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Re: Selegiline Phenylalanine » Larry Hoover

Posted by sfy on October 19, 2004, at 14:35:49

In reply to Re: Selegiline Phenylalanine » sfy, posted by Larry Hoover on October 19, 2004, at 8:54:47

> Mirtazapine withdrawal was the most difficult withdrawal of any I have ever experienced. I'm even including substances of abuse in this statement. It's awful hard to attribute lack of efficacy to the selegiline, IMHO, when mirtazapine withdrawal might be part of the picture.

I don't think this is the case. I wasn't taking mirtazapine for therapeutic reasons, only 7.5 mg at night for insomnia. And I stopped the mirtazapine two weeks before starting on selegiline just to be safe. When I was first on mirtazapine years ago, I think I was up to 30 mg. a day and didn't have any withdrawal issues when I stopped taking it.

> I feel for you, having to try and sort this out for yourself. Have you tried 25 mg trimipramine for sleep? It's also known as Surmontil. Taken one hour before bed, it sets me up well for sleep. At that dose, there's very little risk of interaction with selegiline.

Right now, the generic Benadryl seems to be helping (mirtazapine's strong antihistamine effect is what helps with insomnia). I don't have much problem falling asleep, it's an issue of early awakening - predictably I'll awaken after only six hours of sleep. And since the selegiline trial seems destined to be a failure, I'm not going to mess with other meds right now.

When I mentioned this to the consulting pdoc who recommended the Parnate, he suggested an anti-psychotic like Risperdal to combat the insomnia. Another reason to give me pause.


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