Posted by not exactly on April 22, 2003, at 15:52:00
In reply to Re: AMISULPRIDE! » not exactly, posted by Michael Bell on April 20, 2003, at 10:12:06
> I tried Selegiline (5mg/day) for several months on my self-treatment road, but it really didn't help. By itself, it definitely did not help with SP, and made the paranoid ideation slightly worse. Tyrosine supplementation made me extremely paranoid after a while, though admittedly I was taking much more than recommended.
Selegiline is an odd drug. At doses where it acts as a general MAOI (15 mg/day or higher), it can be a very effective antidepressant for some people. Of course, if you're inhibiting enough MAO-A for it to help, then you also run the risk of the dreaded "cheese effect" (unless you bypass the digestive system via transdermal or sublingual administration).
It lower doses (10 mg/day or less), when it only inhibits MAO-B, then it acts primarily as an "amplifier" - it can make you feel better when you're already feeling good (for whatever reason), but it can also intensify depression and other negative symptoms. Merely causing dopamine to stick around longer (without enhancing its transmission) does not necessarily improve mood, and can cause psychotic-like side effects.
For this reason, low-dose Selegiline works best when combined with something else that it can synergize with. Phenylalanine (a precursor to dopamine and phenethylamine) works well with Selegiline, as does large and/or frequent doses of chocolate (source of phenethyamine, which in the absence of an MAO-B inhibitor would get metabolized before it has much of an effect). Tyrosine can be effective too, but it's more like to produce side effects - NE increase, headaches, raised BP. Ritalin or amphetamines in TINY doses can also synergize positively (but large or even normal doses can be dangerous in this combination).
In general, anything that enhances DA transmission is likely to synergize positively with Selegiline. That's why I thought it might work well with Amisulpride.
Recently, I've been adding a small amount of Selegiline (2.5 mg/day orally) to my BuSpar/Klonopin cocktail with good results. It helps with the anhedonia, and definitely makes the BuSpar seem even more like an antidepressant.
At last, I'm happy not because I'm ignoring my problems, but because I'm solving them. I'm more creative and productive in my volunteer work, I'm thinking realistically about a new career, I'm playing a more active role in my parent's health care, and I'm getting my cluttered house organized and comfortable. Meanwhile, my psychotherapy sessions have degenerated into simply reporting my positive accomplishments (both tangible and conceptual) without gaining much direction/insight from the therapy itself. I'm seriously considering discontinuing the therapy sessions and just sticking with the meds for now.
- Bob
poster:not exactly
thread:219673
URL: http://www.dr-bob.org/babble/20030417/msgs/221513.html