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Re: Selegiline without the Patch

Posted by Elizabeth on April 15, 2000, at 16:03:34

In reply to Re: Selegiline without the Patch, posted by Adam on April 14, 2000, at 16:22:56

> Well, the initial intent was to keep me on 15mg/day indefinitely, and then when I complained it wasn't working, I was immediately bumped up to 30mg, which I foolishly complied with. The result was pretty dramatic and uncomfortable. I should have known better.

How long did you take 15 for before upping it?

> > Tried Ambien?
> No, but I may get some. Heard anything about Sonata?

Too short-acting, but it might be okay for you if you don't have trouble staying asleep.

> Well, everybody's got OCD these days.

????? !!!

> Anyway, I was very interested to read you have experienced similar things. Perhaps it is just a stimulant effect.

I'm sure it's a stimulant effect.

> "Picking" was something I kind of trained myself not to do after a while. Would what I'm experiencing fall under "akathisia?"

I don't think so....

> I find it interesting that neuroleptics, which block DA receptors, cause restlessness, while stimulants, which antagonize DA receptors somehow (among other things), cause restlessness. Does akathisia come only later, after DA signalling has readjusted to dysregulation by DA receptor antagonism?

I don't know about akathisia, but some of the extrapyramidal effects of neuroleptics are supposedly caused by down-regulation, notably tardive dyskinesias & dystonias.

As for your question, I guess anxious people just can't win when it comes to meds!

> And, are these symptoms of stimulants in some way or another inducing a state of "chemical OCD"? That would be way bad for me, I think.

I think you'd be the one to answer that, since you know what OCD feels like. Does this feel the same?

> I think so too, given what I've read about it in "the literature". I just don't know what goes on in practice, which is why I was concerned. I've suggested things to pdocs in the past that I thought made perfect sense, got poo-pooed, and then later I'd read about clinical cases where doctors did exacly what I thought would work. It's frustrating.

I know, I know! Of course, you realize that reading somebody's "we tried this with this one patient and it worked!" letter to the editor does not mean something is accepted practice. But, FWIW, I do know lots of people who've taken Risperdal who have nonpsychotic depression or manic-depression.

> Anyway, as much fun as playing with drugs in my head can be, I'm reluctant in some ways to keep adding things to counter this-or-that side effect only to expose myself to new risks of other side effects. You tried parnate after sel. and had (besides the cardiovascular problems, which I don't want to minimize), some success.

Actually I originally tried Parnate before selegiline -- wanted to see if I could find something else that worked and was tolerable that wouldn't be as risky as Parnate.

> From what I've read, parnate seems to be quite a stimulant also.

Eh, I think it is. I do get the itchies on it (mysterious! my internist wants me to see a derm about it), and I think I've probably been doing the skin picking thing more as a result. (This thread could get really disgusting if we wanted it to, you know. :) Also, it seems to have improved my attention somewhat, and it's not a very good general anxiolytic although it prevents panic attacks. (There's my critique.)

> Is is less so than selegiline?

Apples & oranges.

> I'm giving serious thought to just switching.

It really is too bad you couldn't stay on the patch. I hope that it gets approved -- do you think that transdermal administration might make other drugs more tolerable too?

> Thank you in advance for any or all answers...

Not sure how helpful I was, but you're welcome.




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