep my dose very low -- all I use it for now is a little mental activation and alertness, which 5 mg does seem to provide), low-dose Pindolol itself sure seems to supply a mildly calming effect that nicely builds on my Klonopin's benefits. For all I know, I could get that same effect from various other beta blockers; but since Pindolol is the only one with serotonergic effects, I'm not so sure.

One thing I am fairly sure about is that Pindolol is not a good candidate to help with the fatigue. Indeed, just like other beta blockers, it causes fatigue in many people. This side-effect is especially prevalent for the cardio non-selective BB's, which include Pidolol and Propronolol (Inderal) among others. For me, anything above 5 mg starts to cause a little sleepiness, especially when taken at night. I haven't needed anything for sleep since taking Klonopin (even though I rarely take it after 6 p.m.). Back when I was taking an occasional Xanax at bedtime, I really felt groggy the next day. In fact, if you don't mind weird dreams and your blood pressure isn't too low, bedtime Pindolol might be a gentler sleep-inducer with fewer downside effects and some possible anti-anxiety benefits.

ATTACHMENT (from Selegiline monograph):
It is important to be aware that selegiline may have pharmacological effects unrelated to MAO B inhibition. As noted above, there is some evidence that it may increase dopaminergic activity by other mechanisms, including interfering with dopamine re-uptake at the synapse. Effects resulting from selegiline administration may also be mediated through its metabolites. Two of its three principal metabolites, amphetamine and methamphetamine, have pharmacological actions of their own; they interfere with neuronal uptake and enhance release of several neurotransmitters (e.g., norepinephrine, dopamine, serotonin). However, the extent to which these metabolites contribute to the effects of selegiline are unknown.

> Thanks, Zeke! I will do a medline search on
estrogen. I have a 'gut' feeling that estrogen,
or lessening amounts of it, may be playing a
significant part in the changing personna of my
depression and the reason why previously used AD's affect me differently now. (Or perhaps my aging
synapses and receptors are just rolling over and
dying at a faster rate!)
> Melatonin? Is that indicated with MAOI's? Not
sure if anyone knows what is/isn't indicated with
Selegiline at high doses. Another medline search maybe. Besides the sleep problems, I DO need
Xanax (or something) for the anxiety that
Selegiline isn't touching - or may even be
> Great explanation of Pindolol's mechanism. I
too wondered why it would be of benefit with
Selegiline. In general, I've always wondered why
it is that SSRI's just DO NOT work for me. They
make me so fatigued that I wouldn't notice any
benefit if it were there. Is it possible that
Seratonin just isn't my problem brain chemical, or
is there another mechanism of SSRI's that pushes
my 'coma' button? Is it possible that Pindolol
might lessen my SSRI- induced fatigue?
> I'll do those web searches when I have a quiet
moment today. If I find anything promising (or
confusing), I hope you'll be here to run them by.
Thanks again. Judy




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