Posted by Dr. Bob on August 14, 2004, at 13:20:16
In reply to Selegiline + Phenylalanine, posted by nemesis on August 14, 2004, at 1:42:44
Posted by nemesis on August 14, 2004, at 1:42:44
> I was first diagnosed with major depression 13 years ago, and have had some form of depression endlessly since (and likely prior, too). I've never been able to tolerate the side effects of pure SSRIs (headache, foggy head, feeling drugged and "on another planet", sexual dysfunction, etc.) for long. The SSNRI Effexor took me from major depression, to completely flat and apathetic, and abandoned me there. I couldn't feel any emotion at all. I've taken Wellbutrin for several different courses and always tolerated it well (only side effect, increases my pre-existing anxiety), but found it to lift mood only very slightly. The only TCA I have tried is Pamelor, which markedly and surprisingly helped my anxiety, and made a mild to moderate dent in my depression, but the side effects piled up over time (weight gain, tiredness, dry mouth, dry skin, constipation, hemorrhoids from constipation in spite of fiber supplements), with the side effects counteracting my gains in getting less depressed. I also tried SAM-E (did nothing except give me a headache), and St. John's wort (did it help mildly sometimes? I'm still not sure).
>
> My best response, on a response to side effect ratio has still been to Wellbutrin, but it never gave me nearly enough of a kick; it was like one bite of an appetizer, with no more food to follow. I read that it somewhat inhibits dopamine reuptake, but then cripples itself by reducing the amount of dopamine your body produces. "Stronger" dopaminergic drugs are illegal, have been removed from the market (e.g., Survector), and/or are potentially addictive and not generally prescribed for depression anymore (e.g., Dexadrine). I read that old-school MAOI Parnate reputedly has a dopaminergic effect, too, but within a smorgasboard of effects and side effects.
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> Suspecting that, for me, I needed to elevate dopamine levels moreso than serotonin levels, I did a ton of research and somehow stumbled across information on a couple of studies done on a combination of selegiline (Eldepryl) and phenylalanine. The studies, although not placebo-controlled, appeared to show rapid and dramatic results. Other sources attributed this to a dopaminergic effect coming from accumulation of the "chocolate amphetamine", phenylethylamine (PEA). The phenylalanine breaks down in part into PEA, and the selegiline keeps the PEA from dissipating too quickly to have an effect.
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> Tired of seeing HMO doctors who were always just pushing the next SSRI, or putting me back on Wellbutrin, I located a highly regarded private practice psychopharmacologist, and paid out of pocket to see him. At first he didn't put much stock in my thought of wanting to try selegiline + phenylalanine. He said selegiline isn't an effective antidepressant until you take enough that it becomes a nonselective MAOI similar to Parnate or Nardil. I didn't want to argue on my first visit, that the primary effect was purportedly coming from the phenylalanine (creating PEA) and that selegiline's "low-dose" role was to keep the PEA from metabolizing too quickly.
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> Over eight months or so, he eventually became open to letting me try the selegiline + phenylalanine combo. He prescribed 10 mg selegiline + 500 mg DL-phenylalanine just yesterday. While it's far too soon to come to any conclusions, I have to say I'm nothing short of amazed less than 12 hours into this. I "felt something" within three to four hours of taking my first selegiline + phenylalanine dose. My energy level, sense of balance, clarity, and focus, are already up, and my mood is noticably elevated. (The only similar experience I can relate, is the amazing "relief" I felt the first time I ever took a Xanax for anxiety.) It will be interesting to see how this progresses. Right now I'm just thrilled after 13 years of unsuccessfully fighting depression, that anything could have a positive effect this quickly.
poster:Dr. Bob
thread:377600
URL: http://www.dr-bob.org/babble/alter/20040718/msgs/377600.html