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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by JohnL on September 7, 1999, at 9:11:05
I have the go ahead to add Deprenyl to my Prozac. I have tried it already for a couple days and it seems uplifting with no side effects as of yet at 10mg a day. I understand I may have to get into the 20mg to 40mg range, but I will approach that slowly with caution because of the Prozac. The goal is to kill my one remaining primary symptom which has been untouched by any treatment so far...anhedonia. Keeping the Prozac because it works on all other symptoms and I have no side effects at 30mg. Question though...I am aware of MAOI diets listed in print, and I know there is some debate over that issue, so I wanted to hear from those MAOI users who know...when I get to the 20mg to 40mg range on Deprenyl, what foods/drinks do I DEFINTELY have to avoid? Which ones should I approach with caution but might be OK in small amounts? Again, I've seen all the literature, I would love to hear from MAOI folks in the know. Thanks. JohnL.
Posted by Brandon on September 7, 1999, at 20:49:06
In reply to Selegine Diet, posted by JohnL on September 7, 1999, at 9:11:05
John,
There is some debate on what dose of selegiline the MAO diet applies. Some doctors say 20mg. others say not until 30 or 40. I'm currently taking 25 and I dont follow any of the food restrictions...so far so good. I am a little worried about you going any higher than 10 while taking the prozac. Both drugs have very long half lifes and at doses above 10 a day the risk of serotonin syndrome is greater. At 10 a day you are whiping out about 90% of MOA B and going higher you may run into problems. Good luck with it and let me know how it goes.
Posted by Elizabeth on September 9, 1999, at 2:27:22
In reply to Selegine Diet, posted by JohnL on September 7, 1999, at 9:11:05
John, I would not, under ANY circumstances, combine Prozac with high-dose selegiline/deprenyl. Hell, interactions have even been reported with Prozac + *low*-dose selegiline (i.e., 5-10mg). At 20mg+ you're talking about basically combining Prozac with an irreversible, nonselective MAOI. This is extremely dangerous and just shouldn't be done.
If you decide to take high-dose selegiline by itself, here's the diet I use. It's based on evidence rather than rumor. :-)
Avoid altogether:
most aged cheeses
foreign beers; tap/draft beer
broad (fava) bean pods
banana peels
sauerkraut
concentrated yeast extracts (Marmite, Bovril)
aged or air-dried meatsUse with caution:
American and Canadian bottled beer
mozzarella cheese
liver (I note this one because, while it's safe if fresh, it seems especially prone to contamination)
fresh soy products
pickled herringThe following have been restricted in the past without good reason:
wine (in general it's a good idea to keep alcohol intake moderate, though)
chocolate
bananas (even overripe)
avocados
sour cream
yogurt
figs
raisins
Posted by JohnL on September 9, 1999, at 8:05:22
In reply to Re: Selegiline Diet, posted by Elizabeth on September 9, 1999, at 2:27:22
Hi Elizabeth. Thanks for the diet info. That's exactly what I was looking for. Your concerns about Prozac+Selegiline are valid and well taken. I am fully aware, and you know me, Mr slow and low. Selegiline however already seems destined for the trash can. It is causing bad tinnitus like any other dopamine drug does with me. Even if it worked after a good trial, I can't spend my life with a jet plane in my ears. Thank you for taking the time to create the list of MAOI foods. I won't likely need it after all, but it should be an outstanding reference post for any future inquiries from others about MAOI diets. I look forward to all your posts, keep em coming. :)
Posted by JohnL on September 10, 1999, at 9:16:30
In reply to Re: Elizabeth, posted by JohnL on September 9, 1999, at 8:05:22
>
Hi again Elizabeth. This post is of no real importance, just wanted to touch base. In the past you have pointed me in the direction of Lithium augmentation and that is exactly what my psychiatrist prescribed today. Selegiline is out due to worsened tinnitus. Just wanted to thank you for the Lithium tips and we'll see how it goes.
Posted by Noa on September 11, 1999, at 20:45:25
In reply to Re: Elizabeth follow-up, posted by JohnL on September 10, 1999, at 9:16:30
John, keep us posted. Li is a possibility for me, too. BTW, what are your other meds?
Posted by JohnL on September 12, 1999, at 6:51:33
In reply to Re: Elizabeth follow-up, posted by Noa on September 11, 1999, at 20:45:25
> John, keep us posted. Li is a possibility for me, too. BTW, what are your other meds?
Noa, my primary treatment is Prozac 30mg. Also have many add-ons that are of questionable benefit but certainly doing no harm: Lamictal 125mg, Remeron as needed for sleep, 7.5 -15mg, Nature's Way Perika St Johns, occassional SAMe trials, spoonfull or two fishoil, good multivitamin/mineral with high B's. Have taken the St Johns for a long time. Didn't mix well at all with Paxil or Zoloft, but seems quite benign with Prozac. But like I said, Prozac is the star of the show. Several supporting players that will never be stars.
Posted by Elizabeth on September 15, 1999, at 1:45:57
In reply to Re: Elizabeth follow-up, posted by JohnL on September 10, 1999, at 9:16:30
> Hi again Elizabeth. This post is of no real importance, just wanted to touch base.
Hey, it sounds important enough to me.
> In the past you have pointed me in the direction of Lithium augmentation and that is exactly what my psychiatrist prescribed today. Selegiline is out due to worsened tinnitus. Just wanted to thank you for the Lithium tips and we'll see how it goes.
Sorry the selegiline didn't work out for you. That's odd about the tinnitus...I wonder what causes it. I hope Li+ proves helpful; it should take just a week or two at therapeutic levels to determine whether it's working (for me it was just 5 days or so after I increased it to a dose that turned out to give a therapeutic serum level (0.7 mmol/L, FWIW)).
This is the end of the thread.
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