![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 65 to 89 of 96. Go back in thread:
Posted by Adam on August 22, 1999, at 18:38:33
In reply to Selegiline for depression?, posted by Brandon on May 10, 1999, at 23:07:11
I'm not superstitious, but I sure don't want to jinx this.
Anyway, I have had like five consecutive days that I have
felt unusually good. I don't know for sure if this is
connected to the selegiline patch or not. Having said
that, I am a knee-jerk skeptic, and I was quite convinced
up to this point that I was on the placebo. I may still
be. I don't know. If this change is connnected to the
drug, it has been quite abrubt. But hey, I'll take it.Wish me luck.
-Adam
> Has anyone heard of selegiline for depression. I have heard that it can be helpful.
Posted by Adam on September 4, 1999, at 20:20:49
In reply to Selegiline for depression?, posted by Brandon on May 10, 1999, at 23:07:11
It has been a little over four weeks for me on the transdermal selegiline
study. As for the effects, or lack thereof, the drug has had on me, I have
some thoughts.I have had days and more prolonged periods where I have almost felt as good as did
after receiving ECT, which was unequivocably the best form of treatment I have
ever received for depression. (Of course, after a while, the effects of ECT faded.)I have since had days when I felt wretched, mostly in response to a bad recent event
in my life. I experienced depression as badly as I ever did. I was convinced
again that I must be on the placebo or that selegiline wasn't working for me.I have rebounded from these dark moments. The times that I rebounded I kept
telling myself "no doctor will come and wave a magic wand and make your cares
go away. Selegiline or no selegiline, you've got to fight, to bear the slings
and arrows of outrageous fortune, to reach very deep inside of yourself and find
a way to survive and grow and learn."This seemed to work. Maybe it's working because I'm responding to selegiline.
Maybe it's something more complex. I don't know.What I do know is that fighting depression is incredibly hard, but that I may be
winning. The key is to keep fighting, by any and all means. There are rewards, and
I wonder if my life will not end in some far off suicide after all.Well, like I said, just some thoughts.
> Has anyone heard of selegiline for depression. I have heard that it can be helpful.
Posted by Kim on September 5, 1999, at 2:40:18
In reply to Re: Selegiline for depression?, posted by Adam on September 4, 1999, at 20:20:49
> It has been a little over four weeks for me on the transdermal selegiline
> study. As for the effects, or lack thereof, the drug has had on me, I have
> some thoughts.
>
> I have had days and more prolonged periods where I have almost felt as good as did
> after receiving ECT, which was unequivocably the best form of treatment I have
> ever received for depression. (Of course, after a while, the effects of ECT faded.)
>
> I have since had days when I felt wretched, mostly in response to a bad recent event
> in my life. I experienced depression as badly as I ever did. I was convinced
> again that I must be on the placebo or that selegiline wasn't working for me.
>
> I have rebounded from these dark moments. The times that I rebounded I kept
> telling myself "no doctor will come and wave a magic wand and make your cares
> go away. Selegiline or no selegiline, you've got to fight, to bear the slings
> and arrows of outrageous fortune, to reach very deep inside of yourself and find
> a way to survive and grow and learn."
>
> This seemed to work. Maybe it's working because I'm responding to selegiline.
> Maybe it's something more complex. I don't know.
>
> What I do know is that fighting depression is incredibly hard, but that I may be
> winning. The key is to keep fighting, by any and all means. There are rewards, and
> I wonder if my life will not end in some far off suicide after all.
>
> Well, like I said, just some thoughts.
>
>
>
> > Has anyone heard of selegiline for depression. I have heard that it can be helpful.Adam,
Don't give up! All I want from an antidepressant right now is for it to give me the strength to fight. As long as you can find it in yourself to keep up the battle, you have to think the selegiline is helping. And you're helping the rest of us who just can't manage yet to think that maybe there is something out there that will help. After 35+ different medications, I need to believe that.
Kim
Posted by Adam on September 5, 1999, at 8:59:05
In reply to Re: Selegiline for depression?, posted by Kim on September 5, 1999, at 2:40:18
> Adam,
> Don't give up! All I want from an antidepressant right now is for it to give me the strength to fight. As long as you can find it in yourself to keep up the battle, you have to think the selegiline is helping. And you're helping the rest of us who just can't manage yet to think that maybe there is something out there that will help. After 35+ different medications, I need to believe that.
> KimHi, Kim,
More thoughts:
I honestly don't know if selegiline is helping me, or if I'm even on it at the moment. Either way, I have made a decision
not to wait for it to "kick in" before I try to feel better. Or maybe I'm deluding myself, and this inner strength and resolve
is a function of the drug. At any rate, I am struck again and again by the potency of the placebo effect in antidepressant
studies. There is no reason to believe that antidepressants do nothing, but there is plenty of reason to believe that in even
very severe cases, nothing works just as well. The recent hype over Merk's substance P reuptake inhibitor and the subsequent
letdown (and steep decline in Merk's stock!) when it turned out that the drug was not significantly better than placebo. There
is a great article in the April 9th issue of Science, I believe, discussing many issues surrounding the substance P dissapointment.What I take from this is that mere belief that you will get better can be enormously helpful. Where and upon what we place that
belief may be extremely important. I think many of the claims made about the efficacy of antidepressants are overblown, while
the significance of "placebo" is often downplayed or ignored. It should not be. It just may be that within every person is
something at least as powerful as Prozac and the key is to access that factor. You may not think you've got it in you, but
chances are you do.
Posted by Annie on September 5, 1999, at 21:24:26
In reply to Re: Selegiline for depression?, posted by Adam on September 5, 1999, at 8:59:05
> I honestly don't know if selegiline is helping me, or if I'm even on it at the moment. Either way, I have made a decision
> not to wait for it to "kick in" before I try to feel better. Or maybe I'm deluding myself, and this inner strength and resolve
> is a function of the drug. At any rate, I am struck again and again by the potency of the placebo effect in antidepressant
> studies. There is no reason to believe that antidepressants do nothing, but there is plenty of reason to believe that in even
> very severe cases, nothing works just as well. The recent hype over Merk's substance P reuptake inhibitor and the subsequent
> letdown (and steep decline in Merk's stock!) when it turned out that the drug was not significantly better than placebo. There
> is a great article in the April 9th issue of Science, I believe, discussing many issues surrounding the substance P dissapointment.
>
> What I take from this is that mere belief that you will get better can be enormously helpful. Where and upon what we place that
> belief may be extremely important. I think many of the claims made about the efficacy of antidepressants are overblown, while
> the significance of "placebo" is often downplayed or ignored. It should not be. It just may be that within every person is
> something at least as powerful as Prozac and the key is to access that factor. You may not think you've got it in you, but
> chances are you do.Adam,
I took part in the Substance P study. I experienced no improvement. I thought Merck shelved the whole idea, but was surprised to learn that a new Substance P study is now starting at a higher dose.
I've mentioned previously that I was in the Selegiline Patch study and I don't know if I was on Placebo or not. I experienced little relief until about the 5th week of the open label study (30 mg) and then it suddenly kicked in. Adam, that was the best I've felt in 6 years. It is worth waiting for! I wish you well.
Annie
Posted by Brad on September 7, 1999, at 6:09:47
In reply to Re: What about Moclobemide - ie. Manerix in Cda???, posted by dj on August 18, 1999, at 7:49:58
I've tried about 8 different anti-depressants, mostly SSRI's and with all of them I've experienced nightsweats so bad that I had to discontinue them.
I've started Manerix about 2 weeks ago and no nightsweats or other adverse side effects. No improvement in the depression either....but hopeful that will come. This is the first one where side effects haven't prevented me from continuing use.
I'm in Vancouver also.
Posted by JohnL on September 7, 1999, at 8:45:37
In reply to Re: What about Moclobemide - ie. Manerix in Cda???, posted by Brad on September 7, 1999, at 6:09:47
> I've tried about 8 different anti-depressants, mostly SSRI's and with all of them I've experienced nightsweats so bad that I had to discontinue them.
>
> I've started Manerix about 2 weeks ago and no nightsweats or other adverse side effects. No improvement in the depression either....but hopeful that will come. This is the first one where side effects haven't prevented me from continuing use.
>
> I'm in Vancouver also.Hi Brad. I live in Maine and went to Canada once to get Moclobemide. It is supposedly good for all kinds of depressions, with fewer side effects (as you've already noticed) than SSRIs or other MAOIs. It plunged me into a deep profound suicidal fall at just 75mg, so after 2 days was discontinued. I think that was a very rare reaction. Most people do very well with it. The Canadian doc was excellent. He said higher doses are best, even higher than max if needed. He also said nearly any other AD drug can be added to it in small quantities if needed. USA is missing out on a good drug. Glad you have the choice and you're off to a good start. Here's wishing your best days of the past are your worst days in the future. :) JohnL
Posted by Kim on September 13, 1999, at 1:09:21
In reply to Re: What about Moclobemide - ie. Manerix in Cda???, posted by Brad on September 7, 1999, at 6:09:47
> I've tried about 8 different anti-depressants, mostly SSRI's and with all of them I've experienced nightsweats so bad that I had to discontinue them.
>
> I've started Manerix about 2 weeks ago and no nightsweats or other adverse side effects. No improvement in the depression either....but hopeful that will come. This is the first one where side effects haven't prevented me from continuing use.
>
> I'm in Vancouver also.I'm in that OTHER Vancouver--Vancouver, Washington; although at this point I would be willing to drive to Canada for meds if it would help. My doctor here (psych MD) is really not supportive at all--actually causes me anxiety attacks to have to go see him for refills. How do you get an appointment with a dr. in Canada? Aren't they socialized medicine or something? (Forgive my ignorance . . .) Kim
Posted by Robin on September 28, 1999, at 9:41:48
In reply to Selegiline is great!, posted by Brandon on July 19, 1999, at 20:55:14
> Hey everyone,
>
> It's been about two months since I last posted my question about selegiline, I finally convinced my psydoc to let me try it...so far the results have been outstanding! I'm only taking 20mg a day and I definitely feel much better than I ever did. My level of concentration is way up and my mood is pretty darn good, and the best part is there is no pesky sexual side effects...my libido is actually enhanced! I just wanted to say thanks for all the info and was wondering if anyone here had tried the liquid form. I've heard that it is superior in it's lack of side effects, any info would be appreciated.
>
> Thanks,
> BrandonBrandon, Are you still taking Selegiline? Is it still working for you? Are you still at 20mgs? How fast did you work up to 20mgs? I just started taking Selegiline yesterday (only 5mgs).
Thanks,
Posted by Adam on October 1, 1999, at 12:10:49
In reply to Selegiline for depression?, posted by Brandon on May 10, 1999, at 23:07:11
Well, today is the first day that I begin the open label portion of the transdermal selegiline
study. I am now guranteed a 20mg/patch dose of selegiline HCl for six months.Up to this point I have been dubious enough about selegiline's efficacy for me to wonder if in fact
I might be on the placebo, or, at least, I was in the low dose group (10mg patch). We'll see how
things go. I am noticing no side effects at all from a 20mg/patch dose. From the literature I have
read, in rats selegiline delivered through the skin reaches much higher blood level mg/kg than when
delivered orally, so even 20mg/patch ought to be a whopping effective dose of selegiline. I am
quite suprised by the absence of adverst effects, though I have been told this is not uncommon. I
guess I was hoping I might notice something (which would let me know unequivocably that I was on
a placebo all along and there's still hope I'll get a robust response to selegiline), but such is
not the case.> Has anyone heard of selegiline for depression. I have heard that it can be helpful.
Posted by Friend on October 4, 1999, at 9:23:54
In reply to Re: Selegiline for depression?, posted by Adam on October 1, 1999, at 12:10:49
Yes, I've heard of it being used for depression. Selegiline is an MAO inhibitor. MAO inhibitors can be classified in three ways: (1) Selective or non-selective (that is, it inhibits MAO-A or MAO-B, (2) reversible or non-reversible, and (3) chemical structure - hydrazine and non-hydrazine. Selegiline is non-reversible and a non-hydrazine. At ORAL dosage of less than 10-15 mg/day, it is a selective inhibitor of MAO-B. Inhibiting MAO-B enhances the supply of the neurotransmitter dopamine. At higher doses (ORAL doses above 10-15 mg/day, it loses its selectivity, and inhibits both MAO-A and MAO-B, thereby affecting other neurotransmitters, such as serotonin. My experience is that, unlike Parnate (which is also a non-selective, non-reversible, non-hydrazine MAO inhibitor) it does not cause sexual dysfunction, weight gain, orthostatic hypotention (dizziness upon rising due to lowering of blood pressure), dry mouth, daytime sleepiness, etc. I can't personally comment on its affect upon depression - I took it on the chance it might help my social phobia. I believe there is some additional information on its uses for depression in Dr. Ivan's depression central website.
Hope it works for you.
Posted by Lynne on October 4, 1999, at 15:07:18
In reply to Re: Selegiline for depression? Yes -, posted by Friend on October 4, 1999, at 9:23:54
> Yes, I've heard of it being used for depression. Selegiline is an MAO inhibitor. MAO inhibitors can be classified in three ways: (1) Selective or non-selective (that is, it inhibits MAO-A or MAO-B, (2) reversible or non-reversible, and (3) chemical structure - hydrazine and non-hydrazine. Selegiline is non-reversible and a non-hydrazine. At ORAL dosage of less than 10-15 mg/day, it is a selective inhibitor of MAO-B. Inhibiting MAO-B enhances the supply of the neurotransmitter dopamine. At higher doses (ORAL doses above 10-15 mg/day, it loses its selectivity, and inhibits both MAO-A and MAO-B, thereby affecting other neurotransmitters, such as serotonin. My experience is that, unlike Parnate (which is also a non-selective, non-reversible, non-hydrazine MAO inhibitor) it does not cause sexual dysfunction, weight gain, orthostatic hypotention (dizziness upon rising due to lowering of blood pressure), dry mouth, daytime sleepiness, etc. I can't personally comment on its affect upon depression - I took it on the chance it might help my social phobia. I believe there is some additional information on its uses for depression in Dr. Ivan's depression central website.
>
> Hope it works for you
Friend, Did it help with social phobia? How long did you take selegiline for and at what doseage?
Thanks
Posted by Adam on October 4, 1999, at 15:48:29
In reply to Selegiline for depression?, posted by Brandon on May 10, 1999, at 23:07:11
Oh-KAY,
So, here's the deal. I am wired. It took a couple of days, but I am really wound up
here. I have slept, in the past four nights, cumulatively, maybe 15 hours. And I'm
not missing it. I actually feel quite good. I just got through seeing my p-doc (not
the one running the selegiline study but the doc I had before I entered the study) and
he was certainly impressed. He described my gestures, speech, and apparrent mood as
"expansive." I don't know what the hell to think.> Has anyone heard of selegiline for depression. I have heard that it can be helpful.
Posted by sean on October 4, 1999, at 16:07:41
In reply to Re: Selegiline for depression?, posted by Adam on October 4, 1999, at 15:48:29
> Oh-KAY,
>
> So, here's the deal. I am wired. It took a couple of days, but I am really wound up
> here. I have slept, in the past four nights, cumulatively, maybe 15 hours. And I'm
> not missing it. I actually feel quite good. I just got through seeing my p-doc (not
> the one running the selegiline study but the doc I had before I entered the study) and
> he was certainly impressed. He described my gestures, speech, and apparrent mood as
> "expansive." I don't know what the hell to think.
>
> > Has anyone heard of selegiline for depression. I have heard that it can be helpful.
Adam - I say enjoy it while it lasts because my
experience with such reactions is that it means I
can't take the drug!Sean.
Posted by Adam on October 4, 1999, at 18:06:04
In reply to Re: Selegiline for depression?, posted by sean on October 4, 1999, at 16:07:41
There is no way in Hades I am getting off this if it lasts. I imagine once I settle
in the sleep thing will resolve itself. This is, in a word, great. When they said
this stuff can work quickly, they weren't kidding.I think I probably am a little hypomanic at this point, but I'm not out of control.
I am so glad I held in there and made it to the open portion of the study. I was
NOT expecting this, to say the least. I don't know. Maybe this will evaporate in
a couple days. My doc didn't think so. He really kind of sat there amazed. I have
to say, I made the decision to enter the selegiline study very much on my own, and I
consulted neither my pdoc or my CBT therapist. This was a bad move, and my pdoc was
very concerned about me a month after I stopped taking Remeron and had been on the
patch for only two weeks. I was in pretty bad shape. But I held in there, stuck with
the CBT (which was an enormous help-and I've got a busy weekend being SOCIAL coming up
to prove it-with people I met long before the selegiline "kicked in") and here I am.In January I was in the psych ward at Mass General getting electroconvulsive therapy.
That I am alive at all is pretty amazing at this point. I can't fathom feeling this
good unless it's the drug.So, well, hooray for me!
> > Oh-KAY,
> >
> > So, here's the deal. I am wired. It took a couple of days, but I am really wound up
> > here. I have slept, in the past four nights, cumulatively, maybe 15 hours. And I'm
> > not missing it. I actually feel quite good. I just got through seeing my p-doc (not
> > the one running the selegiline study but the doc I had before I entered the study) and
> > he was certainly impressed. He described my gestures, speech, and apparrent mood as
> > "expansive." I don't know what the hell to think.
> >
> > > Has anyone heard of selegiline for depression. I have heard that it can be helpful.
>
>
> Adam - I say enjoy it while it lasts because my
> experience with such reactions is that it means I
> can't take the drug!
>
> Sean.
Posted by janice on October 4, 1999, at 22:07:26
In reply to Re: Selegiline for depression?, posted by Adam on October 4, 1999, at 18:06:04
I am happy for you! Even your writing is different. Keep us informed and enjoy yourself! Janice.
Posted by Brandon on October 4, 1999, at 22:29:55
In reply to Go Adam, Go!, posted by janice on October 4, 1999, at 22:07:26
> I am happy for you! Even your writing is different. Keep us informed and enjoy yourself! Janice.
Adam,
It's great to hear that the patch is working for you. I've been following your posts and silently rooting for success. This truly does open up new avenues for antidepressant therapy. It's great to hear that you are doing so well!
Posted by Annie on October 4, 1999, at 22:50:36
In reply to Re: Selegiline for depression?, posted by Adam on October 4, 1999, at 18:06:04
Wow! Sounds like you're reacting even better than I did on the selegiline patch. I'm very happy to hear you sound so good! I admit to a little jealousy. When the study was over, I begged to stay on it, but it wasn't possible. I was put on Marplan and the effect (for me) was not even close to the relief I achieved with the patch. The side effects were too much for me and I stopped last week. I have no idea what is next, although I've thought of trying to take selegiline sub-lingually to try to achieve something close to the patch.
Adam, do the researchers have any idea when transdermal selegiline should be available on the market? I'm treading water until then.
Annie> There is no way in Hades I am getting off this if it lasts. I imagine once I settle
> in the sleep thing will resolve itself. This is, in a word, great. When they said
> this stuff can work quickly, they weren't kidding.
>
> I think I probably am a little hypomanic at this point, but I'm not out of control.
> I am so glad I held in there and made it to the open portion of the study. I was
> NOT expecting this, to say the least. I don't know. Maybe this will evaporate in
> a couple days. My doc didn't think so. He really kind of sat there amazed. I have
> to say, I made the decision to enter the selegiline study very much on my own, and I
> consulted neither my pdoc or my CBT therapist. This was a bad move, and my pdoc was
> very concerned about me a month after I stopped taking Remeron and had been on the
> patch for only two weeks. I was in pretty bad shape. But I held in there, stuck with
> the CBT (which was an enormous help-and I've got a busy weekend being SOCIAL coming up
> to prove it-with people I met long before the selegiline "kicked in") and here I am.
>
> In January I was in the psych ward at Mass General getting electroconvulsive therapy.
> That I am alive at all is pretty amazing at this point. I can't fathom feeling this
> good unless it's the drug.
>
> So, well, hooray for me!
>
>
> > > Oh-KAY,
> > >
> > > So, here's the deal. I am wired. It took a couple of days, but I am really wound up
> > > here. I have slept, in the past four nights, cumulatively, maybe 15 hours. And I'm
> > > not missing it. I actually feel quite good. I just got through seeing my p-doc (not
> > > the one running the selegiline study but the doc I had before I entered the study) and
> > > he was certainly impressed. He described my gestures, speech, and apparrent mood as
> > > "expansive." I don't know what the hell to think.
> > >
> > > > Has anyone heard of selegiline for depression. I have heard that it can be helpful.
> >
> >
> > Adam - I say enjoy it while it lasts because my
> > experience with such reactions is that it means I
> > can't take the drug!
> >
> > Sean.
Posted by Adam on October 5, 1999, at 7:52:53
In reply to Enjoy it Adam! It's real., posted by Annie on October 4, 1999, at 22:50:36
Hey, Annie,
I really have no idea when the patch delivery system is going to be available, and I don't think anyone else
does either. Dr. A. Bodkin, the PI in the selegiline study I am involved in seemed pretty bullish, like maybe
in less than two years it would be available. I don't know. Seeing how the FDA works first hand through my job,
I wouldn't hold your breath. But I've heard nothing but promising things about the patch delivery system, and
since selegiline is already approved, I can't imagine why it won't eventually make it to the market. The only
problem might be if, when the trials are over, its efficacy as an antidepressant turns out to be no better than
placebo. It's a real possibility, I suppose, but I'm not anticipating that. The guys who are conducting this
study are pretty enthusiastic about it. They are seeing results that are impressing them. I feel pretty
statistically significant, I have to say.After the study is over, I'll just take it orally and deal with the dietary restrictions. Having to watch what I
eat and drink for a few years beats the hell out of, say, being in the hospital. And I'm suffering no-NO sexual
side effects from this. I'm still trying to figure that one out. But I'll take it, you know?> Wow! Sounds like you're reacting even better than I did on the selegiline patch. I'm very happy to hear you sound so good! I admit to a little jealousy. When the study was over, I begged to stay on it, but it wasn't possible. I was put on Marplan and the effect (for me) was not even close to the relief I achieved with the patch. The side effects were too much for me and I stopped last week. I have no idea what is next, although I've thought of trying to take selegiline sub-lingually to try to achieve something close to the patch.
> Adam, do the researchers have any idea when transdermal selegiline should be available on the market? I'm treading water until then.
> Annie
>
>
>
> > There is no way in Hades I am getting off this if it lasts. I imagine once I settle
> > in the sleep thing will resolve itself. This is, in a word, great. When they said
> > this stuff can work quickly, they weren't kidding.
> >
> > I think I probably am a little hypomanic at this point, but I'm not out of control.
> > I am so glad I held in there and made it to the open portion of the study. I was
> > NOT expecting this, to say the least. I don't know. Maybe this will evaporate in
> > a couple days. My doc didn't think so. He really kind of sat there amazed. I have
> > to say, I made the decision to enter the selegiline study very much on my own, and I
> > consulted neither my pdoc or my CBT therapist. This was a bad move, and my pdoc was
> > very concerned about me a month after I stopped taking Remeron and had been on the
> > patch for only two weeks. I was in pretty bad shape. But I held in there, stuck with
> > the CBT (which was an enormous help-and I've got a busy weekend being SOCIAL coming up
> > to prove it-with people I met long before the selegiline "kicked in") and here I am.
> >
> > In January I was in the psych ward at Mass General getting electroconvulsive therapy.
> > That I am alive at all is pretty amazing at this point. I can't fathom feeling this
> > good unless it's the drug.
> >
> > So, well, hooray for me!
> >
> >
> > > > Oh-KAY,
> > > >
> > > > So, here's the deal. I am wired. It took a couple of days, but I am really wound up
> > > > here. I have slept, in the past four nights, cumulatively, maybe 15 hours. And I'm
> > > > not missing it. I actually feel quite good. I just got through seeing my p-doc (not
> > > > the one running the selegiline study but the doc I had before I entered the study) and
> > > > he was certainly impressed. He described my gestures, speech, and apparrent mood as
> > > > "expansive." I don't know what the hell to think.
> > > >
> > > > > Has anyone heard of selegiline for depression. I have heard that it can be helpful.
> > >
> > >
> > > Adam - I say enjoy it while it lasts because my
> > > experience with such reactions is that it means I
> > > can't take the drug!
> > >
> > > Sean.
Posted by Elizabeth on October 9, 1999, at 3:14:41
In reply to Re: Selegiline for depression?, posted by Adam on October 4, 1999, at 15:48:29
> Oh-KAY,
>
> So, here's the deal. I am wired. It took a couple of days, but I am really wound up
> here. I have slept, in the past four nights, cumulatively, maybe 15 hours. And I'm
> not missing it. I actually feel quite good. I just got through seeing my p-doc (not
> the one running the selegiline study but the doc I had before I entered the study) and
> he was certainly impressed. He described my gestures, speech, and apparrent mood as
> "expansive." I don't know what the hell to think.I think you may just have a case of antidepressant-induced hypomania. Congratulations!
Posted by Elizabeth on October 9, 1999, at 3:18:21
In reply to Re: Selegiline for depression?, posted by Adam on October 4, 1999, at 18:06:04
> I am so glad I held in there and made it to the open portion of the study. I was
> NOT expecting this, to say the least. I don't know. Maybe this will evaporate in
> a couple days. My doc didn't think so. He really kind of sat there amazed. I have
> to say, I made the decision to enter the selegiline study very much on my own, and I
> consulted neither my pdoc or my CBT therapist. This was a bad move, and my pdoc was
> very concerned about me a month after I stopped taking Remeron and had been on the
> patch for only two weeks. I was in pretty bad shape. But I held in there, stuck with
> the CBT (which was an enormous help-and I've got a busy weekend being SOCIAL coming up
> to prove it-with people I met long before the selegiline "kicked in") and here I am.
>
> In January I was in the psych ward at Mass General getting electroconvulsive therapy.
> That I am alive at all is pretty amazing at this point. I can't fathom feeling this
> good unless it's the drug.
>
> So, well, hooray for me!I second that! Congratulations on sticking it out, Adam.
(How was MGH, BTW? Never been there except for emergency late-night (and weekend) x-rays when I was an undergrad. )
Posted by Adam on October 9, 1999, at 12:24:33
In reply to Re: Selegiline for depression?, posted by Elizabeth on October 9, 1999, at 3:18:21
Ahh, Blake 11...
What can I say about being hospitalized? Let's see if I can recall some of the events around that time. I had
just completed about three spectacularly uneffective months on Serzone, and when a particularly traumatic event
happened around that time, my depression and OCD*-driven anxiety went into super-overdrive. I was literally being
reduced to a quivering ball of flesh. I remember one particularly horrifying experience where I was driving on
the Mass Pike and had to pull off the road because I was shaking so badly I could't hold onto the steering wheel.
I couldn't sleep or eat. I couldn't think. Why I didn't run my car at 120 MPH into concrete divider (which crossed
my mind) at that point I don't know. I really, sincerely just wanted to die.Instead I went to the emergency room at MGH, and found myself a few hours later on the 11th floor of the Blake
building getting about every diagnostic they could throw at me. It was actually helpful almost immediately, just
because I felt safe and the confidence displayed by the doctors and the nurses lent me the belief that something
soon would be done to make me feel better.From what I understand, inpatient psych at MGH is considered world class. Having never been anywhere else before
or since, I have nothing to compare it to. In general I found the people there to be professional, and genuinely concerned
about the wellbeing of the patients. I think there is a certain amount of world-weariness displayed by some, esp.
the MDs, who are all super busy and seem to have "seen it all". I'm not sure if they do it this way in other hospitals,
but in Blake 11, everyone was sort of mixed together. It wasn't like I was in the "depression unit" and somebody
else was in the "shizophrenia" unit. I'd never spent any quality time with people who were certifiably insane, and
given my own state of mind, that definetely made some group sessions and dinner-table discussions a bit surreal.
The days were long, with not a great deal to do except look forward to meals and groups, neither of which gave much
satisfaction. Hospital food is still hospital food. The groups were often of little more help than to cut the boredom
of the day. Examples: On day x we had "art", and on day "y" we had "body motion". Both were silly and geared intellectually
toward the lowest common denominator, and thus satisfied nobody really. I would sometimes try to inject my collages
or diamante poems with a little sardonic irony if I was feeling especially frustrated, but nobody got it, not even the social
workers. There were information sessions that were given periodically, and were usually presided over by some very knowledgible
(and I'm sure highly lauded) doctors from the "Partners" ivory tower. Unfortunately, these presentations were also rendered rather
pedestrian and unilluminating ("generalized anxiety disorder is a very distressing illness that can be treated with medications like
Prozac..."). I sometimes piped up and asked some questions about, say, the mechanistics of serotonergic drugs in treating OCD and
how the dopaminergic system was involved and thus the extent that SSRIs acted directly or indirectly, what brain imaging was telling
us about the functional and physiological differences of individuals with affective disorders, and so on. I always got very pat and
sometimes rather condescending answers, which gave me the impression that these guys weren't interested in doing much more than
repeating the contents of a brochure, and didn't consider the admittedly academic interests of a psych inpatient much worth entertaining.
After a while I gave up on trying to derive any therapeutic or intellectual benefit from these unstimulating busy-time hours and
focused on observing those around me. I befriended this one completely delusional man named Simon, who also happened to be very kind
and bright, and since he wasn't particularly distressed at the time by his otherworldly convictions, I mostly just listened to him
talk about a variety of subjects he found fascinating and got a little lost in his skewed reality. It was strange that his insanity
did so much to maintain mine, and I hope I was of some benefit to him, if by doing nothing else than lending a willing ear. No one else
seemed interested in what he had to say, and I think he was lonely. So was I.Anyway, the most simultaneously beneficial and traumatic thing about being in the hospital was the ECT. I remember all of us who were to
be wheeled into the OR being awakend at some ungodly early hour and led in our trazadone-induced haze to gurneys where we laid for what
seemed like hours under bright fluorescent lights in the hallway in a long line to wait our turn. I remember some who didn't like needles
or the hot sensation of the injections sort of moaning before the anesthesia put them under, and how hearing this didn't do much to calm
my axiety as I lay there unable to do much of anything but stare at the ceiling.Like I said, I've heard that MGH is first-rate, and I have no reason to doubt this. I found the one-on-one time (which was unfortunately
quite rare) with one of the physicians and a couple of the therapists (one a social worker, one a psycologist) quite helpful and comforting.
I guess putting myself completely in the care of others at that point helped me regroup, and I responded very well to ECT, so I left the
hospital in much better shape than when I went in. I found the access to a host of referrals to arguably some of the best p-docs and psy-
chotherapists in the area who could follow me after I left of enormous benefit. Playing HMO roulette prior to that and the inadequacy of
the care I got through that approach (hey, after a few months with some of these people I went from fairly functional to being hospitalized,
hence I conclude I derived no benefit, if I was not in fact harmed more than helped) has given me such an appreciation for the need to get
hooked up with good people.My experience in the hospital certainly wasn't an altogether pleasant one. I have a feeling that the deficiencies I found at MGH are more
or less endemic to the world of inpatient psychiatry, and given the need to limit costs, probably can't be helped in any great way for those
who can't afford to be sent to posh private clinics. Given some of the stories I've heard about state hospitals and so on, if I had to do
it again, I'd go back to MGH.
*Yes, I have OCD too, but it has been very much under control because of therapy I did in the past, and I think it
only rears its ugly head when my defenses are completely down - that is to say, I'm so severely depressed I can't
think straight. My OCD fears have been mostly body dysmorphic or other somatoform symptoms, but have run the gamut
from issues with contamination, and even one bizarre flair up where I became conviced I must be gay, which I knew with
the rational side of my head was patently absurd. For the curious...
>
> (How was MGH, BTW? Never been there except for emergency late-night (and weekend) x-rays when I was an undergrad. )
Posted by dj on October 13, 1999, at 1:19:33
In reply to Re: Selegiline for depression?, posted by Elizabeth on May 11, 1999, at 15:36:47
What about with Wellbutrin??
>Also, do *not* take selegiline - even at low doses - with an SSRI, Demerol, dextromethorphan, etc.
>
Posted by dj on October 13, 1999, at 1:41:23
In reply to Re: What about Moclobemide - ie. Manerix in Cda???, posted by Brad on September 7, 1999, at 6:09:47
Brad,
How goes the Manerix, it's been a month now so what's your experience so far. Also, what other ADs did you try -- Wellbutrin? Do you have a good p-doc. here in Van??
> I've tried about 8 different anti-depressants, mostly SSRI's and with all of them I've experienced nightsweats so bad that I had to discontinue them.
>
> I've started Manerix about 2 weeks ago and no nightsweats or other adverse side effects. No improvement in the depression either....but hopeful that will come. This is the first one where side effects haven't prevented me from continuing use.
>
> I'm in Vancouver also.
Posted by dj on October 13, 1999, at 1:54:50
In reply to Re: What about Moclobemide - ie. Manerix in Cda???, posted by Kim on September 13, 1999, at 1:09:21
Just looking back over this and see that no-one answered your question. Yes medicare in Canada is run by the government & paid for via taxes and monthly charges. We are the kinder, gentler system that G. Bush Sr. alluded to & Clinton could not emulate. But I digress...
I don't know how you would get an appt. with a Cdn. doc or psych., however JohnL in his post above seems to have managed so you might check with him or better yet check out selegine which several folks in this thread from the U.S. seem to have had good results with...going to check it out myself...
> I'm in that OTHER Vancouver--Vancouver, Washington; although at this point I would be willing to drive to Canada for meds if it would help. My doctor here (psych MD) is really not supportive at all--actually causes me anxiety attacks to have to go see him for refills. How do you get an appointment with a dr. in Canada? Aren't they socialized medicine or something? (Forgive my ignorance . . .) Kim
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