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Selegiline HCl and anxiety » alesta

Posted by Ame Sans Vie on October 6, 2004, at 15:40:11

In reply to Re: One month on selegiline now and loving it!! » Ame Sans Vie, posted by alesta on October 6, 2004, at 11:45:04

> hi, ame,:)
>
> good to see you again! :) glad your still popping in..

Hi there, alesta -- and likewise! I just figured I needed a forced hiatus from the board to prevent myself from prematurely posting about my exciting response to selegiline, lol. I'm definitely still here.

> i have also heard very favorable things about selegiline for depression, but also that it can increase anxiety, and should perhaps be avoided by the anxiety-prone..perhaps your high dosages of 2 benzos counteracts this? have you noticed any increased anxiety?

I'll look into this a bit further and get back to you later tonight regarding the occurrence of anxiety-provocation as a selegiline adverse effect... I'm tempted to say that it is probably not likely to cause or increase anxiety levels as it's primary method of action is, as far as we know, inihibition of MAO-B. In the clinically important sense, monoamine oxidase type B seems predominantly to degrade "excess" beta-phenylethylamine [PEA]; blocking this enzyme alone doesn't really decrease the degradation of dopamine all that much, if memory serves me correctly. MAO-A is actually perfectly capable of not just degrading serotonin, norepinephrine, and other trace amines as is widely held to be gospel, but also will destroy dopamine. Now, PEA being *SO* closely related to amphetamine suggests that increased levels could be anxiety provoking, but I would guess this might happen only in very susceptible individuals.

However, it *is* quite possible that in addition to MAO-B blockade, selegiline exerts its many effects through mild reversible MAO-A inhibition (even at low doses), dopamine reuptake inhibition, so-called "catecholamine enhancement activity"... there are many theories. Despite the very small amounts produced through its metabolism, it may even be possible that selegiline's active metabolites levoamphetamine (the same l-amphetamine that comprises 25% of Adderall) and levomethamphetamine (available over-the-counter in Vick's Inhalers, though spelt "levmetamfetamine", presumably to avoid stigma) lend their monoamine reuptake inhibiting, monoamine releasing, and MAO inhibiting properties to the resultant effects as well.

All the technical jargon aside, I can personally say that, even if I miss a dose (or more) of my benzos, the selegiline/DLPA combo seems to offer a "balancing" effect that my brain so desperately needs and appears to me to be somewhat adaptogenic. That said, I would never miss more than one full day of my Klonopin/Xanax XR! :-)

> awesome anti-smoking info! that's really fantastic! thanks for sharing that.

You're very welcome. :-)

I think there are some clinical trials that are being conducted (*have* been conducted?) investigating this very approach to smoking cessation. I came across them while searching http://www.clinicaltrials.gov and http://www.centerwatch.com upon realization that selegiline had eliminated my cravings. Good thing too, because TX Medicaid's formulary changed this week, dropping the only other smoking-cessation therapy that's ever worked for me (Nicotrol Inhaler), and $150 for a week's supply of that stuff is enough to make you say, "Eh, cigarettes aren't so bad after all," lol.

> take care,
> amy ;)

Likewise -- all the best,

~Michael
SAD, GAD, PD, OCD, agoraphobia, dysthymia, MDD, ADD, AvPD


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poster:Ame Sans Vie thread:399488
URL: http://www.dr-bob.org/babble/20041002/msgs/399694.html