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Re: Need help with Diagnosis » ttime

Posted by cache-monkey on March 17, 2005, at 1:09:35

In reply to Re: Need help with Diagnosis... ttime, posted by ttime on March 16, 2005, at 20:17:56

Hey TTime,

<< Thanks for your feedback. A few questions, though. Why do you take Lithium for Mild BPII. Does it seem to help? I thought only BPI diagnosis would get the true benefit(s. Also, do you have to have alot of bloodwork to take Lithium? Again I thought this was a med for more intense Bi-Polar Symptoms. >>

I think Lithium works as a mood stabilizer regardless of the severity of one's symptoms. As far as the blood work, yeah I'm getting blood drawn about biweekly, since we're trying to get the level into the "therapeutic range". So far I'm not sure if it's working, especially since I'm not in the the therapeutic range yet. Time will tell, I guess. I haven't found the bloodwork cumbersome.

<< Have you ever tried Lamictal - I have read that this could be a decent place to start if one was BPII and showed less intense ups and downs. >>

You're right, Lamictal is gaining favor for BPII. It was actually what I tried first in terms of mood stabilizers. It ended up not working out so well for me. I found even the smallest dose increments to be tough to adjust to due to extreme agitation. It also was causing me pain/tightness in my lower back and groin muscles, and -- to a lesser extent -- some sexual dysfunction. (Sexual dysfunction is not common with Lamictal; many find it a little prosexual, so I guess I'm a freak in that regard.)

<< With regards to the selegiline, I have seen that mentioned also on these boards. I thought this was for anxiety related symptoms as well as a decent med for sleeping. If it is helping you with concentration, lethargy and the like, I would love to have updates on how this is working for you. These are my main problems (lack of concentration, etc) which then leads to frustration, hostility, no patience, yelling, etc... >>

So, selegiline _in low doses_ is a selective monamine oxidase B (MAO-B) inhibitor. [At higher doses, it also inhibits MAO-A, in a similar manner to traditional MAOIs like Parnate and Nardil. But since it is selective at the lower doses (<10mg/day), there isn't a need for dietary restrictions.]

MAO-B is the enzyme responsible primarily for cleaning up dopamine from the synapses. To a lesser extent selegiline can act as a dopamine reuptake inhibitor. So the end result is more dopamine in the system. More dopamine tends to be associated with more energy and well-being. It's also good for concentration, in theory. (There's a whole dopamine deficiency hypothesis of ADD/ADHD.) Additionally, selegiline is metabolized to some amphetamine-like compounds which are also directly useful for energy and concentration.

Oh, almost forgot: MAOB is also responsible for breaking down the "chocolate" amine phenylethylamine (PEA). So inhibiting, MAO-B could theoretically lead to increased feelings of well being due to higher PEA and dopamine, as well as improved energy and concentration.

Low-dose selegiline might be useful for social anxiety. But the only study that's been published had a very small sample, and the results weren't as strong as for, say, Nardil (one of the unselective MAOIs).

In terms of general levels of general anxiety, the trouble is that selegiline can actually have negative effects in many people. And it can also interfere with sleep.

So it's kind of a tricky drug. I haven't actually tried it yet, but I'll definitely post once I do. You also might want to consider searching through the archives on babble. There have been a number of threads on selegiline over the past couple of years.

Best,
cache-monkey


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