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Re: Selegiline/Deprenyl effective anti-depressant? LizinManhattan

Posted by Larry Hoover on February 8, 2006, at 10:15:42

In reply to Selegiline/Deprenyl effective anti-depressant?, posted by LizinManhattan on February 7, 2006, at 21:35:15

> Hi,
> Does anyone have experience with Selegiline as an anti-depressant? I am currently on Parnate which is effectively controlling my depression. However, I have had a couple of BP scares and so am going off it. willyee on this board just let me know that the Selegiline patch (by the name of Emsam)is due out at the end of the month. I mentioned it to my psychiatrist and he said he doesn't consider Selegiline an effective anti-depressant. So now I was wondering if anyone has heard/experienced differently?
> Thanks a lot!
> Liz

Your psychiatrist is basing his opinion on oral selegiline, which really could be thought of as being a different drug. Selegiline is readily changed by digestive enzymes in the intestinal wall and the liver. This protective net of enzymes is called the first pass metabolism; all oral drugs pass through this gauntlet.

If I recall correctly, as much as 60% of oral selegiline can be metabolized before it even gets into general blood circulation. And, the metabolites have activities that are different than the parent drug.

In contrast, the patch delivery system allows selegiline to trickle through directly into general circulation, avoiding that significant destruction via first pass enzymes. You get different drug effects, because the selegiline pretty much makes it into the brain unchanged.

It remains to be seen that Emsam is similar in effect to other MAOIs. And, individual differences in sensitivity to tyramine makes it hard to predict if food restrictions will apply or not. Some people may still have to watch their diet closely, to avoid BP effects.





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