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Re: Oral deprenyl vs bupropion? SLS

Posted by Jay2112 on June 10, 2022, at 19:28:14

In reply to Re: Oral deprenyl vs bupropion?, posted by SLS on June 7, 2022, at 7:28:09

> Hi.
> L-Deprenyl / selegeline / EMSAM is *selective* for MAO-B, but only at low dosages. At higher dosages, selegeline becomes non-selective and MAO-A is also inhibited, Of these two types of MAO enzymes, MAO-A is the the one that is associated with antidepressant effects. The package label for EMSAM is explicit regarding this. Clorgyline is no longer available, but it is an irreversible *specific* inhibitor of MAO-A. It doesn't inhibit MAO-B at all. The NIH had considered it the most powerful antidepressant in the world, but reserved it for their most treatment-resistant cases of treatment-resistant depression - TRD. It left me improved, but they would not allow me to combine it with a tricyclic antidepressant (TCA) like desipramine or nortriptyline, which I had needed to add to Nardil or Parnets in order to respond. Ultimately, they had to discontinue giving clorgyline to their patients because adverse cardiac events were reported.
> Moclobemide is another MAOI that is specific for MAO-A. It is a reversible inhibitor of monoamine oxidase (RIMA). Unfortunately, it is reversible rather than irreversible, leaving it an inferior choice. Some people get amazing results in the first week at 300 mg/day. However, dosage escalation is usually inevitable to retain the antidepressant response. The maximum dosage is usually considered to be 1200 mg/day. Still, very few people remain improved indefinitely on moclobemide.
> In summary, inhibiting MAO-A is sufficient to yield an improvement in depression.
> - Scott

Moclobomide was, personally, a super-interesting drug. Yes, it has a super short half-life...of 2-3 hours. But, being a rapid metabolizer of drugs, I took smaller doses, like a 150mg dose split in half to a 75mg dose, and I spaced it one of those every 4-5 hours, 4x a day. And boy, it's antidepressant effects are felt immediately! It works more for apathetic, slow, tiring depression, than least at first. I remember so clearly, taking the 75mg dose on a day where I felt deflated by life, and WOW..I was a tad manic, but felt productive.It also has a pro-testosterone effect too. Sex with this stuff was f'ing increadible!! After years of chronic SRI use, just...WOW. So, I keep it in the back of my mind as an emergency drug when all others run out!

And...apparently it works even MUCH better with fact I know of a number of individuals at university who are on this combo, and have been in remission for years. I would add, a STRONG GABA drug, like Lyrica, or a strong benzo, really help cool off the stimulating effects of this drug in the evening.



Humans punish themselves endlessly
for not being what they believe they should be.
-Don Miguel Ruiz-




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